HCP’s Perspective on Diabetes Success: Learn to Celebrate the Small Wins
Many with type 2 diabetes often believe diabetes management is all about what their A1C says every three months. But, so much more goes into what successful diabetes self-management and care looks like. In the interview below, Quisha Umemba RN, CDCES, CHWI, the co-founder of the non-profit Diversity in Diabetes, shares her perspective on what it means to think of success with diabetes outside of clinical guidelines.
Why is it important for people with type 2 diabetes and their providers to define success with diabetes outside of the A1C clinical guidelines? What other health factors (mental, physical, emotional) should they pay attention to?
It’s important for both providers and patients to know that disease does not define them. There are many factors that go into a blood glucose reading and an A1c. Sometimes, those factors can be controlled, sometimes they can not. Success should measure aspects of a patient’s life that they can control.
What are some ways or examples you’ve helped your patients define success? How did they measure it? Is there a brief story about your experience with your patient that you can share?
With the Virtual Diabetes Education Program [at Diversity in Diabetes], we focus on not achieving a ‘perfect’ A1c but rather focus on achieving small weekly goals that are tailored to each participant. I think when someone with diabetes is given resources and education to help them decide what would be best for them to work towards then success feels that much sweeter.
For instance, I have worked with an individual who came into the program wanting to lose weight and lower their a1c. As we went through each week and talked more about each individual diabetes self-management skill they decided they wanted their goal to be the implementation of daily blood glucose monitoring. At the end of the program, they felt successful because they had added multiple blood glucose level checks into their daily routine. It was even better than with achieving this new goal they also saw an a1c decrease from 8.1 percent to 7.3 percent.
I also think that it is so important to understand that living with diabetes unpredictable things can happen. Mentally, it helps so much to sit down at the end of the day and reflect on what you did that felt successful to you. This could be drinking more water than normal, taking the dog on a walk even though you did not want to, or taking time out of the day to do something nice for yourself.
As a provider, how much emphasis do you put on following clinical guidelines for A1C or time-in-range?
There’s not a clear-cut answer as it really depends on the patient, their health status and other individualized factors. I will be honest, there are times when the patient really needs to be at goal. For example, when they need to qualify to have a surgical procedure or operation. When I was providing diabetes education, I encouraged my patients to follow clinical guidelines and the provider’s recommendations but I also helped them celebrate the small wins. If a patient came in for a follow-up visit and their A1c wasn’t at goal, but they had lost 10 pounds since the last visit, that’s a success! It’s important for patients to understand we’re not trying to get them to get all A’s in diabetes. Diabetes isn’t good or bad, black or white.
Do you think success with diabetes can also include mental and emotional well-being, why or why not?
Absolutely! There is a huge mental aspect to managing diabetes. In my experience, the mental and emotional aspects of diabetes often need to be addressed before patients can successfully manage diabetes.
When you’ve spoken with your patients who feel as if they aren’t reaching their health goals/A1C goals, how do you inspire them to keep going? What words of advice/inspiration do you provide?
I help them celebrate small wins. I tell them they didn’t develop diabetes overnight so there are not going to have it all figured out in one night. I ask them what’s important to them and what would they like to focus on and help them set individualized goals. I meet them where they are.
Do you think access to diabetes education and self-management courses can help patients see their diabetes beyond just A1C?
Absolutely, yes! There are so many psychosocial aspects of diabetes care and management that are addressed in DSMES, it’s extremely important for patients to have this type of education to understand how everything, life in general can affect their mood, their emotions, their mental state, overall health and well-being and ultimately, their diabetes.
Read how Bill Santos, a person with type 2 diabetes, shares how he defines success and finds happiness with it.
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