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It Doesn’t Have to Happen

Sep 18, 2018

You may have read Dave Joffe’s Editor’s Note on the relative risk of developing diabetes and how sometimes patients use heritability of diabetes as an excuse for having diabetes. Although we don’t like to blame patients, it is true some people do think and say, “Why try? I have a family history of diabetes. I’m sure to get it too.” Well, we know that isn’t 100% true. Hopefully we work with our patients to help prevent or delay type 2 diabetes.

There is a lot of information out there — the web, books, etc. that promise patients they can reverse their diabetes or prevent getting diabetes if they just do A-Z. As Dave and our text show, it’s not that simple and we really don’t have all the answers.


On the other hand, we do recommend lifestyle changes to hopefully prevent or delay type 2 diabetes. It just can’t always be done. That’s why I do teach my patients personalized lifestyle changes to prevent, delay, or improve their diabetes management, but I do not teach that I can promise they can prevent it for sure. Again, we don’t know enough yet.

I’ve found that to avert the disasters (complications) of diabetes, one of the ways is to discuss not taking the fatalistic-and-blame approach. I teach realistic expectations, including how if they do in fact develop diabetes, it’s not their fault; diabetes can be managed and complications can be prevented. I’ve found this to help them not fear diabetes but instead learn how to best manage “the cards they may have been dealt.” I teach just because their family member may have had heart disease, blindness, kidney disease, amputations, you name the complications patients hear about, it does not mean they have to develop these things. They can make a difference whether they prevent or delay diabetes. We’ve come a long way in the knowledge of and management of diabetes and there’s more to come. There is a reason to try and there is hope.

Lessons Learned:

  • True, we have more to learn, but we know a lot more than we used to know about type 2 diabetes. Type 2 diabetes can be prevented or delayed. If one does develop diabetes due to heritability, complications can still be prevented.
  • Give patients hope through education. Let them know just because a family member may have developed complications of diabetes does not mean they have to as well. Refer to endocrinologists and diabetes educators who have the time and expertise to teach them what they need to know to help them prevent or delay type 2 diabetes and the complications that can but don’t have to occur.

Joy Pape, FNP-CDE
Medical Editor, DiabetesInControl

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