April 30, 2011

Patients Lack Knowledge About Hypoglycemia

I have to take my hat off to the endocrinologists. They took a survey which puts them in a bad light and published it. Most organizations would have put this information through the shredder. Few in the medical profession are willing to to look problems in the eye and address it head on. Will they succeed? – that remains to be seen. There are a lot of hurdles to over come, the biggest is our medical insurance industry, Medicare, and the complexities of the new healthcare law.

Why are patients with diabetes unaware of hypoglycemia and what causes hypoglycemia? To me the broader implication is the lack of time by the medical community at large. Many primary care physicians and doctors in family medicine do not have the time or resources to educate patients. Many are in rural areas, small towns, and even many small city settings that do not have diabetes educators available. Many do not even have diabetes support groups to get support from.

Then add to this our medical insurance industry led by Medicare, that is cutting costs where ever possible and we have a situation ripe for failure. Many patients when they are newly diagnosed are in shock, causing very few to listen carefully to what they are being told by the doctor. Therefore, the doctors should be able to schedule another appointment shortly thereafter to do some education, but most of our insurance companies will not reimburse for the time.

The results of a survey conducted by the American College of Endocrinology therefore does not surprise me. This also shows just how reluctant our medical professionals are to recommend good web sites and help their patients get the information needed.  One site listed here has some information; however, there could be a better presentation and one that is more patient oriented and not so sterile and written for doctors. The information is presented in PDF files that can be downloaded and printed for reference.

The other part of the survey, not mentioned, is where the survey was taken. If it was taken from a cross sample, then good. Otherwise from only rural areas, or only large metropolitan areas could also greatly affect the outcome of the survey. National online surveys can be notoriously misleading and little reliance should be placed on them.

The only real part of this survey is that the numbers, regardless of the method of obtaining them, show that the USA has a serious problem and needs to find a way to educate people with diabetes. Read a doctors interpretation of the survey here and the news release here. The PDF file for low blood sugar is here and the PDF file for high blood sugar is here.

April 27, 2011

Hospital and Medical Mismanagement of Diabetes

Some people with diabetes are being medically mismanaged while in the hospitals in the USA. Why? Because of lack of diabetes education by the hospital staff and outdated hospital management rules for diabetes. Scott Johnson posted an excellent example of this on his blog scottsdiabetes and you should take time to read it now. Some of the comments also bring out some of the problems faced by people with diabetes in the hospital setting.

Disturbing? Most definitely! Why is this happening? In addition to the above reason, patients also need to shoulder some of the blame. Most are not aware that there are patients' rights that must be adhered to by hospitals and many hospitals ignore these rights and enforce their own rules and regulations which most often are not in favor of the patient and the patients' rights. When the day comes that these hospitals are sued for patient neglect and failure to serve the patients and their rights, then maybe, just maybe, some of these highhanded hospitals will get the wake-up call they so desperately deserve.

When I wrote about this back on July 19, 2010, I had not anticipated the extent of medical malpractice that exists in some of our hospitals when dealing with patients with diabetes – and not just those with Type 1 diabetes. Fortunately, not all hospitals are this bad, and some are very accommodating to people with diabetes. Therefore, if at all possible, you need to do your homework before entering the hospital yourself or if a family member or relative with diabetes enters a hospital.

Learn from the experience of others like Scott Johnson writes about. Then talk to your doctors, preferable you should have an endocrinologist, but many people do not. Learn about your patient rights by reading this and related articles this article refers to. Make sure that you ask your doctor for a "self-management order," a document that will permit you to take care of your own testing and diabetes management if you are capable during your stay in the hospital.

If you know when you are entering the hospital, be sure that the hospital will accept the self-management order and that you are capable of using your own testing supplies and medications. I urge you to take time to read my previous blog above as there are some important points in it.

Now is also an excellent time to determine if you have a family member(s) or a trusted friend(s) that will be able to advocate for you if you are admitted to the hospital under emergency circumstances and make them aware of your needs and the paperwork they need to have available. This would include a limited medical power of attorney, a self-management order when you become capable of managing your own care. Do not leave this step unattended to as you cannot know when an emergency will arise.

A little planning now can actually get you better care when you desperately need it. Do not wait for mistakes and mismanagement of your health care to happen when in a hospital, it can and does happen more than we would like. Take time to read the referenced articles and blogs above to avoid many of the problems. Get the necessary paperwork completed and copies available to those that may need it!

I realize that many people will still not have taken these steps to assure their hospital stay is handled properly and I sincerely hope that I will not continue to read many more of these disturbing problems for others with diabetes that happen while in the hospital.