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A Story About Behavior Change—From a Patient

Jul 17, 2012

Guest blog post from Riva Greenberg, health coach and blogger on The Huffington Post. She is also the author of "50 Diabetes Myths That Can Ruin Your Life and the 50 Diabetes Truths That Can Save It" and "The ABC’s Of Loving Yourself With Diabetes."

Recently, I was approached by QuantiaMD to answer questions from health care professionals about how to work more effectively with their diabetes patients. As you might imagine nearly 85 percent of the questions I received were about how to help patients change behavior.

I want to tell you a story that happened to me with my neighbor Carol, a 65-year-old woman with type 2 diabetes. Carol was new to injections and put on an insulin pen.

Carol was frantic about taking her first injection so she called me and asked if I could come and help her. I did. I took the little instruction booklet out of her shaking hands and asked her, “How much insulin should you take?” She looked at me stunned. “Doesn’t it say in those instructions?”

I explained that how much insulin we each take is individualized to our needs and that her doctor must have told her how much to take. She had no idea, thus our first failed attempt to have her take her insulin.

The next morning she called me again. “Can you come help me again, Riva? I know how much insulin to take now.” I went down and we repeated the process, only this time after she inserted the pen into her thigh, she pulled it out before she pressed the injection button. She was so scared, she completely forgot to press the button. I asked her to stick the needle in her thigh once more and—success.

This was a learning process for Carol, but it was also a learning process for me. Patients often don’t change because the basics for them to know how to change are not in place. They may not even hear what you say; I’m sure Carol’s doctor told her how much insulin to take but her nervousness prevented her from hearing it. Carol, like many patients, didn’t have:

1.     The right information. She didn’t know how much insulin to take.
2.     The understanding of how the pen worked.
3.     The skills to work an insulin pen.
4.     The courage to take her injection easily.
5.     Support.

Sometimes we are so knowledgeable and familiar with what we do that we forget what it’s like for a patient who’s confused, frightened and being asked to do something for the very first time. I was grateful Carol reminded me.

If you’d like to hear more about what stops patients from changing behavior and how to create better outcomes for both your patients and yourself, I invite you to listen to my “Ask the Patient” presentations on QuantiaMD.


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  1. Jul 23, 2012

    Hi Robert, Thank you for posting on our blog. In regards to your question about the BC-ADM credential, please check out our web page for more information about the process. Here is the link: Hope this helps! Let us know if you have any more questions. Joyce Lee AADE Communications Manager
  2. Jul 20, 2012

    Hi, this is my first posting, I am a NP in Primary Care/Internal Medicine in a 2 doc practice with one other NP. I am the clinician who treats and manages the majority of T2DM patients and have been doing so for four years. I am interested in pursuing the ADM-bc credencial and going into solo practice as a consultant helping to manage a large Diabetic population from existing primary care practices. I am quite sure this is not a new concept but I certainly need advise on the many intricate elements of the process. Please advise

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