Comments on: COMPLIANCE http://www.type-1-diabetes.zolushka123.com/2004/07/19/compliance/ for anyone who has been touched by this disease Fri, 05 Dec 2008 03:00:29 +0000 http://wordpress.org/?v=2.2.1 By: carol_17 http://www.type-1-diabetes.zolushka123.com/2004/07/19/compliance/#comment-3643 carol_17 Sun, 25 Jul 2004 03:19:43 +0000 http://www.type-1-diabetes.zolushka123.com/2004/07/19/compliance/#comment-3643 Hi Heidi, you are by no means preaching, you are stating facts and I couldn't have said it better myself! My hat is off to you! Carol Hi Heidi, you are by no means preaching, you are stating facts and I couldn’t have said it better myself! My hat is off to you!

Carol

]]> By: Leigh Enriqueta http://www.type-1-diabetes.zolushka123.com/2004/07/19/compliance/#comment-3640 Leigh Enriqueta Thu, 22 Jul 2004 06:14:42 +0000 http://www.type-1-diabetes.zolushka123.com/2004/07/19/compliance/#comment-3640 What a great topic for all of us to be discussing. I've done a lot of thinking and writing about this as it's the topic of my doctoral dissertation (still painfully unfinished but progressing). I think it's so interesting that health care professionals are always telling us to "take charge" of our diabetes, but then want to talk to us about "compliance." I'd like for them to explain how I'm supposed to lead AND follow at the same time!! The crux of the problem is that good diabetes self-care in this modern day and age isn't a straight forward prescription (e.g. take one pill twice a day with food for 10 days). It's more like a bunch of if-then statements and the "right" or "necessary" action is going to change from day to day...or heck, even minute to minute. The concept of "compliance" just doesn't make sense with a complex treatment like diabetes. A doc, for instance, may say to test your blood sugar four times a day...but that's only a general rule of thumb. Some days, four times may not be enough and some days it may be overkill. Now don't get me wrong...I highly value my endocrinologist's wisdom and suggestions. But her "prescription" for when I should do what, and how much, and how often is just a starting point. Then, for each decision I make about my diabetes care, I have to decide how to adjust that "prescription" to take into account all the variables of that particular moment. In my opinion, the goal for taking care of your diabetes should be to do what you feel you need to do given the current situation...not for you to rigidly "comply" to a doctor's generic or "one-size-fits-all" recommendation. In my mind, that's not compliance...because ultimately I am the one who gets to make the decision. If I give myself an injection, I'm doing it because I think it's a wise and good thing for me to do for myself...not because I'm complying with doctor's orders. Finally, I think the biggest thing that doctor's don't understand is that taking care of our diabetes isn't always our top priority. It's only one, albeit an important one, aspect of our lives. Sometimes other things get in the way. Sometimes we may skip a blood sugar test if we're running late and it's more important to make it to work on time than it is to know if our blood sugar is in range. Sometimes it's more important for us to feel part of a birthday celebration by having cake and ice cream just like everyone else even if it means we have to take double the insulin we are normally "prescribed" and may still end up with a wonky reading in a few hours. And sometimes it may be more important to jump into a game of chase with a child without first stopping to test blood sugar and have a snack to compensate for the extra exercise...even if it means we may have to treat a low later. All of these choices may not be the best choice for our diabetes at the time, but they may be the best choice for our sense of happiness and well-being... and therefore, aren't categorically "bad" or "noncompliant." Whew!!! If you made it to the end, thanks for listening...I know I'm just preaching to the choir! Cheers! Heidi What a great topic for all of us to be discussing. I’ve done a lot of thinking and writing about this as it’s the topic of my doctoral dissertation (still painfully unfinished but progressing). I think it’s so interesting that health care professionals are always telling us to “take charge” of our diabetes, but then want to talk to us about “compliance.” I’d like for them to explain how I’m supposed to lead AND follow at the same time!! The crux of the problem is that good diabetes self-care in this modern day and age isn’t a straight forward prescription (e.g. take one pill twice a day with food for 10 days). It’s more like a bunch of if-then statements and the “right” or “necessary” action is going to change from day to day…or heck, even minute to minute. The concept of “compliance” just doesn’t make sense with a complex treatment like diabetes. A doc, for instance, may say to test your blood sugar four times a day…but that’s only a general rule of thumb. Some days,
four times may not be enough and some days it may be overkill. Now don’t get me wrong…I highly value my endocrinologist’s wisdom and suggestions. But her “prescription” for when I should do what, and how much, and how often is just a starting point. Then, for each decision I make about my diabetes care, I have to decide how to adjust that “prescription” to take into account all the variables of that particular moment. In my opinion, the goal for taking care of your diabetes should be to do what you feel you need to do given the current situation…not for you to rigidly “comply” to a doctor’s generic or “one-size-fits-all” recommendation. In my mind, that’s not compliance…because ultimately I am the one who gets to make the decision. If I give myself an injection, I’m doing it because I think it’s a wise and good thing for me to do for myself…not because I’m complying with doctor’s orders. Finally, I think the biggest thing that doctor’s don’t understand is that
taking care of our diabetes isn’t always our top priority. It’s only one, albeit an important one, aspect of our lives. Sometimes other things get in the way. Sometimes we may skip a blood sugar test if we’re running late and it’s more important to make it to work on time than it is to know if our blood sugar is in range. Sometimes it’s more important for us to feel part of a birthday celebration by having cake and ice cream just like everyone else even if it means we have to take double the insulin we are normally “prescribed” and may still end up with a wonky reading in a few hours. And sometimes it may be more important to jump into a game of chase with a child without first stopping to test blood sugar and have a snack to compensate for the extra exercise…even if it means we may have to treat a low later. All of these choices may not be the best choice for our diabetes at the time, but they may be the best choice for our sense of happiness and well-being… and
therefore, aren’t categorically “bad” or “noncompliant.” Whew!!! If you made it to the end, thanks for listening…I know I’m just preaching to the choir!
Cheers!
Heidi

]]> By: carol_17 http://www.type-1-diabetes.zolushka123.com/2004/07/19/compliance/#comment-3639 carol_17 Mon, 19 Jul 2004 20:12:35 +0000 http://www.type-1-diabetes.zolushka123.com/2004/07/19/compliance/#comment-3639 Thanks, Rhonda! My heart goes out to you and Sydney. Take a bow, you are doing a great job from what I've read! Nutrition labels make me nuts, you really have to read them to make sure you aren't being fooled! :) Take care, Carol Thanks, Rhonda! My heart goes out to you and Sydney. Take a bow, you are doing a great job from what I’ve read!
Nutrition labels make me nuts, you really have to read them to make sure you aren’t being fooled! :)
Take care,
Carol

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