Coping With Chronic Illness: What Goes Wrong
When it comes to self-managing chronic conditions, patients often make mistakes.
Like other chronic conditions, diabetes doesn't allow for any slack in treatment adherence. But according to certified diabetes educator Michelle C. Sheldon-Rubio, RN, CDE, it happens a lot. "Some patients think management leads to control [of diabetes] and control leads to cure. So then they think, 'I can go back to my old habits'," says Sheldon-Rubio, education coordinator at the Joslin Diabetes Center at University of Maryland Medicine.
That's why effectively educating patients about the disease is critical. "Part of the education process is to let people know that diabetes is a progressive disease, and it is chronic," Sheldon-Rubio tells WebMD. She sees self-monitoring as key to this education process. "By getting people to take their blood sugar before a meal and two hours after, they can see how their blood glucose levels change after they eat. They get immediate feedback," she says. "The more people monitor their blood glucose levels, the better off they are."
Many people with diabetes also don't realize the importance of routine exercise and weight control in helping keep their blood glucose under control.
Regular self-monitoring also plays a significant role in managing heart disease. Steven Nissen, MD, a cardiologist with The Cleveland Clinic, advises his patients to get automated blood pressure cuffs, take their pressure at home regularly, chart results, and bring them to office visits. "The best sampling of blood pressure is in routine daily life. It's a tremendously valuable part of the [doctor-patient] partnership," he tells WebMD.
Patients frequently fail at other components of this partnership, explains Nissen.
"The percentage of people who actually lose weight when you advise them to is about 5%," Nissen says. This, despite the central role that weight loss often plays in controlling heart disease.
Plus, many patients stop taking their cholesterol-lowering drugs without their doctor's approval. "They think they can take it temporarily and get benefits," Nissen says. "But cholesterol-lowering therapy is given for life. Patients are not comfortable being on medicine for life. We have to help people understand that having a chronic condition is not a fault," Nissen tells WebMD.