December 30, 2015

Doctors Can Help People with Diabetes

I often see people coming to the diabetes forums wondering what they can do. Most are very discouraged by their diagnosis and wondering where they can learn how to manage their diabetes. Most are not too polite in describing what their doctor said to them. Many feel that their doctor was accusing them for their diabetes and others felt their doctor was ridiculing them and a few felt that they were being bullied by their doctor.

This is often quite a bit to overcome, but most answers to their questions do their best to allay their guilt and encourage them to conquer their fears and then suggest following links to some very positive messages. Others tell them that they have experienced similar problems, but the people on the forum could help them and they would learn as well.

Varun Iyengar and Adam Brown describe in the diaTribe newsletter what Dr. Bill Polonsky said when he gave a talk on diabetes distress at the recent IDF World Diabetes Congress in Vancouver. He covered what this emotional state looks like, how and why it occurs, and simple strategies for addressing it. This reflects his research dedicated to one big question: how can we help people with diabetes feel motivated to succeed?

Dr. Polonsky stressed that doctors and other providers often communicate the wrong message, rather than hope, patients hear negatives and feel fear. The reason for vigilant management is not to live a long and healthy life, but to avoid complications. That framing makes a difference, as people with diabetes often go on to develop distress: an attitude of feeling defeated by diabetes.

Dr. Polonsky shared what “diabetes distress” sounds like in practice:
  • “Diabetes is taking up too much of my mental and physical energy every day”
  • “I am often failing with my diabetes regimen.”
  • “Friends or family are not supportive enough of my self-care efforts.”
  • “Diabetes controls my life.”
  • “I will end up with serious long-term complications no matter what I do.”

How common is diabetes distress? (You are not alone!)

The rate of diabetes distress is far greater than is often appreciated; 39% of type 1 and 35% of type 2 patients experience significant levels of diabetes distress at any given time. This distress cannot be treated with depression medications because…it is not depression! Rather, it requires a greater focus on acknowledging and addressing the emotional and behavioral obstacles associated with diabetes.

This statement by Dr. Polonsky is the way he turns a negative into a positive, “Well-controlled diabetes is the leading cause of nothing!” This is how Dr. Polonsky stresses the need to adapt the messages people with diabetes hear from doctors, providers, and caregivers, moving away from “blame and shame” to a new message, positive in nature.

Varun Iyengar and Adam Brown had much more to say about Dr. Polonsky's talk and I hope that the above link works, as it is very interesting.

2 comments:

Denise Elliott said...

I have been fortunate to hear Dr. Polonsky speak several times at TCOYD conferences and he's always very insightful about the emotional effects diabetes has on both the newly diagnosed and the veterans. What saddens me is that the first time I heard him speak on the topic must have been at least 20 years ago...and virtually nothing has changed: doctors and most of those in the medical profession who have direct contact with patients still don't understand how to communicate properly to avoid worsening the distress. It's a good thing I'm a natural optimist, or this would be discouraging! :)

Bob Fenton said...

I have only heard Dr. Polonsky speak once at a TCOYD, but it was well worth the time.

My problem is my resistance to poor doctor communications and telling them so. I have been dismissed by more doctors for this habit of mine. I do not tolerate doctors that try to bully me, blame me, shame me, or don't listen to my answers to their questions. In that I am not a polite patient. I feel that if a doctor does not have a positive attitude, then I am not required to have a positive attitude about him/her and I can be very negative and speak my feelings to the doctor. This is not good for all concerned and I am normally on the losing end, but I now have some great doctors.