DIABETES: Keeping Overwhelmed Under Control
Dealing with the day-in/day-out stress of the disease
BY:MYRA DEMBROW
Living with diabetes can be so difficult that some people find it disheartening, and that attitude can create conflict.
"The people who care for those with a chronic disease like diabetes think about that disease and about preventing long-term complications," says Elbert Huang, MD, assistant professor of medicine at the University of Chicago Medical Center. "The people who have a chronic disease think about their immediate lives."
Diabetes regimens are geared toward both controlling the disease and avoiding complications. As a result, adults with diabetes typically take as many as eight pills a day to control blood sugar, hypertension, cholesterol and blood clotting. They must monitor everything they eat and drink, exercise regularly and check their blood-sugar levels several times a day. Some require insulin injections.
The cumulative result has a powerful impact on their quality of life, Huang's research team reports in a study appearing in Diabetes Care. The team interviewed more than 700 patients with type 2 diabetes. Between 10 percent and 18 percent said they would give up eight to ten years of healthy life to avoid their regimens.
The result is often poor compliance, which leads to long-term complications requiring even more medications and treatments, Dr. Huang says. For example, foot problems associated with diabetes can lead to amputations. In that regard, it's good for all diabetes caregivers to heed the U.S. National Diabetes Information Clearinghouse recommendations regarding daily foot care:
- Wash feet in warm—not hot—water
- Make sure feet are completely dry
- Inspect for blisters, calluses, cuts, sores and redness
- Apply lotion for dry skin, but never between the toes
- Gently file down corns and calluses with a pumice stone
- Don't walk barefoot, always wear socks or stockings, and make sure shoes fit properly
Dr. Huang's findings "certainly ring true with me," says Louis Philipson, MD, PhD, a diabetes specialist and professor of medicine at University of Chicago Medical Center, who as not involved in the study. "Some patients, if you judge by their behavior, would rather be well on the road to future blindness, kidney failure or amputations than work hard now at their diabetes."