CONSUMERS/QUALITY: A DIY Approach to the Diabetes Epidemic by Amy Tenderich

#1 health care blogger, well actually #1 patient blogger, but probably the most important one in the whole medical blogosphere, Amy Tenderich has written a book called called Know Your Numbers, Outlive Your Diabetes about (obviously) how to manage diabetes. We don’t deal much with actual medical care over here at THCB, but for your holiday Monday I thought that an introduction to her book would be a great start. And of course who better to introduce it than Amy herself!

Forget any inkling you may have had that the media is sensationalizing the "diabetes epidemic"€ story. It’€™s real folks. In fact, the American Diabetes Association just launched a campaign called "Every 21 Seconds"€ as in that’€™s how often another American is diagnosed. Diabetes now affects the lives of 20.8 million children and adults in this country, and at the going rate, could rise to 50 million by the year 2025.
With the medications and tools available here in the US, the devastating effects of this disease are largely preventable.

So why aren’t patients doing better? A few simple reasons: they’re
often under-informed and/or overwhelmed by their diagnosis, and we’re
all pretty much stuck in the outdated state of mind that the doctor
is responsible for treating what ails the patient. In fact, even if
there were enough providers with enough tools and knowledge to handle
every person with diabetes in this country (far from the case), this
still wouldn’t be sufficient, because diabetes is the ultimate self-managed disease.
Unless patient themselves know what to do day-in and day-out, and are
motivated to make these efforts, they are on the direct path to the
damaging complications of diabetes, including heart attack and stroke,
blindness, and limb amputations.

Why aren’t people diagnosed with diabetes or pre-diabetes motivated to achieve a long and healthy life, you ask? They are, of course. Everyone wants to live well. The trouble is that most patients are on the "do-what-your-doctor-says" or"try-to-do-everything-at-once" diabetes treatment plan, which both tendto lead to inertia, because: 1) diabetes requires dynamic day-to-day management, rather than minimal check-ins with your doctor just 3-4 times a year; and 2) trying to make drastic lifestyle changes can be incredibly overwhelming and frustrating.

In counterpoint, what I try to espouse over at my blog, www.diabetesmine.com, is the "Do-It-Yourself-Good-Health-With-Diabetes" approach: you’ve got to learn some basics and take achieving a healthy life into your own hands, rather than expecting some medical
professional to do it for you.

Amazingly, while the "therapeutic goals" for diabetes patients are well-publicized, nobody gives most patients much idea how to achieve them. Until now, no useful, practical guide existed to help people with diabetes get a handle on their own health

So Dr. Richard Jackson, Director of Outreach at the Joslin Diabetes Center in Boston, and I have paired up to create just that – the first-ever, hands-on DIY guide to avoiding the long-term damage that diabetes can cause.

In very plain (and hopefully somewhat amusing) language, our new book teaches readers to understand, track, and prioritize their own 5 most critical health factors — A1c, blood pressure, lipids (HDL, LDL, triglycerides), microalbumin, and yearly eye exam. If any values are out of range, we offer detailed strategies and doable action plans for improving them.

These 5 simple medical tests are currently the best and only measures indicating each person’s own individual diabetes health risks. Yet despite being widely accessible and easy to administer (and covered by nearly every health plan), fewer than 42% of adults with diabetes have either had these tests, or understand what the results mean, according to an April 2006 report by USA Today.

We think this book, called Know Your Numbers, Outlive Your Diabetes, can be powerful for millions of Americans whose lives are touched by diabetes. It gives them the ability to more precisely and successfully manage their health with diabetes, and can thus help chip away at this nationwide epidemic.

We’re pleased to report that early reviews from physicians, patients, and diabetes educators support the DIY approach as a turning point in diabetes care.

10 replies »

  1. Re: … We have designed a food chain that produces cheap toxic food which passes the costs on to your healthcare budget.
    I would like to say that WE, the consumer, have not made enough fuss about what’s in our food, leaving nutrition to the government (Dept of Cows and Chickens, not nutrition), just like many leave their health care in the hands of their physician.
    But we vote with our money EVERY DAY. No one forces us to buy garbage; we do it based on cost, not nutritional quality.
    Use your grocery money to kick some processed-food A**. Stop buying lousy apples, packaged vegetables with corn syrup in the sauce, and meat that is given antibiotics to make it grow fast.
    Organic foods are too expensive? You’re going to pay the money one way or another. It’s just a question of will you pay it for good food up front, or pay ten times as much for sick care at the back.
    It’s your choice. Always has been.

  2. From my experience as a former diabetes diagnostics rep, most glucose monitor manufacturing companies will jump to the (initial) aid of patients without insurance – marketing their monitors to them free of charge.
    However, the larger and continued cost comes into play with the strips required for the individual tests. The strips are spendy items, and of course you don’t get THOSE for free.
    Additionally, I have seen D&E (diet and exercise) work wonders for people with Type 2 DM. Unfortunately, by the time someone has been diagnosed with Type 2 DM, many of the deep-seeded behaviors that got them to that point in the first place are in direct contrast to the ones that could make a big difference in their disease state. Still… it’s worth broaching the topic!

  3. Here is an excellent site for those with diabetes, or questions abour coverage in their state.
    Click on “Government Affairs and Advocacy” then
    Click on ” Health Insurance Options”.

  4. Amy, I did pass this link on your book to a friend with diabetes. He takes pills and watches diet, so no insulin yet. His GP did not have a clue about control so he has switched to specialist. By the way he has a very good state retirement healthcare benefit that covers most costs, so the specialist is not a barrier. I don’t know how the uninsured get diabetes monitoring.

  5. I’m quite the omnivore myself. You need a lot of protein if you want to keep your blood glucose stabilized.
    Anyway, thanks for the input on our book. In fact, there is a very fat chapter on dealing with food (no pun intended 🙂

  6. “Appetite for Profit” by Michelle Simon.
    Posted by: john
    John, I’ve put it on my to get list, thanks. At present I’m reading “The Omnivore’s Dilemma”, by Michael Pollan. I’m not done yet but if want the inside history of the government/ag industry conspiracy on industrial food production this is a must read. We are basically a processed corn fed nation with some alternate in soy beans as they rotate well with corn. Every page reminds me why I became a vegetarian.

  7. Peter,
    Good point. I just got a pretty good book that came out this year on this very subject. “Appetite for Profit” by Michelle Simon. It’s quite current.

  8. One thing this book won’t do is change the junk food crap and industrial food crap causing diabetes. We have designed a food chain that produces cheap toxic food which passes the costs on to your healthcare budget.

  9. One of the most interesting things is the disconnect right now between the P4P quality measures and the actual day-to-day issues associated with chronic diseases.
    Most quality measures right now for diabetes are done on an annual basis and may/may not have actual clinical values associated with them. Basically, a physician/medical group is giving a diabetic ideal care if they tested their HBA1c once in the past 12 months.
    Health care does need to measured but I do agree with physicians that the actual quality measures right now mean very little in regards to the actual day-to-day care of a chronic disease. Just a big disconnect.

  10. Physician-centered chronic disease care works poorly. Patient-centered chronic disease care works better. Patient-centered, physician-facilitated chronic disease care “should” work the best.
    This looks like an interesting book; will have to check it out.