According to the Arkansas Department of Health (ADH), an estimated 797,000 adult Arkansans have prediabetes. They are at high risk for developing type 2 diabetes. In Arkansas’ more rural counties, it can be challenging for families to access healthy foods consistently. The only grocery stores close to them often sell cheap, processed foods. Healthier options are more costly and farther away. An unhealthy diet combined with poor physical activity can lead to Type 2 diabetes. However, Arkansas health care professionals can take steps to encourage patients to prevent and treat diabetes.
I’ve asked Laura Hieronymus, DNP MSEd, RN, MLDE, BD-ADM, CDCES, FADCES ADA, the vice president of Health Care Programs for the American Diabetes Association (ADA), to help identify the barriers that exist for patients in rural areas, resources for providers, and ways health care professionals can collaborate to promote a healthier community.
Some of the most significant barriers keeping people with diabetes from recovering quicker or living healthier lives are the cost of medication and treatment, lack of access to healthy foods, and a lack of reliable transportation. “All of these barriers may be overcome by learning what resources exist to help with management,” Laura says. “When diabetes is diagnosed, it is important to have a team of health care professionals to help the person with diabetes. Diabetes is a chronic disorder, so early on, it is essential to have people with diabetes learn all they can to help them thrive.” One of the ways that they can do this is by reaching out to health care professionals who have the tools and knowledge to properly educate patients on ways to treat their diabetes once diagnosed.
Telemedicine also helps patients break down health care barriers, especially in rural populations. “There is a growing body of evidence that supports telemedicine’s effectiveness, particularly regarding optimal glucose and A1C targets,” Laura says. With web-based portals and text message capabilities, providers can communicate more easily with patients with diabetes than before. “Other virtual environments can also offer diabetes self-management education and clinical support,” Laura adds, “and may remove geographic and transportation barriers for people with diabetes living in under-resourced areas or with disabilities.”
While providers communicate directly with patients who have diabetes, health care organizations also have an important responsibility to educate providers on resources such as the National Diabetes Prevention Program (DPP) and the recognized/accredited services for diabetes self-management education and support (DSMES). “The National DPP is a partnership of public and private organizations working to prevent or delay Type 2 diabetes and is designed for those at risk for Type 2 diabetes and those with prediabetes,” Laura says. Providers and patients can visit the Centers for Disease Control and Prevention National DPP. “Services for DSMES can be found by locating those that are ‘recognized or accredited’ to offer people with diabetes high-quality education services,” Laura adds. Options include the American Diabetes Association Education Training Program and the ADCES website. Providers should also work with their health care systems and local health departments to discover more resources for DPP and DSMES.
Laura also mentioned that it is essential for providers to collaborate with others inside and outside of their workforces to provide care for people with chronic health conditions like diabetes and to facilitate self-management for people with diabetes. Diabetes management is a group effort requiring multiple parties, including the patient, to work together to ensure that treatment is successful. While resources like telemedicine, National DPPs, and DSMES systems successfully delay and treat diabetes, patients with diabetes often face stigmas surrounding their diagnosis. Through positivity and collaboration, providers can help patients push through and thrive, despite the negativity around them.
“The use of empowering language in diabetes care and education can help inform and motivate people,” Laura says, “yet when language shames and judges people with diabetes, this may undermine the efforts made to help them be their best selves.” All it takes is a few words, and someone again feels ashamed of their diagnosis. Instead of being motivated to fight and to get healthier, a person may give up and feel like they can’t keep going. They may even revert to old habits that perpetuate their diabetes. For patients with prediabetes, shaming and other judging language could be the difference between prevention and diagnosis.
“All health care professionals working with people with diabetes can use language free from stigma. During discussions with patients, [providers should] use neutral, nonjudgmental language based on facts, actions, or physiology/biology,” Laura says. “Ideally, providers use language that fosters collaboration with people with diabetes.” Learning to be positive and think about the language they’re using can help providers develop a stronger relationship with their patients that will aid in their recovery. Laura also mentions the importance of using patient-centered language. Instead of saying “diabetic person,” Laura recommends that providers say “a person with diabetes.” Patient-centered language helps keep the focus on the person rather than the illness.
While patients have many resources to aid them in preventing and recovering from diabetes, providers must help push them in the right direction. Providers have the critical responsibility of assisting patients in knowing where to turn. Health care organizations must also work with providers to ensure they know the best and most successful resources and methods to improve the provider’s quality of care. While diabetes is a chronic illness that affects hundreds of thousands of Americans every year, there are resources in place that keep it at bay and allow people with diabetes to live their everyday lives. Arkansas providers and health care organizations have work to do. Still, with the proper support and continual collaboration, they are closer to making a difference in the lives of thousands of patients diagnosed with diabetes.
Sources
- American Diabetes Association. The Standards for Medical Care in Diabetes—2022. Diabetes Care, 45(1), S1-S264. Retrieved from Volume 45 Issue Supplement_1 | Diabetes Care | American Diabetes Association (diabetesjournals.org)
Dickinson, J.K. (2018). The experience of diabetes-related language in diabetes care. Diabetes Spectrum, 31(1), 58-64. Retrieved from The Experience of Diabetes-Related Language in Diabetes Care | Diabetes Spectrum | American Diabetes Association (diabetesjournals.org)
Dickinson, J.K., Guzman, S.J., Maryniuk, M.D., et al. (2017). The use of language in diabetes care and education. Diabetes Care, 40, 1790-1799. Retrieved from The Use of Language in Diabetes Care and Education | Diabetes Care | American Diabetes Association (diabetesjournals.org)
