DON'T FEEL GUILTY

by Ed Bryant

Most of us know there are an estimated 16 million diabetics in the United States, and that many have difficulty in coping with or controlling their diabetes. Many thousands of diabetics have experienced blindness, kidney disease, amputation, neuropathy, etc., while others have not experienced ramifications.

I communicate with many people concerning diabetes. I hear from far too many who have been led to believe their diabetes, or its complications, result from bad behavior or personal defect. This is not true. Too many diabetics "do their best," do everything they are supposed to do, and still face serious complications. DIABETES CAN CAUSE MANY PROBLEMS, BUT WE DIABETICS SHOULD NEVER FEEL "GUILTY" ABOUT HAVING THE DISEASE, OR ABOUT HOW IT HAS AFFECTED OUR LIVES.

Good education is critical to proper diabetes self-management, and there are many good health-care professionals who diligently strive to help patients understand and practice good diabetes management. Unfortunately, there are other doctors who haven't kept abreast of new developments, who don't spend much time educating their diabetic patients about the condition. These diabetics are sometimes led to believe they should feel guilty about whatever difficulties their diabetes may have caused. In other words, the negative is accentuated instead of the positive.

I review many diabetes publications, and I find some of them seem to tell readers they will have little or no problems if they take good care of their diabetes. I am fully cognizant we need to do anything possible to keep our blood sugars in normal range (euglycemia), and make every effort to keep the disease in check. But we also need to recognize that we can do all this, do it correctly and diligently, and still have problems.

We know that complications can be prevented or delayed if our blood sugars are kept under control, if we eat correctly, if we exercise, if our medication regimens (insulin and oral meds) are monitored, if we keep our blood pressure in a safe range, if we don't smoke, if our cholesterol is under control and if we don't... Unfortunately, many people follow all the "rules," to keep their diabetes in check and guess what, they still have problems.

There are others, who for years didn't keep their diabetes under good control, because they just didn't realize what complications could pop up. I have communicated with many of these folks, and most of them say they didn't receive much diabetes education. Too often they say their health providers diagnosed, prescribed, but didn't provide adequate information about diabetes. This lack of education is not a past-times issue; it is very prevalent even today.

Diabetes self-management is a discipline, and both lay people and health professionals should constantly educate themselves about the disease and new approaches and findings on the subject. Unfortunately, there are doctors today who do not ask patients to regularly have a hemoglobin A1c lab test. Others tell patients it is okay for their blood sugars to average around 200mg/dL. Some don't check the diabetic's feet each office visit, or don't keep informed about new diabetes medications, or...

There are a lot of fine specialists providing the best possible diabetes care. But, many of us only have access to a "General Practitioner," or "Primary Care Provider," and to expect these folks, responsible for all types of medical conditions, to be "up" on the latest research findings, is unrealistic--but we do, and they do, too. There are some less than fully "clued up" doctors out there, far too many, who don't do the best job when working with diabetics--because they haven't kept abreast of the changes in diabetes care.

The health provider's job is to serve his/her patients in the best possible way. Any decision, any treatment, any advice that falls short of "the latest and most accurate" is substandard health care--and when people pay their bill for services rendered, they have every right to expect good service. Otherwise, you should consider seeing a different doctor.

How do you know if your doctor is doing a good job with your diabetes? As education is a requirement for both doctor and patient, you learn as much as you can, taking full advantage of all possible sources: VOICE OF THE DIABETIC, other diabetes magazines, support groups, websites, e-mail discussion lists, and the many patient handbooks published by doctors, dietitians, and diabetes educators. The more you, the diabetic, learn, the more you'll be able to tell whether you're receiving the best possible care. And you might consider passing on the latest material to your doctor...

To repeat, most health-care teams who deal with diabetes do good work, but if you are not being kept apprised about diabetes issues, you should consider seeing a different doctor. Diabetologists and endocrinologists would be the first choices, but this doesn't mean an educated and informed family doctor is not capable of doing a good job in taking care of you and your diabetes.

Our Diabetes Action Network knows that upbeat attitudes are contagious. Our positive attitude is perhaps our best attribute. There is absolutely no reason for anyone to lose self-esteem or dignity because of a hurdle in the road. I hope this article serves as a catalyst, starting people moving in a positive direction. If we diabetics have a negative attitude and feel guilty about our condition, then often our loved ones and friends are affected. When I participated in the Juvenile Diabetes Foundation International's world diabetes teleconference/press briefing, held March 19, 1997, as part of the JDFI Fourth World Diabetes Conference, I heard Emily Spitzer, a JDF national board member, remind us all that people are "not at fault" if they develop diabetes or its complications.

IT IS NOT SHAMEFUL TO BE DIABETIC. AGAIN, DON'T FEEL GUILTY IF YOU HAVE DIABETES OR HAVE EXPERIENCED ANY OF ITS COMPLICATIONS.