I think many of us have experienced a situation like this, or we know someone who has experienced a situation like this.
You are diagnosed with type 2, with an A1c of 13, and you're 50 pounds overweight. Unlike a lot of people, you take this seriously and work really hard on figuring out the best diet for you. After 3 months, you've lost 25 pounds, your A1c is 7.5, and you exercise every day.
You're feeling pretty good about yourself, and you see your doctor for a follow-up appointment. The doctor looks at your chart and says, "You need to lose weight, and your A1c is too high. Your lipids aren't good either."
What? You've worked so hard, and you've accomplished so much, and all you get is criticism? You're angry. You're deflated. You came in feeling good about yourself and planning to stick with what you were doing until you could lose the other 25 pounds and get your A1c into the normal range, but now you've lost your enthusiasm. You go home and have a big piece of chocolate cake topped with ice cream.
It's too bad that many doctors and other health care providers don't realize how destructive this type of approach can be. It's true you hadn't reached your final goal yet. You already knew that. But you'd worked hard, and you'd accomplished so much. Couldn't the health care people acknowledge that?
How much better it would be if doctors would start out with a little praise. "Wow! You've lost a lot of weight! And your A1c is way down. Good for you. How have you managed to accomplish this? Many of my patients can't."
Then, when you explain your approach, whatever it is, the doctor can move on to the further steps. "Of course you already know you haven't reached your destination yet, but if you keep doing what you're doing, I'm sure you will. You probably also know that the last pounds are more difficult to get off than the first pounds, so don't get discouraged if the weight loss is a little slower now. Focus on the A1c. Do you have any questions?"
Wouldn't an approach like this keep the patient's spirits up more than simply pointing out what still needs to be done? And keeping the patient's spirits up will make that patient willing to put up with the many challenges facing anyone dealing with a diabetes diagnosis.
Physicians have a lot to learn in medical school, and not a lot of free time for more courses. But at least a few classes emphasizing the tremendous effect the mind can have on health and how having a positive attitude can do a lot to improve a person's health -- sometimes even more than drugs -- might benefit everyone. It's certainly cheaper than having the patient take a lot of drugs or follow a path that will lead to amputation and dialysis.
Published On: February 10, 2010