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The Human Side of Diabetes. The Why Questions

Feb 15, 2002

Earlier this month I was a guest speaker at a sales training meeting for a major diabetes supplies distribution company. This is a really nice company with a national sales force and people who really care about people with diabetes. I have been impressed with their concerns about how to better meet the needs of patients and health care professionals. They had asked me to do several things.

I was to give the staff an update on diabetes, its diagnosis and current treatments and the educational needs of people with diabetes. I was to discuss patient education and what they could do to help diabetes educators, a subject close to my heart. I started my lecture looking into the eager and enthusiastic faces of my audience and everything was going along fine until I got the WHY questions.


Why doesn’t every health care provider know these basic standards of care? Why doesn’t every patient have A1c tests done every three months? Why isn’t every patient referred to a diabetes educator? Why doesn’t every patient know what they are entitled to under the recent reimbursement changes?

Every time I hear these questions I wonder where the diabetes community has missed the target. There are wonderful organizations who do nothing but diabetes care and education and still the American public is amazingly ignorant about diabetes. People ask me questions on planes and at parties that astound me and make me question what we have accomplished in the past twenty five years. The epidemic of diabetes has been discussed on the cover of the New York Times and major News publications this year and still people talk about a mild case of diabetes and the world famous Borderline!

We have not convinced the public that this is a really serious disease. A wonderful colleague of mine, Dr Richard Guthrie, suggested years ago that we should put the shoes of all those who have lost their legs on the steps of the Capital Building in Washington. Another colleague from Austria asked me why we still had so many diabetes related cases of blindness in the United States when their numbers had been going down steadily for the past five years.

I sit in meetings frequently that ask the question over and over again, How do we get the message out? For over twenty years I have heard wonderful speakers at diabetes conventions all over the world and still we preach to the choir.

How do we reach the Primary care providers who are so very busy caring for patients that they cannot get to meetings? How do we reach the people who will not accept their diabetes and get to the people who can help them? How do we help the people we cannot reach?

Sounds like the never-ending story. I know how well people can do when they are connected to the right providers and educators. I have seen wonderful results and the outcome data has been coming in since the DCCT proved that patients do better with a team approach to diabetes care.

If the article sounds pessimistic it is not. It is a call for awareness and a change to the thought process that believes that we have solved all the problems about diabetes care and education. As long as I cannot answer the why questions we will be searching and looking and listening. So I have some suggestions.

Lets start teaching everyone about diabetes. To the entire public. Lets teach it in health classes in schools and to everyone who will listen. How about an information campaign about diabetes to people without diabetes? Maybe we will find those missing millions and get to the people who know the people with diabetes. The idea is to reach those people I meet on planes who tell me about friends and families. How about major radio and TV adds that do not target “diabetics” but ask if the listener knows someone who has or may have diabetes. Perhaps we have been looking in all the wrong places?

Before you start throwing costs at me I would like to remind you that the US spent over one hundred billions dollars last year caring for people with diabetes.

Any suggestions?

Take care.

Ginger Kanzer Lewis has been teaching people with Diabetes for almost thirty years. She is a Registered Nurse with a Masters Degree in Education from Harvard University and Certification in both Diabetes and Continuing Education and Staff Development. Ginger has spent over twenty years teaching educational methodology to health care professionals while working as Director of Staff Development or Education in Hospitals through out the North East. Ginger is the immediate Past President of AADE and is a well known national and international speaker.

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