People living with diabetes need to take their medications, adhere to a healthy lifestyle and continually monitor their disease. Regular clinic visits to their physician is a key strategy but this happens on average at three-month intervals. In between self-management with home blood glucose monitoring, following a physical activity regimen and an acceptable diabetic diet will spell the difference between a favorable and unfavorable result in next visit’s assessment.
At a typical clinic visit, doctors have barely enough time to examine the patient, review test results, adjust or modify the therapeutic regimen, and advise if there is a need to repeat certain tests prior to the next visit. There is but a few minutes to review the diet, inquire whether the patient has been exercising or check if that glucose monitor is being used properly, much less review all the recorded readings. Because of these time constraints, more physicians now ensure that patients are seen by a diabetes educator—a nurse or dietician who is specially trained to help them manage their diabetes.
There is a growing awareness that diabetes is best managed by a multidisciplinary team composed of the physician, a nurse and a dietician. In the country, there are now more diabetes centers where patients have easy access to resources. An added advantage to these centers is that patients can visit anytime outside of their scheduled clinic visits. They may call the diabetes educators to ask follow-up questions especially on diet, insulin use and glucose readings. Reinforcement of lifestyle modification, dietary changes and restrictions, and compliance with medications, thus become easier.
In spite of the growing awareness and acceptance in the multidisciplinary approach in the treatment of diabetes, the management of a diabetic patient still remains challenging. Our culture, particularly our sense of hospitality, is centered on food. Meals are a social event. Ideally, therefore, the whole family should be engaged most especially when dietary changes are needed. This, unfortunately, seldom happens. Family members … and even the patients themselves … frequently give the excuse that there is no time available to have a proper discussion about nutrition. Aside from this obstacle, our inability to say “No” makes eating healthy very difficult. Who can resist going out with friends on a Friday night? Can you decline your hostess’ urgings to bring home some of the leftover food?
To help mitigate these difficulties, as well as to highlight the disease, Diabetes Awareness Week was started. It has been so successful that it is now a monthlong event held all over the country. Patients and their families are educated via games and quizzes … exercise is emphasized with dance and zumba sessions … and proper nutrition is taught to all.
Diabetes is a lifelong disease. Using a multidisciplinary approach and with adequate support, patients and their families can learn to live well and be healthy.
Dr. Marsha Tolentino is a consultant endocrinologist in Cebu Doctor’s Univeristy Hospital and Perpetual Succour Hospital (PSH) in Cebu City, and past president of the American Association of Clinical Endocrinologists Philippine Chapter (AACE-PC). The A to Z of Health Information Advocacy is a joint initiative of a group of medical specialists and supported by AstraZeneca Philippines aimed at raising public awareness on various diseases and providing health information and updates to the healthcare community.