How can we make diagnosing type 2 diabetes more difficult?

[00:00:00] Scott K. Johnson: Welcome to BDI Brief. This is another exciting episode that briefly examines important emotional issues of living and working with diabetes. Thank you for joining us today. I’m here with Dr. Bill Polonsky.president of Behavioral Diabetes Research Institute and Dr. Susan Guzman, Director of Clinical Education. Behavioral Diabetes Research Institute. They are both world-renowned diabetes psychologists and two of my favorites.

My name is Scott Johnson. I have been living with diabetes for over 40 years and have been active in the diabetes social media space and industry for many years.

So without further ado, Bill, what are we going to talk about today?

[00:00:53] Dr. Bill Polonsky: Thank you, Scott. I want to highlight a topic that really doesn’t get enough attention. And this has implications for what happens when people with type 2 diabetes are first diagnosed. The day they first found out they had type 2 diabetes. And often it is not understood that this is a very difficult moment for people. Sometimes very strong emotional reactions occur, and often very strong negative emotional reactions occur. People are scared of what this means for my future and how others will see me. All I worry about is disappointment and discouragement because I thought I was doing everything as well as I could, but how could this be happening? This premonition of death, will my life be shortened? Not dealing with so many strong emotional reactions can actually prevent people from dealing with diabetes effectively.

So people might end up saying, “I’m not going to think about that.” And over time it can lead to really bad outcomes.

So, as medical professionals, we know that there is this special moment when we sit down with someone who is learning for the first time that they have type 2 diabetes. How you talk to people about it can have a big impact.

And the reason we’re talking about this today is because as I was looking through recent literature, a series of recent articles really struck me.

A small qualitative study by colleagues. We will now tell you the name of the first author. I’m afraid of mispronouncing it, but I think it’s pronounced Boa-key. So she and her colleagues actually proposed these three great papers of hers that have been published over the past few years. These papers emphasized, first of all, that these very serious and alarming negative emotional reactions to society are very common. The diagnosis of type 2 diabetes is (https://pubmed.ncbi.nlm.nih.gov/36714250/).

Also, how rarely these feelings are addressed, talked about, or asked by health care providers, and how common it is for people not only to feel fear and anxiety about the future, but also to feel abandoned. and the importance of what they mention. Having type 2 diabetes and not really knowing what you need to do next, feeling like you have someone on your side who can really support you, etc.

And she also says that in these articles she and her colleagues are asked about what patients want, what they need, and how they feel when they find out they have diabetes. Emphasize what you want. Their questions will be resolved and better support will be provided. Therefore, I highly recommend checking out some of these articles. These are published in Clinical Diabetes and Diabetes Spectrum, which have just been published in the last few years.

The bottom line is that what these articles are telling us highlights what we’ve actually known for a long time. So this big problem exists and we can do better. What should we do and how should we go about it? Well, I’m proud to say that my colleagues and myself have been thinking about this issue for many years over the past few decades.

In fact, all the way back in 2017. The first in a series of articles has been published We surveyed more than 3,500 people around the world. There were participants from 26 countries. And we asked them, all of this he is a type 2 diabetic, what happened to them when they were diagnosed, the good and the bad. Specifically, we wanted to know what happened to them during their interactions with health care providers.

One of the things we looked at was the moments that were really good for you. It helped him feel that he could live with type 2 diabetes for the next few years and that he could actually take on the challenges of type 2 diabetes and feel okay about it and be successful. .

These two factors were particularly salient in our study. When I say, of course I’m going to go, but it’s often difficult to put it into practice.

One is the extent to which healthcare providers were able to send encouraging messages to these newly diagnosed patients.

I want people to know that just because you are Type 2, this is not a death sentence. Here in the 21st century, that’s quite possible. With enough care and effort, you have a good chance of living a long and healthy life with diabetes. And it gives an encouraging sense of what Type 2 means and how it can be done. But we are also doing this in a collaborative way. This is his second point.

So we need to not just tell people this, we need to have a conversation. Ask people about their concerns. Ask them what their questions are. Wherever possible, make sure people understand that they and their health care team will work together to do this. See you again soon. Let’s see where we go next.

We would like to work with you to come up with a plan that is achievable for you. And we’ve found that these two factors have a huge impact on people’s success over time. Now, in these recent articles by Boakye and her colleagues, again, just in case she, her, or any of her colleagues who are listening right now, I apologize if I got the name wrong, but they did a really great job. In one of her previous articles, she proposed an important topic: what we, as healthcare providers, need to do for our patients. The first picture is from her 2022 article. And this actually seems to be well followed from our own paper. And it talks about the importance of not just telling people this, but having it as a conversation.

So I’d like to take a moment and talk about what they proposed with this beautiful figure. And I can’t do it as well as my colleague Dr. Guzman. So, Susan, please explain a little bit about what’s on this table.

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