Saturday 14th November 2020 is World Diabetes Day, so we wanted to do our part in raising awareness and explore the experience of Diabetes from the perspective of patients and their families.
Here at mdgroup, we felt this year’s ‘nurses make the difference’ theme was one which is very close to our hearts. Consequently, we interviewed our Home Health nurses so they could share their past experiences with diabetes:
What is Diabetes?
Simply stated, Diabetes (Type 1 and Type 2) is a disease in which blood glucose (blood sugar) levels are too high. Glucose (sugar) comes from the foods we eat, and insulin is a hormone that transports glucose from the bloodstream into the cells of the body to provide the body with energy.
With Type 1 Diabetes, your body does not produce insulin. The body simply breaks down carbohydrates from food and turns them directly into blood sugar to use for energy.
Type 2 Diabetes is the most common form of Diabetes and means that your body doesn’t use insulin properly. Type 2 is a common, yet extremely serious, problem that many people often ignore.
People with Diabetes try to control their blood sugar levels by eating healthier foods or with exercise, but others may need medication or insulin.
We understand Type 1 Diabetes is not affected by your lifestyle; therefore, you cannot affect your risk of developing type 1 by lifestyle changes. On the other hand, things such as eating healthily and being active are two important things which can help you prevent type 2 Diabetes.
What are the biggest challenges for Diabetic patients?
Three of the biggest challenges for Diabetic patients today are:
- Adherence to medication and the diligence to stick with treatment programs. Uncompleted treatment programs are often due to a lack of awareness of disease severity if it is left untreated.
- The gap between “pre-Diabetes” and developing Diabetes. Intervention is possible by teaching “pre-Diabetic” patients to make necessary lifestyle changes which can greatly improve and decrease the overall conversion rate to Diabetes.
- The cost of medications and treatments in a world where many patients have greater responsibility for their own healthcare costs. Many people (in the US especially) find managing their Diabetes difficult due to increasing insurance premiums, plus the additional cost of meeting deductibles, copays, and coinsurance.
Is there a way for patients to reverse Type 2 Diabetes?
While there is no cure for Type 2 Diabetes, studies have shown that it’s possible to reverse it. This can be attributed to diet changes and weight loss, which may lead to normal blood sugar levels without the need for medication.
Type 2 Diabetes is an ongoing disease to manage which means you are not “cured” – it simply means that your lifestyle changes have made a difference in reducing or eliminating the need for taking medication. The disease may return, but it’s possible to go years without a need for the medication and the health issues that come with Diabetes.
Patients manage their Diabetic health with routine blood tests and medical visits to avoid damage to the heart, blood vessels, eyes, kidneys, and nerves.
The patient experience of Diabetes
It’s very normal to feel overwhelmed and confused when first diagnosed with Diabetes. Common questions are asked by patients all over the world, including why did this happen to me? How did I get this disease?
Once you get past any initial shock, it’s time to act. Many patients start with looking at ways they can manage their Diabetes through diet, exercise, medical support and even emotional support groups. However, it is always important to follow and adhere to recommended treatment plans from a Doctor.
We interviewed a few patients and their family members and asked for their experience of Diabetes:
“I always associated Type 2 Diabetes with being a common disease among the elderly population until I was diagnosed with it at the age of 44. I thought there was a mistake and that I couldn’t be a Diabetic patient being so young. I remember feeling disbelief and fear at the same time.
“At that time, I was hospitalised for an autoimmune disease that suddenly took over and overturned my life. I didn’t want to know about Diabetes, I didn’t want to learn how to live with it and I was in complete shock every time the nurse came to check my glycaemic levels while I was hospitalised. For a while I was scared to learn and ask questions about Diabetes as in my mind, I couldn’t be a Diabetic patient – or at least not yet.
“Over the years I learnt to live with Diabetes. I have changed my lifestyle and started to exercise more. I know how my diet and exercise are so strictly related to the glycaemic levels, as I have an instrument to measure them. As a result, I managed to come off the injectable insulin and overcome my fear although I know diabetes won’t go away on its own.” – A 52-year-old Italian male patient.
“When my Dad died in 1999, he never knew he had Diabetes. He was taken into the hospital as he was feeling tired, went into a short coma and died. Only after he died, we realised he had suffered a glycaemic peak which caused the coma and subsequently his death. Everything was so quick and sad, had he known he was diabetic he would have taken more precautions with his diet. We couldn’t believe he died, he was in a good shape, not overweight and never had a health problem.
“Diabetes is an awful disease as you may not realise you have it. First, you are in disbelief. You are fit, your life is fine, and you can’t see any physical problems – so it is hard to believe there is something wrong with your body. When undiagnosed though, it can come with a series of complications such as diabetic nephropathy. This is the name given to kidney damage caused by Diabetes. It develops slowly, over many years, and is also referred to as kidney disease.
“Metformin was the first medication I was prescribed after my diagnosis – which works by lowering glucose production in the liver and improving your body’s sensitivity to insulin, so you use insulin more effectively. After a while though, Metformin started to interfere with my kidneys and if your kidneys are not functioning properly, Metformin can build up in your system and cause a condition called lactic acidosis.
“After a few consultations with the specialists, they decided that insulin was the treatment for me. Now, I inject insulin four times a day, so I plan my meals around my medication and travel with insulin when I leave home – which can be inconvenient if your plans change. Thanks to medical device progress, the insulin is quite easy to inject now, but it is also a nuisance when you are not at home or if you’re surrounded by other people.
“My relationship with diabetes has changed over the years – to start with I was in complete denial. I would not even mention the word “Diabetes” and would say “high glycaemia” instead, which are two different things. I hated the word “Diabetes” – maybe because I associated it with my dad’s death.
“After that initial shock at the age of 46, I looked after myself, I started to cycle more and took Metformin which also helped me to lose some weight initially. I felt I was finally winning. After this period though, I realised my victory was only apparent as my kidneys were being silently damaged and I could no longer take Metformin.
“Now at the age of 66, I have learnt to live with Diabetes. I feel I can keep it at bay and I feel lucky that I received the right diagnosis. I wish my specialists had spent more time explaining how diet and exercise could have substituted my medicines, and I wish I’d taken a different approach from the start rather than opening the medicine cabinet when I still had a chance. – A 66-year-old patient.
“Diabetes runs in my family. From a young age I have been exposed to how Diabetes subtly and gradually can take over our lives. Not only are you lucky to get the right diagnosis at an early stage, but you will be even more empowered if you’re equipped with the right educational resources.
“I know the importance of nutrition and exercise and how this can shape your future years. If ‘we are what we eat’, how can we demand our bodies and minds to function at their best when we eat junk food? More often than we think, our body tells us we need to change.
“Over the last few months, I’ve had the chance to experiment with how the food I eat has an impact on my behaviour and how I feel. I have definitely enjoyed learning more about nutrition and I am feeling the benefit.”– Valeria Nicoli Carr, VP Patient Engagement at mdgroup.
Education and funding are vital to support healthcare professionals in the fight against diabetes.
In 2020, the World Diabetes Day campaign focuses on promoting the role of nurses in the prevention and management of diabetes. Learn more about the theme and key messages and view the resources available here.