What are you eating? Are you exercising? How often are you testing your blood sugar? What are your blood sugar results? Are you taking your medications? How is your stress level? Are you doing foot exams? Are you setting goals? Do you smoke? Are you ready to change—today, tomorrow, next week? The list of questions and topics for patients really is exhausting. They’re frequently bombarded with information they may or may not want to hear. Instead, how about focusing on what the patient’s needs are right now. Actually…the one need that’s “bugging them most about their diabetes.”
It’s hard because we as clinicians think to help our patients; we need to cover every topic—now. Maybe we have a checklist of information we’re supposed to run through. But, is thatreally what’s best for the patient? Nope. Helping them focus what’s on the top of their mind, “what’s bugging them” about their diabetes is far more impactful.
One of my patients went through my hospital-based diabetes education course a few years back. It really was a great series of classes with excellent educators. We even made it fun with hands on activities, healthy snacks, and included a multidisciplinary team of nurses, an exercise physiologist and dietitians. A year later she came back into my office and said, “I loved your course but I really didn’t pay much attention to what you said. There was a lot of information I wasn’t ready for. I was really stressed out and needed to deal with that first. Now I’d like to focus getting on track with my eating.” Yep—ready to focus on what’s bugging her most.
We have multiple drugs for diabetes, amazing technology, and well trained healthcare providers but if we seek out our plan, not what’s on the forefront of the patient’s mind, all of that really doesn’t matter quite as much. Think about the patient, smiling and nodding in the office (pretending to listen about the importance of taking medication twice per day), but they are so focused on their only social event out, pizza night, that they think you just took away. Now that’s something we could easy clear up, if we would have just started with that one question….what’s bugging you? By doing that, now you have a relieved (and much happier) patient, who learned how to fit pizza into their meal plan!
Other than working on the challenges the patient wants to address first, why does it matter? It matters because a step-by-step approach can help patients be more adherent to their diabetes care plan. Deal with their initial concerns, gain their trust and weave in the care plan challenges at just the right time for them. That’s what we’ve found that works best anyway
Helping patients focus on what’s on their mind and their top priorities gets better results and a bigger impact. It’s a simple question, “what bugs you most about your diabetes?”.…and let the patient lead from there.
Sherri Isaak, MS, RD, CDE, BC-ADM