Fundamentals

Something’s been bothering me, something I had forgotten.

A few weeks ago, my friend was diagnosed with Type 2 diabetes. I was sorry to hear it, but it ran in her family and she said she was on solid ground and that her family was supporting her, so I figured that she had the help she needed. I made sure she knew she could call and ask questions whenever and then I let it be.

Cycle forward about a month. I called to check on her, and it turned out that she didn’t have the help she needed. And by help, I mean information. And by information, I mean fundamentals. Yes, she was following the regimen that had been given to her at diagnosis, but no one had explained to her why she was on that regimen. They had given her a target blood sugar range that was the end goal without telling her that it’s ok if it’s more of a stepped process instead of immediate. Your body has adjusted to the higher blood sugar for better or worse, and as you come down, you are going to feel really sick until it adjusts to the new healthier range. Unless you are in crisis, or immediate danger of serious complications, which she was not, dropping from the sustained high blood sugar to “normal” can be dangerous. They hadn’t even taken the time to tell her what Type 2 diabetes was and how it worked.

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So much missing information.

Immediately, I thought, “Why? Why didn’t someone in the emergency room take 10 minutes to explain what was happening to her?” And then, I remembered. No one does. No one explained any of my conditions to me at diagnosis, especially when I was a kid. My knowledge comes from research, experimenting on myself (not necessarily in a good way), and asking questions. Lots and lots of questions.

That isn’t right. If we want the best possible outcomes, it seems reasonable that we tell people what part of their body isn’t working properly and why the recommendations and the prescriptions will help return their body functions to normal. It doesn’t have to be in-depth. The fundamentals will do in the beginning: “Type 2 diabetes is when your body doesn’t make enough insulin to cover your current dietary intake. There are several ways we can address this, and the most effective course is usually a combination of medication to increase insulin production, exercise to burn some calories without insulin, and decreasing caloric intake so you don’t need as much. It wasn’t your fault. (Eating sugar cannot cause diabetes -- you have to be predisposed and your body has to stop functioning properly.) We will work together to get your blood sugars down to a healthier range. It will take a lot of work, but we can do it.” So not even 10 minutes. If most people speak 100-150 words/minute, it comes down to one minute. Not a big ask.

If someone had bothered to take that minute to explain even that much to my friend, she wouldn’t have been beating herself up for not hitting the target a few weeks out. Her mental health wouldn’t have taken the hit it did. And perhaps without those stresses, she would have reached her target range faster.

Of course, it’s not just diabetes. Most diagnoses can be effectively explained in a minute or two beyond, “Your test results say this. That means you have that.” It might also help to explain what the test results are and why they indicate that you have the condition.

But I won’t push. Right now I would settle for the fundamentals.