An evaluation of the “Get Checked” by Auckland university has shown that the control of blood sugar levels in diabetics has not been improved by the program. This does not actually surprise me, as most improvement in blood sugar control comes from lifestyle changes such as eating the right food, exercising and loosing weight. Lifestyle changes are typically not effected by doctors – we and our practice nurses can talk until we are blue in the face and hand out a mountain of pamphlets, but people rarely change their lifestyles. It is practically impossible to persuade someone to forgo the immediate comfort of a couch-potato, KFC and chip eating lifestyle in order to preserve their kidney and heart function in 10-15 years time. Human beings don’t seem to be wired that way.
However, before the DHB’s abandon the “get checked” program as a failure, I should remind them that there is more to diabetic control than blood sugar levels. The program has ensured:
- Blood pressure and cholesterol levels are now better controlled
- Diabetics are at least having regular medical check ups so that we can detect problems sooner
- There was a small improvement in blood sugar levels and the current medical evidence is that even small improvements in blood glucose has long-term benefit.
So I don’t see the program a a failure or a waste of health dollars, but I do think that diabetics need far more than medical input. They need proper diet advice, including advice on purchase and preparation of foods (and, yes, that may include cooking lessons). They need input from lifestyle coaches who can help them get the exercise they need. All diabetics need to be seen by a diabetic nurse, instead of just the ones on insulin.
Diabetes is the foremost medical reason why Maori and Pacific health statistics are so poor. We need to put a great deal more effort into this problem, not less.
PS: I know someone is going to start talking about people taking responsibility for their own health etc. To this I say: