Diabetes management is a serious concern for nearly one-third of the U.S. population.
The Centers for Disease Control (CDC) reported in July that as of 2015 – the most recent year for which data is available – more than 100 million adults in the United States were living with diabetes or prediabetes. Of those, 30.3 million (9.4 percent of the population) had Type 1 or Type 2 diabetes.
It is a health challenge that, quietly, is as potentially devastating as any the American public has faced in its history.
The word “quietly” applies because, according to the CDC, one in four American adults living with diabetes – more than 7 million people – are not aware that they have it.
In response, the CDC created its National Diabetes Prevention Program. Because so many people with diabetes do not know it, one of the key components of the prevention program is to increase awareness.
In addition to advising individuals about vital lifestyle changes that can help prevent the development of Type 2 diabetes, the CDC provides a detailed plan for healthcare professionals to work with their patients to prevent, diagnose and treat diabetes and prediabetes.
A major takeaway from the CDC’s deep diabetes resources is that it requires a team to tackle diabetes. It starts with the individual, of course; diabetes prevention and detection is much more likely if a person takes an interest in his or her own health.
Here is a breakdown of the roles played by various stakeholders – patients, physicians, nurses, therapists, and more – in the ongoing quest to prevent, diagnose and treat diabetes:
Patient’s Role
The “team captain,” so to speak, is the patient herself or himself. Every individual should accept the responsibility to know his or her risk factors, curb potentially harmful eating habits and motivate the healthcare team to monitor, screen and otherwise address the potential for prediabetes and diabetes.
Patients need to be able to answer this important question: Are you considered at-risk for prediabetes or Type 2 diabetes?
Find out if your parents or other close relatives have been diagnosed with diabetes or other glycemic disorders. Learn about healthy eating habits and determine a healthy weight based on your body shape and type.
If a physician recommends that a patient enter a lifestyle change program, that patient needs to be ready to embrace those changes whole-heartedly. That means learning to:
- Eat healthy
- Increase physical activity
- Handle stress
- Work through moments of weakness (especially regarding food!)
- Set goals and live up to them
Individuals who are considered at-risk for diabetes should ask their primary care physicians about tests that screen blood sugar levels.
Physicians’ Role
The physician is the “quarterback,” the person who triggers all major screening and treatment decisions and represents the focal point for all other healthcare personnel involved in the fight against diabetes.
The physician is responsible for all of the major elements of the American Diabetes Association’s Standards of Medical Care in Diabetes. The ABA’s publication provides clinicians, patients, researchers, insurance companies and other stakeholders with updates and best practices for diabetes prevention and care.
These elements include:
- Diagnosis and classification
- Assessment of comorbidities
- Lifestyle management
- Glycemic treatment
- Obesity management
- Cardiovascular disease management
- Microvascular complications and foot care
While a physician obviously can’t force the patient to stick to a treatment plan, he or she can explain the potential consequences in clear detail to make sure the patient understands the risks.
Nurse’s Role
With diabetes management, as with many chronic diseases, a nurse typically represents the first and most frequent point of contact for the patient. A nurse is often responsible for taking vital signs at the start of an office visit, and for asking key questions that will help a physician later to determine the efficacy of a specific form of treatment, or to determine how well the patient adheres to a treatment plan.
Phlebotomist’s Role
The test that provides information about a patient’s blood glucose levels is called the A1C test, and it is administered through a blood draw performed by a certified phlebotomist, or healthcare professional trained specifically to draw blood.
The A1C measures the blood glucose levels over a period of three months. It is given as a percentage; a normal level is below 5.7. Anyone with a level of 5.7-6.4 is considered prediabetic. Anyone with a level of 6.5 or greater has Type 2 diabetes.
Checking blood glucose levels also is a regular part of diabetes management for patients.
Lifestyle Coach’s Role
If someone is diagnosed with diabetes or prediabetes, he or she will need to make lifestyle adjustments. Unfortunately, this probably won’t be a simple matter of reducing caloric intake and adding a walk around the block to the daily routine.
The CDC recommends undergoing a year-long lifestyle change program, led by a lifestyle coach who can serve as nutritionist, fitness guide and motivator. The lifestyle coach helps patients establish new habits, learn new skills and gain confidence in his or her own ability to manage diabetes.
For more information on diabetes management and detection, check out the CDC’s main diabetes page or the American Diabetes Association’s website at diabetes.org.
