Wondering what the hardest thing to get across someone who has diabetes is? Is it motivation to stay on top of their diabetes? Is it the importance of what a good diabetes management means to your overall health and future? Or is it learning to become your own advocate?
Everyone’s journey with diabetes is different, therefore, some people may have it easy to learn one thing over the other. But what do experts have to say about their struggles in trying to convey the message across? The finest of the experts share their thoughts about their experience on what they find the hardest thing is for them to teach someone who has diabetes. Read on to find out what they want you to learn in order to empower yourself!
1. Kelly McCombs, MS, RD, LD, CDE
I think the hardest thing to teach someone with diabetes is the concept that this is not a static disease. What someone is doing today to manage their diabetes (dose, medication, diet, physical activity, etc) will most likely not be what works in the future. Whether it be puberty, pregnancy, surgery, illness or just the passage of time, many people with well controlled diabetes may see their BG numbers slowly increasing and perceive that as personal failure. I believe it is important to help people understand that diabetes management is a continuous process, and that following up and checking in with their CDE they can control their diabetes over a long time.
2. Mike Taylor RN, MHA, CDE
The hardest thing to teach someone about diabetes is how to be their own advocate. Patients need to navigate often conflicting advice they get from health providers, family, friends and the media. Ownership of diabetes is a key to success.
3. Joan Hill, CDE
In my 30 years of teaching, I’d have to say the hardest thing to teach someone with diabetes is they need to put themselves first! It’s very hard to say your health comes before everything else. Before the laundry, groceries, homework, trekking to all children activities, before your partner, and other family members! Finding time to do the small details required for managing diabetes is more than knowledge, it is a skill. So, how do you teach someone who might not be organized, to get into a routine of checking glucose levels, looking at their feet, finding the right foods at the grocery store etc., etc.? The solution, take it in small bits and bites!
4. Diana L. Malkin-Washeim, PhD, MPH, R.D., CDE, CD-N
The most challenging areas of diabetes for me as a health care provider is to fully convince my patients that they have the ability and control over their emotions, making decisions and that the decisions they make do have consequences. I teach short-term and long-term decision making. Threats neither work nor are productive. Motivation through fear is inappropriate and a waste of time. I find truth, facts and compassion overrides any negative feedback or dialogue. Repetition and having all of the healthcare providers on your team saying the same thing or being on the “same page” goes a long way because if the story is different from one person to another, the patient is not only confused by the message and by the messenger but there may be a lack of trust between the health care provider and the patient.
5. Bonnie Masterson MS, RDN, CDE
The hardest thing to teach someone with diabetes is that this disease is in their control. The responsibility of treatment lies in their hands. After they have accepted they have the disease the individual is responsible for care which is through nutrition, exercise and medication. The doctor can only prescribe the medication as an adjunct to nutrition and exercise. It will not solve the problem. Most people would like to see a pill solve the problem of blood sugar and not have to worry about nutrition and exercise. Getting a person with diabetes to understand that whether or not they have control of the disease depends on all three facets of care is a major accomplishment of education.
6. Esther Kinuthia, RN BSN BA
The hardest thing to teach a diabetic is how to be compliant with the daily treatment plan. Diabetes is a chronic disease and a diabetic is supposed to adhere to the doctor’s daily treatment plan. However, as the treatment progresses, a diabetic can lose interest and fail to take medications and other prescribed treatments correctly. There are phone apps available which a healthcare professional can use to motivate a diabetic to adhere to the treatment plan.
We are also developing Diabegram (Instagram for people with diabetes) to help diabetics connect and motivate each other by sharing their treatment journeys.
7. Pam Bureau, RN, Diabetes Educator
Getting them to understand how important physical activity is and how it benefits not only their diabetes management but their overall health. Also there are easy activities to start with that can be done at home.
8. Becky Brundin, MPH, RD, CDE
The hardest part is overcoming any resistance or denial of having diabetes . First is getting them the understanding for the importance or seriousness of taking control of their diabetes . I will find out what they know & what matters to them personally then expand to their strengths and desires. Series of steps develops their motivation which is critical to get them started taking care of themselves. After breaking down the barriers, they can develop good habits that will keep them going. Any steps ( small or large) leads to them building their confidence and giving them new hope that they can mange diabetes successfully.
I found this saying that sum it up for me. “Motivation is what to get them started, habits is what keeps them going “
9. Mary S. Klinger, MS, RD, LD, CDE
I think one of the hardest concepts to teach people with diabetes (PWD) is the pathophysiology of diabetes. Teaching people this is a chronic and progressive disease with many organs involved. It is difficult for many patients to understand that diabetes is not just caused from eating “sugar”. Sometimes carbohydrate counting can be very challenging for patients. It is hard for patients to understand the complications that accompany diabetes and the long term effects of uncontrolled blood glucose levels. In addition, many people are resistant to taking medication or adding insulin. They do not always understand the progressive nature of the disease.
It is so fortunate that we have many ways to treat diabetes with meal planning, activity, education and medication. If PWD understand why they need education and support from the medical professionals instead of crazy stuff they read on the internet – that would also be great.
10. Tracey Sinibaldi, RD, LDN, CDE
Time management is one of the hardest things to teach any client including a diabetic. Diabetes can be overwhelming trying to figure out meals, blood sugar monitoring, medications, physical activity, and just life in general. Suggestive steps to managing diabetes more efficiently:
1. Utilize a calendar system and record your “schedule”. Include meal times, work schedule, family events, doctor appointments, blood sugar check, medication dosing, and exercise time. Add phone alarm reminders.
2. Organize your diabetes supplies. Keep in one location so you are not searching for everything.You will also notice quickly when supplies are running low and when to refill them. Update your medication record with new medications, dosing information so you and your support team are aware of the changes.
3. Create a diabetes travel kit to include medication, testing supplies, snacks, water, and glucose tablets to treat your low bloods.
4. Plan a 7 day dinner menu; create your shopping list and then food shop. Add options to your menu to cook once and dine twice such as roasted chicken one dinner and then remake into chicken fajitas the next night.
5. Create a support system so you are successful to include family, friends, and your health care team including a dietitian and diabetes educator.
11. Melissa Herman, R.D., LDN, CDE
Diabetes, plain and simple is a challenging disease. As a Certified Diabetes Educator, I find the most difficult aspect of diabetes care to teach is unique to each patient. Self-care is influenced by each patient’s beliefs and that in turn impacts their decisions regarding diabetes and their ability and wiliness to care for diabetes. Stress, denial, financial concerns, fear, depression, poor coping, lack of knowledge among others can all lead to a difficult journey. Patients should work with a Diabetes Educator to explore what drives their decisions and prevents them from achieving their goals. Finding support, focusing on small goals and developing strategies to break down barriers can lead to success!
12. Joan Stollberger, MS,RD, CDN, CDE
The hardest thing to address with people with diabetes are the many bits of advice they bring with them into my office given by well-meaning friends, family and other health care professionals. These ideas are often wrong yet patients expect me to expand on these rather than give them correct advice. A lot of time has to be devoted to correct the beliefs they bring to me. A lot of them surround eating based on the glycemic index and a lot of them have been told to try and eliminate carbohydrates and sugars. This backfires for them and it takes a lot of patience to re educate them with what is most important.
13. Sylvia White, MS RD CDE
Teaching a child to prick a finger or give a shot is hard, but the hardest thing is conveying to a parent that their child will be okay and will live a long and productive life. When a parent hears their child has been diagnosed with a chronic disease, fear is the first feeling and, far too often, prevents them from seeing a future where things are okay.
As a mom of two children with diabetes and an educator who’s worked with hundreds of patients, I’ve seen the resilience of kids and their ability to live a full life despite their condition. With good diabetes care, kids with diabetes can still do most anything other children can do and will live a very normal life.
14. Diane Greenleaf-Kisner, MS, RDN, LD, CDE
As a registered dietitian for 30 years and a CDE for 16 years, I think the hardest thing to teach a person with diabetes is the need to be consistent with their carbohydrate intake. Carbohydrates have the biggest effect on blood sugars but so many diabetics don’t know the sources of carbohydrates and what is a serving size. The person may have very little carbohydrates at one meal and 3-4 servings at another meal and then doesn’t understand why blood sugars are high or low, especially Type 2 diabetics or those on insulin that have been told to take a certain amount of insulin per meal without a insulin to carbohydrate ratio.
15. Ronda Merryman-Valiyi, MSN, RN, CDE
The most difficult thing to teach someone with diabetes is the lifestyle change component. People have developed their lifestyles over time and are often very attached to their routines. Many patients would rather take a medication than to make significant lifestyle changes. They feel like they might have to give up the way they relate to others, especially around food and eating habits. Additionally, people are often hesitant to increase physical activity because by the time they are diagnosed with diabetes they may have other co-morbid conditions, like heart conditions or joint problems that restrict their ability to be physically active. For individuals who do choose to adopt lifestyle changes, they report changes to all aspects of their lives that give them more energy and stamina as well as managing diabetes better and preventing complications from diabetes.
16. Toby Smithson, MS, RDN, LDN, CDE
Mindfulness about lifestyle changes is the toughest thing to teach people diagnosed with diabetes. Because diabetes is a chronic condition that affects you 24 hours a day, 365 days a year, a person with diabetes needs to be conscious about how lifestyle decisions will affect their blood sugar. Most people ( without diabetes) don’t think twice about tasting food as they cook, skipping a meal, going for a walk in the neighborhood, sitting out in the sun at the beach, or getting poor sleep. But, for someone with diabetes each of these tweaks in lifestyle can make a difference in blood sugar control, and in long term health.
17. Laurie Alisa Block
Insulin injections are certainly not easy …but considering many people with diabetes do not require insulin I would say the hardest concepts to teach someone with diabetes is a belief system that motivates them to make healthy lifestyle choices ; nutritious diet, stress management , exercise and creating a balance that assures that one can manage time to take care of personal health . One has to be internally motivated and have so much personal insight to be able to manage a chronic and complicated task of managing blood sugars.
18. Jill Weisenberger, MS, RDN, CDE, CHWC, FAND
I struggle to help my clients see that diabetes management is about so much more than blood sugar control. That’s a huge part of it, but so are cholesterol levels, blood pressure, heart disease risk and cancer risk. Having diabetes increases other health problems unrelated to blood sugar levels. A common strategy, which is to cut carbohydrates from the diet, does little – or nothing – to help these other problems. I want my patients to address their total health, not just their blood sugar levels. That means eating a diet that improves insulin resistance, embracing disease-fighting carbohydrate rich foods (beans, lentils, yogurt, fruits, whole grains, vegetables), getting adequate sleep, engaging in muscle-building exercises, participating in aerobic activities and limiting sedentary time. It’s short-sighted to focus on carb restriction. Instead I want my clients to upgrade their carb choices. Other than offering carbohydrates, there is little that lollipops and lentils have in common.
19. Marie Feldman, CDE
I think the hardest thing to teach is self motivation for self care. Motivation cannot be taught, but rather fostered. CDEs are the ones who need to partner with the patient to coach them, providing them with the tools and skills to self manage effectively.
20. Lisa Merrill, MS,RD,CDE
Wow that’s a loaded question- to help me best communicate, I do this first:
- I always ask my clients what they do for a living (or did if they are retired) or in a roundabout way if they are more visual or more number oriented
- I will ask them what THEY want to learn.
- I really like to emphasize 15 gm carb increases blood sugar 30-45 points IN ADDITION to where they started.
- And I use the analogy of Lucille Ball boxing chocolates (lucy is the insulin- don’t stress her out)
Applying this concept to meal planning and showing what 30-45 grams carb looks like in a meal and building their confidence on the meal planning is probably the most difficult.
I do give them the exchange books and we do look at lots of menus.
One of the most frustrating things for me is old school doctors who put people on the same amount of quick acting insulin no matter what they eat. So they are fighting crashes a lot.
I like to empower!!!! Give them confidence even through baby steps.
21. Ali Miller, RD, LD, CDE
Working with diabetics is such a rewarding experience as there is data with glucometer reads to correlate behavior and results as well as provide accountability for goals created. One of the most difficult things that I see when working with diabetics is their mindset of disease and failure. I am passionate about empowering them that they do have a choice, they can consciously limit carbohydrates and processed foods focusing on healthy fats, ample protein from clean sources, and antioxidant rich non-starchy vegetables.
Once diabetic exchanges have been memorized, the client has the ability to control their body’s response once they can determine their trends of reactivity from CHO gram consumption. I like to take things a step further and qualitatively categorize foods focusing on whole, non-processed options that support optimal function in the body thus preventing complications and symptoms.
My cookbook, Naturally Nourished: Food-as-Medicine for Optimal Health has provided successful outcomes that have yield medication wean through following my 12- week low-glycemic plan. Teaching clients that whole foods can not only heal, but that they can be delicious too is my favorite part of my job!
We found this expert round up to be pretty rewarding in terms of what we have learnt about what they think you should focus on if you haven’t yet. Everyone who has diabetes finds it hard to learn one thing or another. This is a learning curve for us all. Diabetes is a journey of resilience and courage for those who have it. You may not know everything that there is to know about diabetes. But there’s always time to grasp at new knowledge and make the journey to educating yourself on what you need to know in order to empower yourself!
We thank our experts for taking the time to share there experience and wisdom with us!
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