October 21, 2014

Diabetes, The Poorly Managed and Invisible Disease

Diabetes is one peculiar disease. There are few illnesses and fewer diseases where the patient is totally responsible for his/her own care. Yes, the doctor is there for guidance and is the one issuing the prescriptions, but even the doctor is limited in caring for you. Most doctors are not reimbursed for education, extra advice, and will not be reimbursed for anything extra. Very few doctors will go beyond the tests and finding out the medications you are taking to decide what medications you can take.

Too many doctors do not even do the tests necessary to be sure they have the correct diagnosis. Then to make matters worse, most doctors do not have certified diabetes educators available for diabetes education. A few that do have found them useless because of the mandates they use and lack of true diabetes education. Many doctors have found that even having registered dietitians available is hard to come by and more have found them promoting too many carbohydrates and whole grains so heavy that the patients have a difficult time lowering their HbA1cs.

This is one reason many of the local doctors prefer working with diabetes support groups and promoting support groups. They can spend time with us away from the office and promote education one time a month and then follow up the next month. This has surprised some of us and since the group I take part in has no doctor as a leader, they are surprised that we will not let a doctor become our leader. Yet they let us help educate their groups and take part in meetings when we bring several groups together for a meeting.

What many patients desire is more access to the doctor. However, what they often do not understand is that the insurance companies, Medicare, and Medicaid limit the time that they will reimburse doctors for in a year. So if the patient could get unfettered access to the doctor, they would soon not be able to see the doctor for much of the year, because they have used up the limit for the year.

Many people with type 2 diabetes have a difficult time in realizing that the doctor cannot be with them 24/7 and refuse to learn how they can manage their diabetes. Back a few years ago, there could have been good reasons for not learning, but with the internet of today, learning how should be the goal of every person with type 2 diabetes. I will be the first to admit that there a many charlatans on the internet trying to convince people that they have a cure for you. Of course all they want is your money for something that will not cure diabetes.

Even though they claim to have been cured, they have not had diabetes in the first place and make their claims knowing they are lying to take money from you. This is a common scam.

There are some social media and other sites that help people with all types of diabetes. Some are reputable and very reliable, some are good and generally give out good information, and some are unreliable. A few follow the ADA guidelines to the extreme and are not good for the majority of people with type 2 diabetes.

There are some very good sites that basically tell it like it is for people with diabetes and by gleaning the information carefully, many can learn how to manage their diabetes.

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