April 13, 2014

Lifestyle Changes More Important Than Medications

This blog from the Center for Advancing Health (CFAH) is written by a person that attended the Diabetes + Innovation 2013 conference. I found her blog most interesting and while I am generally not able to attend such conferences, there are many thoughts she put forward that I have known and thus am not surprised. The following are lifted from that blog:

#1. Diabetes management falls squarely on the patients' shoulders. While many patients with diabetes feel that they should be receiving more information from their doctors, time does not allow for this. People with type 2 diabetes on oral medications often see their doctors at most two times a year. This will vary by the level of their HbA1c, but often depends on the doctor. The better managed their diabetes is, the less time their doctor will want to see them. Many patients managing diabetes with nutrition and exercise will not see their doctors but once a year once they have proven they can do this.

#2. The responsibilities and tasks of diabetes management can seem overwhelming. The fact that there is no vacation from diabetes can cause this and leave patients feeling alone and otherwise isolated. This is one reason our diabetes support group works so well and we enjoy each other's input. If you are feeling isolated, search out a support group in your community. Or if needed consider organizing a diabetes support group.

The following are three patient themes highlighted by Milly Dawson, the blog author:

#3. The main caregiver for a person with diabetes or prediabetes is himself or herself.
Diabetes prevention and treatment efforts should make it easier for people to make choices, but not in isolation, but within families and communities. The goal should be to make good choices about food and exercise. This “default choice” involves healthy eating at work and at home. It also means finding the right exercise regimen that the person can accomplish and enjoys on a daily basis.

#4. Behavior or lifestyle changes should be the first in treatment plans. Review the lifestyle changes from my blog – components of lifestyle change. Be sure to include weight loss if needed. Many of the lifestyle changes also reduce a person's risk of heart disease, cancer, mental illness, severe depression, and other health issues.

#5. People often have a hard time changing habits. To succeed, people often need other support besides doctors. Again, a support group, family, and community support may be needed. Do not forget caregivers, social workers, nutritionists, health coaches, and even peers, trained or untrained, online connections, and social media.

Presently, primary care physicians (PCPs) are not in a position to give the needed assistance. Often your time with a PCP is very limited and your insurance carrier generally is of no help.

The blog author rightly emphasizes food and exercise over medications. The American Diabetes Association and the American Association of Clinical Endocrinologists do not and push oral medications heavily, even before insulin. Food and the right food plan is critical in the management of diabetes.

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