Get Checked
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:
Yeah, right.
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Dec 4 08 2:06 pm
Actually a family history of type 2 diabetes (both mother and grandmother had it) was the reason I started eating better, exercising and as a consequence, losing weight.
Dec 4 08 2:33 pm
Effective blood sugar control is important for everyone, not just diabetics.
I swear by blood sugar control for weight loss and energy and I have no hint of diabetes.
Dec 4 08 6:28 pm
Nice to meet motivated people, ladies. But, of course, you are both special people because you read my blog.
Dec 4 08 7:53 pm
Blood pressure control is really the key, to be honest. What kills diabetics is cardiovascular disease.
I think annual diabetes reviews do help some people who are motivated to stay on track. But lots of people don’t care (yet) and no amount of legislation can make people change their habits. But studies do show that brief interventions by GPs , repeatedly mentioning things like should stop smoking should lose weight do have effects when people are ready to hear them.
How they’ll ever be ready to hear them when our advertising industry and the woeful ignorance of so many people about nutrition is not countered by sensible food messages.
I’ll know something is having an effect when fewer parents come and tell me their kids had pies for breakfast or hot dogs for lunch, and fewer poor children have their diet dictated for them by the what the school canteen stocks. I am shocked how many poor kids get 5 bucks a day for lunch, and have parents who never dream of creating a sandwich for a few cents. Or when less parents come and ask me if McDonalds is healthy, because thats why they buy their kids every day….
Sigh
It gets wearying being more worried for folk than they are for themselves
It certainly does.
Dec 6 08 11:05 am
The thing that stunned me about blood sugar control is how many things it benefits and the role insulin plays in so many things. I wish that information was more out there then people wouldn’t be so obsessed with avoiding fat, which is actually something very good for you in the right quantities and type, and embracing all carbs which are not by any means created equal.