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ODs in ‘perfect position’ to educate patients with diabetes
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Today I saw a certain long-term patient on my schedule ... and winced. While I have always enjoyed seeing her, over the past few years I have become increasingly concerned about her.
She has type 2 diabetes, and I had watched her fall victim of an all-too-common scenario — a long and sedentary work day, poor lifestyle choices, an inappropriate diet, obesity and, of course, a worsening of her diabetes. With each dilated fundus examination I became increasingly fearful of what I might find.
As I braced myself and entered the exam room, I was shocked ... and pleasantly surprised. She looked great. Having lost a considerable amount of weight and exhibiting a semblance I had not seen in years, she boasted an A1c of 6.5. After complimenting her for what was clearly a huge turnaround, I could not help but ask: How? Was it a new job, a different medicine or an epiphany of sorts that was the genesis for change?
She simply smiled, raised her arm and pointed to a wrist band activity tracker. She told me how it had been a gift and, initially, how shocking and embarrassing it was to see just how inactive she had become. She challenged herself to move more, which led to loftier goals, which required a better diet and, well, you get the picture. Nearly 9 months later she was in the best shape of her life. I could only think to myself, really? An activity tracker? Really?
Many of you know I am big on disease prevention through patient education and advocacy. You also know I am a firm believer that if we are ever to curtail health care costs in the U.S., it will require a concerted effort among all stakeholders, patients included. Perhaps no other condition is more demonstrable of this than diabetes.
The National Diabetes Statistic Report reminds us that in 2012, 21 million Americans were diagnosed with diabetes, and another 8 million were yet to be diagnosed, with as many as an additional 80 million being pre-diabetic. The cumulative cost to society is estimated at $245 billion per year. And this is despite what health care providers feel is a reasonably good effort at managing diabetes.
Unfortunately, it appears our vision is not necessarily aligned with that of our patients with diabetes. One would think an escalating A1c is motivation enough for any diabetes patient, but apparently not. Maybe it is because many patients fail to grasp the magnitude of their condition or lack a complete understanding of their role in management. Maybe it is because they have not received a clear, singular message from their health care team. Or maybe it is because they have not heard it from their optometrist. Regardless, we need to do a better job.
While I am thrilled with my patient’s progress, I am also humbled — humbled that it was not her internist, endocrinologist, diabetic educator or even me who motivated her. But, rather, it was an activity tracker. Her experience is a sobering reminder that we just never know what will resonate with a given patient. For one, it might be an image of their diabetic retinopathy while, for another, it might just be an activity tracker. Either way, it underscores the importance of our ongoing efforts to educate, communicate, advocate and innovate. As primary eye care providers we are in the perfect position to do just that.
In this issue, our article “Health care reform increases ODs’ role in diabetes care” provides great perspective on how each of us can play an even bigger role in caring for these patients. I think you will agree, this is a significant opportunity for optometry, our health care system and, most importantly, for our diabetic patients.