Something that I experience often in my diabetes education practice is patients not knowing they have diabetes. I realize that this sounds kind of crazy, but it really is a pattern. I get a referral from a health care provider, I call the patient to set up an appointment, and they say, “I don’t really have diabetes.”
Because I don’t want someone to have an unnecessary appointment, and because I don’t want them to end up paying for it (health insurance won’t pay without a diagnosis of diabetes), my next step is to call the health care provider and confirm whether or not the patient really has diabetes. Chances are, the provider will tell me that the person’s A1C (3-month average blood glucose) is elevated and they have been started on Metformin (type 2 diabetes medication) and, yes, they definitely have diabetes.
For a long time I honestly thought that providers avoided coming right out and telling people they have diabetes because they don’t want to be the “bad guy”. I still have a “bad guy” theory, but I’ve come to realize that this is not what is always happening. Now I realize that it is actually a combination of providers not clearly stating that the person has diabetes and the person not hearing them say it. In other words, some people are told, “your A1C is high and I’m going to recommend that you start taking this medication for diabetes” and what they hear is “your blood glucose is slightly elevated, so you need to take this medication to bring it down.”
Although I wish health care providers would be clear and confirm that people hear what they say (and understand it), I can’t really blame someone for interpreting the words the way they want to. Nobody wants to be told they have diabetes. It’s much easier to digest another version of it – maybe one that sounds better or nicer or easier to handle.
For many years, people used the term “borderline diabetes”. Today we, in the diabetes professional community, use “pre-diabetes” because “borderline diabetes” was (is) too easy to dismiss. Many people have said, “Oh, I’m just borderline. I don’t have to worry about it.” On the other hand, pre-diabetes basically implies that it’s about to happen. And that’s the truth – if you have pre-diabetes, it’s just a matter of time before it becomes full-blown type 2 diabetes (unless you do something to prevent it).
I fully believe that ignorance is bliss, and I’m guilty of living that way from time to time. I do believe, however, that when it comes to our health we need to be fully aware and in charge. No room for ignorance if we want bliss (health). So how can we help patients and providers improve the lines of communication? Ideas, anyone? Have you had a personal experience with this sort of thing?