With the rate of diabetes and prediabetes continuing to trend upward in the United States, education to help people effectively manage this chronic disease has never been more important. To put the challenge facing our nation in perspective, the Centers for Disease Control and Prevention states that over 30 million Americans have diabetes and over 84 million have prediabetes, meaning their blood sugar levels are higher than normal but not yet high enough to be diagnosed with diabetes. Approximately 90 percent of those diagnosed with diabetes have type 2, which is associated primarily with lifestyle.
To ensure people with diabetes in our community have access to all the information and support they need, Mercy Health is offering a comprehensive Diabetes Education Program at Mercy Health – St. Vincent Medical Center as well at Mercy Health – St. Anne Hospital, Mercy Health – Perrysburg Hospital, and other locations. The program is recognized and certified by the American Diabetes Association.
According to registered dietitian Jeannie Wagner, clinical coordinator of Diabetes Education Services at Mercy Health – St. Vincent Medical Center, patients’ responses when first diagnosed with diabetes can vary considerably and often fall somewhere within the five stages of grief associated with loss or terminal illness—anger, denial, bargaining, depression, and acceptance.
“It’s really interesting,” she explains. “Some patients come to us already in the acceptance stage because, for example, they have a family history of the disease and had some awareness that they were at risk. Others might be in denial and argue that the diagnosis can’t be right or there’s something wrong with the testing. Still others might be in depression, lamenting that they brought this on themselves and could have avoided it if they’d been eating healthy foods and exercising. The responses really run the whole gamut. Our job as diabetes educators is to establish a rapport with patients, assess where they are, and then work with them at the stage they’re in. You really have to understand that psychological component.”
The Mercy Health Diabetes Education Program is offered on an inpatient and outpatient basis, and concentrates on the topics of healthy eating, being active, monitoring blood sugar levels, reducing the risk of complications, and the use of medications. The team works with patients to help them incorporate these elements into their daily lives as well as help them problem-solve when they encounter challenges.
“Managing diabetes takes a whole new routine, and there are going to be bumps in the road. For instance, if a patient’s blood sugar level is running high and they can’t seem to bring it down, we can teach them how to get it under control and help them adjust to their new reality with different coping strategies. It’s a patient-centered process. We look at ways to empower them to make their own decisions because people are more likely to change things that they’ve determined are issues. We’re here to support and coach, not to tell them what to do,” says Wagner.
Sandra Miller learned firsthand the support that comes from joining the program. Sandra was diagnosed with diabetes in May 2019 after she felt so ill that she ended up in the emergency room followed by a stay in the intensive care unit. She had no idea that she was diabetic.
Sandra began attending the Mercy Health Diabetes Education Program soon after leaving the hospital. She says that it has made all the difference in her managing this disease.
“You don’t know what you don’t know,” she says. “It’s an invaluable class. I don’t care what stage you are in—newly diagnosed or living with diabetes for years—there is always someone else you can learn from.”
One of the team’s goals is to broaden the program’s reach, with every newly diagnosed patient being referred right away and then returning once a year for a refresher so the healthy habits they’ve learned don’t fall away. Currently, less than 60 percent of people with diabetes have ever had formal diabetes education, whether due to lack of insurance coverage, inability to afford copays, being at a grief stage that makes compliance challenging, or other factors.
In some cases, patients don’t think diabetes education will benefit them because a family member had the disease and they believe they already know what to do—or they say they can get all the information they need from a pamphlet. However, as Wagner points out, “No two people experience diabetes in exactly the same way, so you can’t base your expectations on what happened with a family member. That’s like being a passenger in a car versus the driver. You may not really know where you’re going until you’re the one behind the wheel. Also, there’s a difference between reading about something and actually understanding how to implement it on a day-to-day basis. That’s where our program comes in,” she says.
Another challenge diabetes educators face is overcoming the misconception that healthy eating with diabetes means being assigned a highly restricted diet. Wagner points out that most foods can be accommodated in a diabetes-friendly diet, though it might be necessary to watch portion sizes and potentially limit how often certain foods are consumed. On the other hand, some patients think being on medications to help control their blood sugar means they can eat whatever they want whenever they want it, which is not accurate either.
Wagner likes to use the image of a dinner plate to help patients determine proper portions for different types of food. “Half the plate should be filled with vegetables, one quarter should be meat, and the other quarter should be starch. In addition to the plate, a serving of fruit or milk can be added,” she says. Of course, careful blood sugar monitoring goes hand in hand with healthy eating as well.
Another common misconception among patients with diabetes is that having to go on insulin means they’ve failed. The reality is, diabetes is a progressive disease that often requires different treatment at different stages. “We can often start out with control through lifestyle changes, including eating healthy, exercising regularly, and limiting stress. But eventually we may need to incorporate medications and then insulin or a combination of medications and insulin. It’s not your fault; it’s just that your body needs a little more help as the disease progresses,” Wagner says.
After only a few months, Sandra has controlled her levels and no longer requires daily insulin. She credits the amazing support of her husband and family as well as the invaluable education she received—and continues to receive—from the Diabetes Education Program.
“I learned a different way of looking at things, especially diet,” she says. “What I really learned is how truly uninformed I was.”
To schedule an appointment or to learn more about the Mercy Health Diabetes Education Program and locations, call 419-251-4505. ❦