Diabetes mellitus: a disease of one person or the whole family?

Only 3/4 of the relatives of patients with type 2 diabetes mellitus ask them about the results of a visit to the doctor, and this is where their involvement in the problem and support end. At the same time, people with diabetes, their relatives and doctors unanimously agree on the importance and necessity of supporting patients from the close circle. This is evidenced by the results of a survey in which 800 people from 7 cities of Russia took part .                     

In today diabetes 2 type is the most common pathology structure endocrine diseases. On his accounts for about 90% of all cases of diabetes. By Unfortunately, until now the disease enters a chronic, that is, it stays with the patient on life. However, experts note that diabetes is quite successfully treatable. The key role is played by timely diagnosis, adequate treatment and the implementation of the recommendations of the doctor.              

“The treatment of diabetes is aimed primarily at preventing late complications that may develop with inadequate treatment. It is in such a situation that constantly elevated blood sugar leads to damage to small and large blood vessels, which can result in a heart attack or stroke, serious kidney damage, ” says Olesya Gurova Ph.D. , endocrinologist, Permanent Medical University . I.M.Sechenova.          

To date, type 2 diabetes is the most common pathology in the structure of all endocrine diseases. On his accounts for about 90% of all cases of diabetes.      

Despite the appearance in the arsenal of doctors of modern effective tablets of sugar-lowering drugs and insulins, in our country, almost half of patients with diabetes mellitus do not reach the target glycemia. One reason is patient non-compliance with treatment recommendations . This is confirmed by doctors and relatives of people with diabetes who participated in the survey.            

Diabetes mellitus is a disease that requires patients to change their usual lifestyle. First of all, this is a change in nutrition, expansion of physical activity, body weight control, regular self-monitoring, constant intake of sugar-lowering drugs or insulin, counting bread units and so on. However, many patients are not ready for this step. The main problem is the fear of change.         

In Russia, almost half of patients with diabetes mellitus do not reach glycemic targets     

“Perhaps, for no chronic disease, the compensated course does not depend to such an extent on the patient’s lifestyle as in diabetes. But the “sentence” to a healthy lifestyle causes fear, and desperate resistance to change, and the desire to defend your favorite habits almost at the cost of your own life. Who or what can help the patient, keep from despair, support in changes? In psychology, there is the concept of “psychological support”. These are people, goals or objects with which a person has a close emotional connection. First of all, it is people. Therefore, the involvement of the patient’s close relatives and relatives in the treatment process , not only their sympathy, but also their active complicity, is so important , ”explains Larisa Rudina Ph.D. , associate professor at the Institute of Psychology of the Russian Academy of Sciences.                          

The maximum support of relatives is especially in demand at the stage of prescribing insulin therapy, when the tablets become ineffective. This is also noted by the endocrinologists who took part in the survey. If for a doctor prescribing insulin is a certain stage of the disease, and insulin is another drug, then for patients it is, above all, a collapse of life principles. As a rule, in many patients the fact of prescribing insulin is associated with a sharp deterioration of the disease, which, in fact, is far from reality.            

The maximum support of relatives is especially in demand at the stage of prescribing insulin therapy, when the tablets become ineffective   

In every person with diabetes 2 type, sooner or later there is a need for insulin, and this is due, above all, with the passage of the disease. Our main goal in this situation is to help the patient overcome the negative attitude to insulin therapy, dispelling existing myths, Olesya Gurova believes. On today insulin is the most effective hypoglycemic agents. But only if it is used correctly (following the regimen prescribed by the doctor, the rules of the injection technique, following nutritional recommendations ), it can achieve normal sugar levels. That is why it is extremely important that relatives and relatives of a person with diabetes not only support and stay close, but help. To do this, they need to possess sufficient information. “For example, such simple advice as accompanying a relative with diabetes to a doctor’s consultation can be invaluable. Sometimes, most of the recommendations are not carried out because their patients do not remember, feel insignificant or not to fully understand their need. With the support of a loved one, who can not only listen to what the doctor says, but also understand the essence of the problem, and later help to implement the recommendations, it is much easier to achieve diabetes compensation, ”the expert is sure .                                    

The knowledge of the patient and their relatives about diabetes, about how to live with him and how to manage it, is a great help for the doctor, because it’s easier to communicate with a trained person on such a complex topic as, for example, insulin therapy, it’s easier to convey information to him . It is the possession of certain knowledge and skills that allows patients to avoid the development of concomitant complications and live a full life. Patients can learn the basic rules of life with diabetes by attending special classes in diabetes schools, as well as in Regional Education Centers (RTCs). Classes in educational centers are conducted using innovative methods and approaches developed by the Federal State Budgetary Institution “Endocrinological Scientific Center” of the Ministry of Health of the Russian Federation. However, according to the survey, 1/3 of the respondents have never heard of diabetes schools and only 4 out of 541 relatives attend classes with their relatives .                           

A third of respondents have never heard of diabetes schools, and only 4 out of 541 people attend classes with their relatives .        

By Unfortunately, despite the fact that all family members are worried about the appointment of insulin, only 50% of respondents have any kind of support, and only 1/5 of them visits a doctor and find out what actions are needed to their side. Moreover, as experts say, the patient needs help from relatives not only at the start of insulin therapy, he needs it in everyday life. In what does it consist? This is, first of all, a constant reminder of the importance of insulin injections, as a patient who is on long-term therapy may have breakdowns, motivating the patient with positive examples, as well as providing support and monitoring in compliance with the principles accompanying insulin therapy. However, as the results of the survey showed, only 37% of relatives occasionally help to conduct a blood test for sugar and 43% help with insulin injections (of those patients who receive insulin).                            

Only 50% of respondents provide any kind of support, only 1/5 of them visit a doctor and find out what actions are required on their part     

Olesya Gurova warns that the incompatibility of insulin injections with a normal lifestyle is a myth. In the world people receiving insulin therapy in any age, lead an active lifestyle, work, travel, drive cars, doing your favorite sports and achieve their life goals.         

As the results of the survey showed, only 37% of relatives from time to time help to conduct a blood test for sugar and 43% – insulin injections.     

“Numerous studies show that psychological support is a prognostically accurate factor in behavioral success. That is, when there is someone nearby who supports you, success becomes much more likely and reliable. Moreover, if at first a person is able to cope with very serious problems independently , in the long run it is difficult to overestimate the need and effect of support. Therefore, it is very important to help a loved one comply with the doctor’s recommendations, not just formally be interested in health, but to understand the essence of treatment, try to control the whole process, support the patient both psychologically and real actions, ”says Larisa Rudina.              

The fight against diabetes is a team work in which the attending physician, the patient and his relatives are involved . Only by combining joint efforts, setting specific goals and objectives, building a strategy, and also distributing areas of responsibility in a team, you can achieve brilliant results that will allow a patient with diabetes to live a long and fulfilling life.           

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