Try and comply…again.
I’ve been having a lot of discussions about “patient compliance” lately, which in the pharmaceutical industry means how well people adhere to taking their medicine and following a doctor’s advice. And in the diabetes world, you’ll hear a lot of healthcare providers gripe about a lack of patient compliance and that if patients just did what they are supposed to, they’d feel a lot better. True and agreed. But the real question here isn’t if lifestyle changes or medicines will help people if they do them/use them, it’s WHY don’t patients do what they need to do to get healthy?
Ask a patient if they’d rather be sick or healthy, and anyone of sound mind will tell you of course, they want to be healthy. So why don’t they lose weight/cut their carbs/test their blood sugar/take their pills when a healthcare provider has made it clear that this will make them better. Yes, there are patients who just aren’t motivated. But often time the barriers to good control are incredibly layered and psychological. They’re embarrassed to inject at work. They haven’t told their family members they have diabetes because they’re afraid and they eat what everyone else does at a family dinner. Or they think that everyone in their family gets Type 2 diabetes anyways and they can’t do anything to help it. Who knows. The bottom line is that the reason people don’t take care of themselves is most often more complex than meets the eye.
I was faced with a psychological barrier myself recently: as I’ve blogged before, I suffer from carpal tunnel and ulnar nerve issues in my arms which causes painful numbness at night that rouses me from my sleep. The last doctor I saw asked if wore arm braces at night that keep my arms in a neutral position, preventing the numbness. I told him I had them and that they help, but that I rarely wear them. Rightly so, he asked why I don’t wear them even though they help. I didn’t know the answer until the words came out of my mouth:
“It’s just that I already wear a pump and a CGM which sometimes beeps at night that I just feel like I’m already wearing so much hardware to a place that’s supposed to be comfy and cozy, the thought of putting on those hard braces is…unappealing.”
There it is. I’m the non-compliant patient here. It’s not a good reason for not wearing them, but it IS the reason I don’t do it. It’s not because I don’t know better or that I think they won’t work, I know they do. I just…don’t do it.
At the end of the day, we’re the captains of our diabetes ships (and overall health), and as with any chronic disease, it’s up to us to actually DO the work. And I ain’t preaching here, I’ve not been the most “compliant” patient these days (should we talk about what I ate after the half marathon? I think not). With diabetes, the challenge is finding that motivation EVERY DAY to try. Non-compliance happens, but at least we’re lucky enough to get to try again tomorrow. Onward, with some motivation and mojo!
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