Healthcare Providers Need Compassion to Address Diabetic Epidemic

            Fear in the form of denial can prevent treatment of any disease.  After all, there exists no one-size-fits all diagnosis, so facing the prospect of a given treatment not working can be a tough pill to swallow (pun intended). Fear can escalate in the case of a potential diabetes diagnosis given recent evidence that there may be a link between type 2 diabetes and various types of cancer (Gallagher and LeRoith,).  Furthermore, given the symptoms of a condition such as diabetes, it can be easy to validate denial by dismissing signs of high glucose as standard age related decline (e.g. fatigue, inflammation, neuropathy, etc.).  The way to break this cycle is to employ genuinely compassionate health care providers to ease the pain of shattering denial.

            A great example of this, although not directly relating to diabetes, is a doctor in rural Indiana who runs an opiate addiction rehab (McEvers).  This doctor addresses the state’s issue of both opiate addiction and HIV epidemic by offering a warm hug and a warm greeting to any new patients who walk in, immediately dissipating any fears or regrets that patients may have walked in with.  A hug, although perhaps a small action, makes a world of a difference in outcomes for these patients.  More importantly, it may work to help ease fears with diabetes.

            A less intimate form of reaching out to select potential diabetes patients may be set in practice in the near future. Researchers developed a more reliable metabolic marker to predict at risk patients who have gestational diabetes that may develop into type 2 diabetes in a study published this year (A. Allalou).  Although not yet approved for clinical application, this metabolic marker allows health care providers, who truly care about their patients’ health, additional opportunities to reach out to those who may have a more difficult time with making the right lifestyle choices or may have apprehensions about such a life-changing diagnosis.

            With so much funding going into diabetes research, we as a society can do better than aiding the small subset of individuals diagnosed with type 2 diabetes, which evolves from gestational diabetes; there should be more personalized outreach to the whole of people with or without a diagnosis.  Research has shown that the socioeconomic class with by far the highest percentage of both diagnosed and undiagnosed diabetes worldwide is the low-middle socioeconomic class (Jessica Beagley).  Logically, this makes sense, because these are the types of people who may have enough resources to acquire enough food to avoid complete starvation and malnutrition, but may not have the means to afford better quality food or the time to prepare a meal.  Many families may face the tough choice of choosing food quantity over food quality.

            In many cases, this may not simply be an educational issue.  For instance, the California Department of Education as a part of the State Common Core Curriculum developed an information pamphlet to for all seventh grade students to bring home to their parents or guardians.  Many middle schools and high schools throughout the nation work in lesson plans about type 2 diabetes.  This does not stop after high school for some; nutrition majors here at SUU get figuratively beaten over the head with lectures focusing on diabetes.  Yet, nutrition majors here are not absolutely required to complete a communications class specifically centered on this concept of compassionate delivery of health advice (Javenes).  This trend is not present exclusively in the nutrition bachelor’s degree program here; health care providers throughout the nation for some reason or another often lack empathy and need to go out of their way to express compassion, which can make an impact on someone’s life.

            I have witnessed such fear in the form of denial whose only treatment is loving compassion.  For the past year, a family member lived in my mom’s basement after a rough eviction.  When I visited, I noticed the toilet in that basement had some kind of black organic growth within.  Now, I’ve used that same toilet all through high school, and never resulted in any organic growth (the poor thing never got cleaned while I was there I’m embarrassed to admit).  In order for any sort of living thing to grow in such an unsympathetic environment such as the toilet bowl, they must have at least a food source.  No growth happened before this family member moved in and within a few weeks after the move, these organisms somehow acquired a steady food source.  Perhaps they found food in the urine now?  Since all other variables remain relatively unchanged, it’s safe to logically conclude that this family member had glycosuria, sugar in the urine, and more importantly a telltale sign of type 2 diabetes.  No such formal diagnosis was made; the last visit to the doctor hadn’t occurred in decades.  Why?  Fear of coming to terms with a drastic new lifestyle of plenty of medication with chronic and unexplained rising costs of care (American Diabetes Association). 

            Many people exist, like this family member of mine, who know all about diabetes but do not want to be a burden.  This is exactly the reason why enhanced compassion in our health care providers is critical to assisting this population full of fear.  With increased emphasis on empathy in these curricula, new healthcare providers can reflect genuine care and improve the well being of their patients both new and seasoned.

Works Cited

A. Allalou, A. Nalla, K. J. Prentice, Y. Liu, M. Zhang, F. F. Dai, X. Ning, L. R. Osborne, B. J. Cox, E. P. Gunderson, M. B. Wheeler. "A Predictive Metabolic Signature for the Transition From Gestational Diabetes Mellitus to Type 2 Diabetes." Diabetes 65 (2016): 2529-2539.

American Diabetes Association. "Economic Cost of Diabetes in the U.S. in 2012." Diabetes Care 36 (2013): 1033-1046.

California Department of Education. Diabetes Managment. 12 November 2015. 21 September 2016 <http://www.cde.ca.gov/ls/he/hn/diabetesmgmt.asp>.

Javenes, Kyle. Nutrition Majors at SUU Katie Rose. 21 September 2016.

Jessica Beagley, L. Guariguata, C. Weil, A. A. Motala. "Global estimates of undiagnosed diabetes in adults." Diabetes Research and Clinical Practice 103 (2014): 150-160.

LeRoith, Emily Jane Gallgher and Derek. "Obesity and Diabetes: The Increased Risk of Cancer and Cancer-Related Mortality." Physiological Reviews 95 (2015): 727-748.

McEvers, Kelly. "The Home." NPR. NPR, 31 Mar. 2016. Web. 22 Sept. 2016.