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Top 3 Assumptions Clients Have About Taking Diabetes Medication
Asking three questions can help you come alongside clients who are ambivalent about taking medication for diabetes care.
There has been a lot of press surrounding the idea of food as medicine and that most people don’t need medication for blood pressure, cholesterol, or diabetes if they make the appropriate dietary or lifestyle changes. The suggestions regarding dietary and lifestyle changes include everything from becoming vegan to going carb-free or ‘keto’ to intermittent fasting.
Looking at the assumptions surrounding the “Food Is Medicine” movement, especially in diabetes care, can help you come alongside your clients and provide inclusive diabetes care. Ask yourself these questions:
Could clients be unsure why they need medication for diabetes, blood pressure, or cholesterol?
What specifically makes clients uneasy about taking medication for their diabetes?
Is the ambivalence caused by the different classes of diabetes medications available?
If you said yes to any of these questions, this article can help you understand the top three assumptions about medications for blood sugar management.
Assumption #1: A healthy diet can replace medication.
Let’s face it - diabetes is confusing, and the idea that food is medicine is adding to the confusion. Yes, a healthy diet is important for everyone; however, can it replace the need for diabetes, blood pressure, and cholesterol medication?
The current guidelines for diabetes care explain lifestyle changes are the first intervention, but they are unlikely to be effective long term. Why? Diabetes is a progressive condition, and type 2 diabetes has eleven core defects unrelated to food, eating, or diet. Helping your clients understand the four factors of diabetes is a helpful way to begin educating them. This model is something I created to explain there are four factors of diabetes - dietary, lifestyle, medical, and environmental – which intersect. The goal of diabetes care is to find a sustainable balance of these four factors. This teaching model can help you explore if additional lifestyle and dietary changes are possible, the environmental barriers to making these changes, and why adding medication can help clients find greater balance. The model makes it easy to reinforce the goals of diabetes care, which is having balanced blood sugar, not avoiding medication. It can also be helpful to share that 88 percent of people with diabetes take medication.
Assumption #2: Taking diabetes medications will cause problems.
Type 2 diabetes is genetically linked, meaning type 2 diabetes runs in families. This familial effect can impact how receptive your clients are to starting or adding some diabetes medication. Simply asking, “Has anyone in your family ever been diagnosed with diabetes?” can get the process started and help you get curious and learn about their experience. “What were the things that helped them manage their diabetes?” is another great question. Asking open-ended questions builds counseling trust and helps you understand many unspoken fears.
Patient: “My mother took insulin. I remember her having to eat, and then she would have these spells.”
Response: “Your understanding of insulin is because of your mother’s experience.”
Patient: “Yes, I saw her struggle, and I am afraid that taking insulin will cause problems. I don’t want to go on medication.”
Response: “That must have been really hard to watch.”
The patient nods in agreement.
Response: “You want to understand if things have changed.”
Patient: “Yes, I do.”
Response: “Understanding the different classes of medications would be a good place to start.”
Having your client feel seen and heard is foundational to Inclusive Diabetes Care. Clients’ questions and concerns about medications are real and often made worse because healthcare providers are unsure about diabetes medications. Explore the different types of medication by following these helpful links:
Assumption #3: Diabetes medications do the same thing.
Diabetes medications work in many places in the body. This handout by Kaiser Permanente is helpful. Learning about diabetes offers simple handouts in many languages. Helping clients understand that diabetes medications work in different parts of the body can help them understand why they may be prescribed one, two, three, or four different medications to treat or manage blood sugar, blood pressure, or cholesterol.
Promoting inclusion in diabetes care includes normalizing the need for diabetes medication. This can happen by coming alongside your clients and addressing their fears and concerns by acknowledging the social pressure to resist medication. Listening and anticipating concerns about taking medication will build your counseling relationship. Clarifying and reinforcing that diabetes medications work in different parts of the body and that diabetes is a progressive condition will help your client understand why medication adjustments are an important part of their overall diabetes plan.
Inclusive Diabetes Care, IDC offers monthly courses to help you explore four essential tools in providing Inclusive Diabetes Care. You can learn more about IDC and our programs in four ways.