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What’s the Best Teacher?

Jul 18, 2017

Over the years I’ve found the best teacher for people who have diabetes is their numbers. Without teaching the patient targets, they don’t learn much.

This patient is just one example of many. A man, 57 years of age, visits a community diabetes education course. He tells me he has type 2 diabetes, hypertension hyperlipidemia. He said his doctor told him his numbers were fine about 9 months ago. When he came to the course, he was losing weight, was thirsty and was very tired.

When I started to teach the class about goals and target for diabetes management, he admitted he had no clue about what I was talking about. He was not alone. Here was a room of about 20 people who had diabetes. Some had meters, some did not, even those who did did not know what their glucose targets were.

I taught the class what targets to “shoot” for. The first week I taught them to check their glucose at fasting and one to two hours after eating. This was a start for them for the first week. I also asked them to keep a food log and how different foods affected their glucose.

Those who did check came back saying they learned so much. They could tell what foods they thought raised their glucose levels and those that did not raise them as much. Sure enough, it was the higher carb foods that raised their glucose the most. Yes, I had taught them that, but the patients told me it wasn’t until they checked themselves that they became  true believers.

Later during our sessions, I taught them to do block testing, which is testing right before a meal and one to two hours after. That was another lesson as was learning about their blood pressure, the best time to check, and what numbers they were “shooting for,” including with lipids.

During the time of the course, the patient noted above did visit his hcp because he saw his glucose was in the 200 range and learned why he wasn’t feeling well. His treatment was changed and within two weeks, he was hitting his glucose targets and feeling much better!

Lessons Learned:

  • Teach patients that managing their diabetes is not just about glucose (known as sugar to many).
  • Sugar doesn’t just mean sweet foods, but rather to look at carbohydrates.
  • Teach to check their glucose levels, not only how to but what numbers they should be looking for.
  • Same for blood pressure and lipids.
  • Once patients know their target levels, it makes it a lot easier to “hit” the target.
  • Patients need to be given the tools, including the education, to teach themselves.
  • Refer patients to diabetes self-management education.


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