Importance of Education of the Diabetic Patient by their Health Care Team

It is no surprise that the United States is always at the top of the obesity charts, and with obesity comes type 2 diabetes. With that comes all of the co-morbidities (diseases also caused by being diabetic) and life-altering and threatening complications. While preparing for a board exam last year, I was surprised at how different the statistics (in European countries) were when it came to a health care provider taking the time to talk and communicate with the patient, their family, and the other members of the care team, they noticed a drop in the incidence of complications (not just limited to the foot).

I am also surprised when I see a new patient for a diabetic foot exam that has been diabetic for 10+ years but this is their first time seeing a podiatrist. In January 2021, Diabetes Care released an article, "Improving Care and Promoting Health in Populations: Standards of Medical Care in Diabetes". One of the highlights I really love is caring that is proactive, not reactive. This means by educating the patient, we can hopefully prevent kidney failure, cardiac issues, loss of sight, or non-healing wounds/limb loss. Once diagnosed as being diabetic, your primary care provider should refer you to see both a podiatrist for a foot exam and to the optometrist/ophthalmologist to heave your eyes checked.

As a podiatrist we exam your circulation, your nerve sensation, and the overall appearance of your foot and range of motion. Based on what we find, we communicate what risk category you fall into, and follow up is based on this. Patients with changes in sensation or circulation, and/or inability to care for themselves should see their podiatrist routinely for nail/callus care as a way to avoid complications. I also love to dispense education material to review daily prevention skills as well as self-care. Most important we make sure they know what to look for and when to be concerned and do not hesitate to reach out.

Also using evidence-based results and continuing to learn and alter care plans based on new information. What this means in layman's terms is that we have care providers evolve treatments based on what current research studies tell us. It is so important to keep of with the times!

Another big one is self-management support. The patient should understand their diabetic medication isn't a cure-all. They have to do their part in regards to diet and exercise (if appropriate), seeing all care providers routinely, and not be afraid to reach out when concerned. I always encourage my peers to learn about their patients, what things they enjoy doing in their free time, and what their home lives are like. Understanding the person and their support team really helps to tailor prevention and treatment plans. Not to mention, having a relationship with the patient makes them more comfortable with reaching out.