Talking about diabetes with healthcare professionals – Helen May
This Diabetes Week, Helen May reflects on talking to healthcare professionals about her diabetes.
I think of myself as healthy. There is no part of my health which stops me doing what I want to do. I may not have enough time to learn to play the piano, or the basic coordination to play tennis well, or the motivation to run a marathon, but I can’t blame diabetes for that.
However, despite my belief that I am healthy, I can’t seem to avoid healthcare professionals. As well as my annual diabetes review, I visit the dentist for a checkup, the nurse for holiday jabs, the radiologist for a recent scan and the physiotherapist for tennis elbow (from climbing). And, during these visits, diabetes often comes up: the dental nurse asks if my “other conditions” are up to date; I ask the nurse if the jab will have any impact on my blood sugar levels; the radiologist when we discussed what to do with my insulin pump during a scan; and the physio when we discuss the downsides of a cortisone injection in my elbow.
My assumption was anyone in healthcare would know something about a condition that more than 3.7 million people in the UK have been diagnosed with. And, they do know something. Unfortunately, my experience has been they don’t know much.
Should I expect my physio to know about diabetes?
Take my recent trip to the physio. He is a great guy who knows far more than I do about physiotherapy. We meet once every three weeks when he re-evaluates my elbow, changes my exercises and suggests alternative treatment. After three months, the pain has reduced but it is not getting better as fast as either of us want: especially me as I want to get back to climbing.
Therefore, we have been discussing cortisone injections. I had one of these a few years ago when I hurt my thumb. I think the injection helped, but I had to endure 10 days of high blood sugars and extra pain (partially due to high blood sugars always magnifying any little ailment), so I would rather avoid repeating this with my elbow. On the other hand, if the usual exercises and manipulations are not working, we need to try something else.
So, to the cortisone injection discussion. I explained my reluctance. He told me it was OK as long as my fasting blood sugar was less than 7.0 the long-term effect would be insignificant. I tried to explain the short-term effect of a high blood sugar was a problem (which I may be able to handle by raising my basal dose). And, when diabetes is treated with insulin, I am not sure what is the relevance of a fasting blood sugar.
I don’t want to put a downer on my physio. His specialism is arms (hand to elbow to be precise) not pancreases. So why should I expect him to know about diabetes? It’s the same when I had an operation last year, I would not expect the anaesthetist to know how to handle an insulin pump.
I am the diabetes specialist
As a result, when we are talking about diabetes to anyone who is not a specialist in diabetes, I have to realised I am the diabetes specialist. It does not mean more that the person I am talking to works in healthcare: healthcare is a huge topic and we cannot expect anyone to know everything about our condition. Added to this diabetes is a complex condition which affects different people in different ways, so we are the only experts in our diabetes.
Thankfully, being an engineer, I am the kind of person who wants to understand how things work and, working in sales, I am used to explaining how things work to other people. However, this is not true for many people. Could our diabetes teams be proactive about providing a personalised diabetes pack to share with other healthcare professionals we come across? Could DAFNE and DESMOND type courses include a session on explaining diabetes? Or, with so many people with diabetes, should it be the responsibility of all healthcare professionals to know more about diabetes?
Share and read more tips on talking about diabetes
This Diabetes Week we want to make it easier to have those tricky conversations about diabetes. Share your tips on social media using the hashtag #TalkAboutDiabetes. You can also find out more, share your tips online and read tips from other people with diabetes on our Diabetes Week page.