As a CDE who specializes in obesity medicine and diabetes, I hear many patients with either or both diagnoses say they are ready to get a “new start.” It’s not unusual for patients to change the medications, or even stop the medications, we have agreed on for them, and their numbers go up.
During this holiday season, I’ve had several patients tell me their numbers (weight and glucose) are up. They have also asked me if I think their meds are right for them. My first question is to ask them what are they taking now. I find they are not taking the meds as we agreed upon last time we communicated. They have told me they have changed them, not taking them or not taking them regularly. I then asked why, wanting to make sure this was not due to untoward side effects or affordability. I was told it’s not due to untoward side effects, or because they could not afford them. They told me they stopped or changed because they did not want to take medicine, or forgot to take it, or other reasons than the two I mentioned. I responded by saying, “How do I know if this is right for you if you are not taking them?” We have then made mutual agreements, shared decision making, to take the meds for one week and let me know how things go. So far, two of the patients have gotten back to me and let me know that they are taking their meds as we agreed to and numbers are coming down.
- Once numbers start improving, it is not unusual for patients to stop checking or stop taking their medications. When discussing obesity and/or diabetes, teach early on that the medications are helping to not only get their numbers down but keep them down. Discuss the importance of continuing their medications to help keep the numbers down and not to stop without discussing first.
- Both HCPs and patients need to be warned of the temptations of the holidays, not only to overeat and be less active, but also not to follow the med regimen. Teach tips of holiday management, which is not all about food and activity but also about meds. It seems most know or are taught about the food and activity but not the meds.
Joy Pape, FNP-C, CDE
Medical Editor, DiabetesInControl
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