Empathize, listen for diabetes distress when caring for people with complications
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Diabetes care and education specialists should be understanding when people with diabetes develop complications, listen carefully to them and be alert for symptoms of diabetes distress, according to a speaker.
“Life with diabetes and complications is tough,” Susan Guzman, PhD, director of clinical education at the Behavioral Diabetes Institute in San Diego, said during a virtual presentation at the Association of Diabetes Care & Education Specialists Annual Conference. “It’s tough physically, it’s tough emotionally and it’s tough on families. Be aware of your own attitudes, even if you think they don’t show up in your sessions, they probably do, so be aware of your own biases around people with complications and a history of self-care challenges. Remember there are a lot of obstacles that get in the way of good care, and make sure you listen for them.”
Diabetes complications are difficult to manage for many people because they require more medication, more medical appointments, an additional financial burden and more restrictions to functioning, Guzman said. These changes can lead to grief and loss as the complications bring about changes to normal life.
There are a few lessons diabetes care and education specialists should remember when speaking to people with diabetes complications, according to Guzman. First, health care professionals should recognize complications present difficulties. People with diabetes complications may be feeling fear, sadness, shame, guilt, helplessness and grief.
Health care providers must be aware about their attitudes toward people experiencing complications. Guzman said there are inaccurate beliefs among health care professionals when it comes to people with diabetes complications, with a survey of physicians revealing at least half believed people with diabetes complications had poor self-discipline or poor will power. This may lead some providers to urge people with diabetes to have more willpower, threaten them with bad outcomes or give unwanted advice. These tactics do not work, according to Guzman.
“What happens is the opposite of what we really want to happen with behavior change,” Guzman said. “What happen is people end up becoming more frustrated and disengaged with diabetes, may become immobilized with fear, more hopeless and feel like they’ll never achieve goals. If they feel more shamed or judged, they’re more likely to skip their follow-up appointments, which are so important.”
Guzman said health care professionals should realize there are legitimate reasons people are experiencing diabetes complications, including a lack of skill or knowledge, medication side effects, health care professional communication, unachievable goals, depression and harmful health benefits. To combat this, Guzman said, providers should help people with diabetes address the obstacles they are facing while also increasing their understanding of the benefits of diabetes care in their personal life.
It is also crucial for diabetes specialists to be on alert for depression and diabetes distress. The risks for distress and depression increase with diabetes complications. Hopelessness and helplessness are common, Guzman said.
Diabetes care and education specialists should focus on being a partner to people with diabetes to help them overcome their complications.
“Your efforts to be a partner to treat not only diabetes, but whatever complications they are facing, can help this person have the best possible outcome. They can still have a quality life with diabetes and complications, and you can help them achieve that.”
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Guzman S. D-13. Presented at: ADCES21; Aug. 12-15, 2021 (virtual meeting).
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