You’re a 50-year-old woman living with Type 2 Diabetes. Along with diabetes medication, you're also managing medications for a history of stroke, high blood pressure, high cholesterol, Hepatitis C, and various other medical problems. Because of the impact of these conditions on your day-to-day life, you’re also struggling with anxiety and depression. Additionally, a number of financial, social, and geographic limitations have filled your journey toward greater overall health with stumbling blocks and hurdles.
Now imagine this situation from a different angle…
You’re a healthcare provider—maybe a primary care physician, a diabetes educator, or a doctor in the emergency department. You’re attempting to provide high-level care to the patient above while managing a massive caseload. Depending on your education and specialty, you may or may not feel prepared to talk with this patient about all of the care options available to her. Because of limitations in the patient’s life that you have little influence over, you know that some of the care and education you provide will have little impact.
Whether you’re the person living with this chronic condition or the healthcare professional providing care, how do you manage the many dimensions of Type 2 Diabetes? What resources are available to you? What are your biggest challenges? What other kinds of support do you need?
Since starting on Monday, the 2015-16 Health for America Fellows have already begun our journey toward answering some of these questions and working toward a solution that improves health outcomes for patients living with Type 2 Diabetes.
In the midst of the first week’s meet and greets and crash courses, we had the remarkable opportunity to spend a day at the MedStar Diabetes Institute, a hub for diabetes care, education, and research within the MedStar health system. The Institute is directed by Dr. Michelle Magee, a clinician, researcher, and educator with a contagious commitment to improving health outcomes for patients living with diabetes.
During our daylong diabetes education day, Dr. Magee introduced us to a number of Certified Diabetes Educators on her team: Gretchen Youssef, Carine Nassar, and Madeleine Said. Throughout the day, Dr. Magee and this remarkable group of professionals led us through conversations surrounding the causes and complications of diabetes; the impacts on individuals, communities, and health ecosystems; and the challenges of diabetes management in terms of lifestyle changes and medication adherence; and much, much more.
While the information and resources shared with us could easily fill our blog for weeks to come, I’ll share three moments of discovery that are still swirling in my mind…
1. Access: Even on the basic level of transportation, access is a huge challenge in diabetic care. I, for one, was late to our morning meeting with Dr. Magee because of WMATA bus delays. If I were a diabetic patient on my way to an appointment, would I have missed it? Would I have to reschedule and take another morning off work or out of school?
2. Education: People whose diabetes is newly diagnosed are tasked with wading through and wrapping their brain around mountains of information, all of which is critical to their overall health. While teaching us about blood glucose meters and insulin pens, Ms. Said demonstrated the process of testing blood glucose then handed the meter over to me to give it a try. After making a mistake on the first step of the process, I had to wonder—how would this process feel if I were sitting alone at my kitchen table rather than next to a highly-qualified, highly-engaged diabetes educator? What other missteps might I make in my own care?
3. Individuality: Later in that same conversation, Ms. Said emphasized to our group that “all kinds of people can be in denial about their diabetes, and all kinds of people can take control of their diabetes.” I’m still unpacking all of the implications this statement will have on the work ahead of us. I’ll keep you posted.
Stay tuned for more posts to come as the team dives deeper into our journey toward improving health outcomes in people living with Type 2 Diabetes. In the coming weeks, we’ll be conducting more interviews with a range of stakeholders, attending conferences, and even spending two weeks simulating Type 2 Diabetes management!