August 18, 2010

The attitudes of diabetes

Tom Ross, who writes in his home page at Not Medicated Yet explains some of the nature of type 2 diabetes very well.

I quote… because of an unusual aspect of Type 2 diabetes: it's a treatable disease, but it can't be treated by doctors. The practitioner who is going to be administering your diabetes treatment is you. Doctors can advise you, and they can give you legal permission to buy certain controlled substances, but (unless you happen to be in a coma), they can't treat your diabetes for you, any more than the GPS device which advises you to take the River Road exit can drive your car. Doctors simply aren't in the driver's seat, because they cannot live your life for you. Success or failure at getting healthy (and staying healthy) after a diabetes diagnosis will be determined mainly by what goes on during that part of your time which is not spent at the doctor's office or the pharmacy. Diabetes care involves a lot of things, and getting prescriptions filled is a pretty small part of the picture. (For me, so far, it's no part of the picture at all.)

Although the idea of solving your diabetes problem by taking pills (and doing nothing else) has a certain appeal, it's clear by now that this approach doesn't work very well. It's also clear by now that there is another, better approach available. Most doctors try to talk their patients into adopting it. Unfortunately, most of their patients would rather be given pills than advice on how to live. "Why change my habits when I can simply take prescription drugs?", they ask themselves. That would be a valid question, if the drugs were enough, by themselves, to keep diabetes patients healthy and safe. They aren't. Unquote.

Tom manages his diabetes with exercise and nutrition (diet for those who prefer the term - that fails for so many). This takes effort and dedication, something that many patients decide to bypass. Tom covers two of the attitudes of diabetes, those of many patients and many doctors, and hints at the third attitude – his - a lifestyle change.

Although the attitude displayed (pushing pills) by doctors is common, and hides other motives, this commonality is an attitude that must be challenged by every patient. Will this happen? When we read the attitude Tom described by the patient, it is highly doubtful. Too many patients are in the “pill cure attitude, and let's get on with life”. What these patients do not understand is that the oral medications can be much more harmful than nutrition and exercise, or even insulin. At least some in the medical community are trying to emphasize the change in lifestyle as a viable route in controlling diabetes.

Leaving Tom's attitude aside, I need to cover something I did in my blog on Doctor – Patient Relationships in my blog of May 18, 2010. The first type of patient has an attitude that too many patients subscribe to. They could care less about pills from the doctor and some won't even take them. As soon as they are outside the doctors office, they are on the cell phone or on their way to the local health food store to check in with someone to find out what the local snake oil salesman has for diabetes, or to talk to a neighbor about what to take that is natural for diabetes. If these people are in the early stages of diabetes, they may have some temporary relief, but this will not last long and they will be in big trouble, unless they change their lifestyle.

If they have the desire to change their lifestyle and among those that are able to control their diabetes with nutrition and exercise, they should go for it. This along with the stage that they are at will determine how much they have as a possibility of delaying the progression of diabetes. A good thing for those that are able to to control their diabetes early on.

Another attitude of diabetes is depression. This often arises after you, the patient, realizes what the daily routine is and the time, patience, and education this disease requires from you. Diabetes is a disease that will not go away, constantly makes changes to confuse us, and at times seems to have a mind of its own. One of the hardest parts of depression is not letting it take control as this will help diabetes get the upper hand and then the problems really multiply.

Yes, there is anger, denial, acceptance, but these are all stages of the process of coming to terms with your diabetes, and not attitudes.

And last is Tom's attitude, of “get it done” - let's see what can be done to maintain tight control and manage my diabetes instead of it managing me. His attitude takes determination in addition to effort and dedication. This is the attitude of a person that is proactive in their health care. This attitude also requires the best attitude - a positive attitude which is often lacking with the other attitudes.

There can be a multitude of other attitudes, but none of them matter unless you can cultivate an attitude like Tom's. Everyone can have this attitude regardless of the point they are at with their diabetes. Read his blog of August 10, 2010 for his answer of what moved him to do what was necessary. This is Tom at his best.

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