Expert Insights

Working with patients to help lower their A1C

Diabetes, that word strikes fear in so many patients; they think of shots, a family member who lost a limb or went on dialysis, or someone they know who died from complications. It can be a challenge to treat, but I believe it can be more easily treated and managed by clinicians. 

First and foremost, is having an open, honest therapeutic relationship with your patient. It is our job to spend a little extra time to see what fears, access to care, or financial implications that might interfere with a good treatment plan. Simply saying "watch your diet and exercise", isn't helpful. Knowing what hinders them at home and work is helpful for everyone.

In most situations, letting the patient know that you are with them on their quest for a healthier life, getting on their level, asking about their families, helps build a greater rapport, which in turn helps with compliance. 

I tell my patients, "I am your cheerleader, and biggest fan. I want you here another 10, 20, 30 years, etc." We cheer, high five, and even hug as they meet each goal. When they don't meet goals, we collaborate and revamp out plan. 

Accountability is crucial. Often times I will bring my patients with uncontrolled diabetes in on a monthly basis. We review blood sugars, any barriers, and victories they have made. Even my most well controlled diabetics, I have come in every 3 months. 

I hear so often, "well they are just non-compliant", and while that is true for some patients, I believe most patients want to live their best life. Sometimes it just takes a little sideline cheerleading, accountability, and a good provider-patient relationship to make that happen.