One of my biggest challenges is convincing health care providers (MD, OD) that even if a patient has had diabetes for a long time, they still need to regularly see a diabetes educator. I can’t tell you how many times a patient with reasonably controlled BG values has self-referred and after a few sessions, questioned why they hadn’t been encouraged to come in earlier. Not to mention those who have poor control and everyone (including themselves) have given up!
New technologies (pens, monitors, insulin pumps), the latest websites and phone apps and education about the mechanisms of medications to help control BG values are all valued topics. In addition, the “newness” of the diagnosis wears thin and old habits return, making control more challenging. Just a friendly reminder of what to eat with some delicious recipes may be enough to get them back into a diabetes focus mind set. Suggesting a website such as diabetes.org/myfoodadvisor might help provide ideas for a more varied and healthful food plan.
Problem solving around changes that occur in the lives of the individual is also an important role for the diabetes educator/patient relationship. For example, I recently had a delightful gentleman come in who lost his exercise partner to heart disease. They had worked out together for years, and his abrupt death left my patient bewildered. He had not exercised in 4 months when I saw him and his weight and BG values were skyrocketing. Linking him to other men who enjoyed exercise as well as some exercise coaching helped to get him back on track.
Are your providers remembering that this is not a one time meeting, but a continual coaching and problems solving relationship with patients throughout an entire lifetime of having this disease? Do you have any tips to share on how you encourage referrals outside of the newly diagnosed patient?