I have been away the past 2 months taking a short sabbatical due to a family member’s illness. It has been educational and enlightening to experience the healthcare system from the other side. During time spent waiting at doctor’s appointments, at diagnostic and therapy sessions, and at children’s activities to allow some relief for the harried parents, I have been catching up on my reading and listening to concerns from the patient’s viewpoint. Although I have always tried to listen to my patients’ views and opinions, in the professional setting there is often not enough time to thoroughly discuss concerns in the time allotted.
Not everyone knows about the newer technologies. Not everyone feels comfortable and competent using the newer technologies.
While reading, something I basically knew but started to pay closer attention to, was the lack of advertisements for meters in the journals. The focus has switched to continuous glucose monitoring systems and continuous insulin infusion therapies. What a milestone in diabetes management! We are living in a wonderfully transitional time in how individuals manage and care for their diabetes.
Yet, while talking with others in waiting areas, I find people are still poorly informed and confused about what they should be doing to control their diabetes. Not everyone knows about the newer technologies. Not everyone feels comfortable and competent using the newer technologies. Not all insurance companies pay for the newer technology — although we are making strides in that area. Not everyone has insurance to cover diabetes supplies. Then there is the dreaded “donut hole” for those on Medicare, a coverage gap that seems to be a constant worry for many seniors.
It did not take long for others around us to join in and share their concerns about changing treatment goals, medication costs and the cost of monitoring supplies.
While healthcare professionals and various organizations continue to argue about the appropriate goals for managing diabetes and how to best achieve them, individuals with diabetes get caught in the crossfire. They are unsure about what to do as the message continues to change. While in one waiting room, a gentlemen shared with me that he was recently taken off all his diabetes medications. I asked him why and he said that his primary care provider told him his diabetes and blood glucose control was “too good” since it was recommended that A1c values hover around 7%. I asked what his A1c had been — he replied 6.2%. When I asked about complications such as hypoglycemia, he denied any problems. I thought perhaps his insurance was balking at paying the high cost or perhaps he had a high co-pay, but he was on very inexpensive drugs — you know which 2 those are.
It did not take long for others around us to join in and share their concerns about changing treatment goals, medication costs and the cost of monitoring supplies. It seemed several were not aware of the new continuous glucose monitoring systems available and how easy they were to use. We had a short, impromptu information session while waiting for our loved ones. Hopefully my new acquaintances can return to their providers with more information to discuss options that may be helpful to them. I continue to be surprised by how little people actually understand about what their providers tell them.
AADE18 coming up next month and I encourage you to make the time and effort to attend. If you have not attended in the past, it’s a wonderful way to elevate your knowledge, discover some new innovations to help you in reaching and teaching your clients, and find some new motivations to keep you and your clients batteries charged. For those of you who are unable to make it to the conference this year, check out the education opportunities in DANA, AADE's new resource for all things diabetes tech.
About the Author
Barbara Walz is an RN, BSN and has been a certified diabetes educator since 1986. Since 2000, Barbara has coordinated a multi-site diabetes study examining the macro-vascular effects of diabetes at the South Texas Veterans’ Healthcare System under the supervision of Dr. Ralph DeFronzo.