How do we teach about the complications of diabetes? How do our patients deal with their risk for complications?
This blog is a bit of an extension from my previous one on support groups, and how we address the issue of complications and motivate the individuals we care for to make positive behavior changes.
Everyone seems to deal with the idea of complications differently. Some people may accept them as inevitable. “I am sure I’ll get an amputation at some point. Everyone in my family with diabetes ended up with one.” Some have a great fear that may be helpful or may get in the way. Others have an attitude that they will do anything possible to conquer diabetes and avoid complications. And other reactions cover everything in between...
The large diabetes trials that evaluated the importance of good blood glucose control to decrease or avoid complications tell us that there is much people can do to avoid them. Of course, we as diabetes educators know that some people can ignore diabetes, not manage blood glucoses, skip medications, live a sedentary life, and never have a problem. Then, others seem to do all the “right” things and still get complications. Everyone is different. We can certainly educate each person about the importance of good control to avoid complications and hope for the best.
But what is it that motivates people to follow the recommendations? Is it fear? Or a more positive approach?
I saw a horrendous video a couple of days ago. Someone asked a nurse educator in our office for feedback on a video he'd created for people with diabetes. It was a cartoon describing what could happen if a person with diabetes does not do the "right" things, and it shows images like someone sawing off a leg. It was disgusting. The educator clearly told the person that scare tactics do not work. I have to agree. In 28 years of physical therapy and 16 years of diabetes education, I have never found the need to threaten a person. You can get more bees with honey…
That's why I was so excited to get my mail yesterday and see a big envelop from AADE. There was the new Diabetes Prompt Deck focused on this topic with the tagline: “Stack the Deck Against Diabetes Complications.”
The deck is very proactive with lots of positive ideas of how to help people with diabetes avoid complications. But, that does not mean that the information is sugarcoated (pardon the expression). The questions and activities in the deck are supposed to help educators have open and honest--and motivational--conversations with their patients about behaviors that can help them avoid or delay complications.
I worked on this project with a team of others, including some fellow bloggers. I felt that it was very important to try to be positive when creating the items found in the deck. I do think most people with diabetes are well aware of the possibility of problems. They do not need to be told about losing a limb or their eyesight if they do not shape up. But engaging in discussion around these potential problems can be motivational and positive. I think we did a great job.
Have you gotten your deck yet??
I am anxious to hear what you think about the deck and how you plan to use it. Thanks to AADE and the sponsors for providing another tool that we can use to interact and engage our patients!