As a specialist in diabetes, I have to take the endocrinology certification exam once every 10 years. My time is up in November, which happens to be Diabetes Awareness Month. This year, the theme of Diabetes Awareness Month is “Family and Diabetes.” As I reflected on my endocrinology knowledge, I realized that most of the knowledge and experience that I have accumulated over the past 10 years I did not learn in medical school and will not be tested on the exam. It doesn’t have to do with esoteric molecules or arcane side effects of infrequently used drugs. Most of the things of value I have learned over the past 10 years have to do with people and families.
When thinking about the impact of diabetes, and other chronic diseases, it is easy to focus on the patient, while neglecting to consider how it affects their family. This impact is not only the smaller impacts like taking time off work to support their loved one at their medical appointments. Diabetes may also include major changes to their lifestyle, daily activities, and other major family decisions.
I am thinking of Ms. A, a patient with type 2 diabetes on dialysis whose sister sold her house and moved from out of state to live with her and take care of her. Imagine how she transformed her life to help her sister. Ms. A is doing so much better today in no small part due to her sister’s support.
I am thinking of Ms. G, who has type 1 diabetes. She went on a ski vacation with her husband and son.Ms. G experienced multiple episodes of hypoglycemia while skiing down the slope, ultimately ruining her vacation.
Technology and Diabetes
Over the past couple of years, my ability to improve the care of people with diabetes has been transformed by technology. Patients are now frequently wearing continuous glucose monitors. When they come for a visit, we view their data together on a big computer screen in my examination room, and I can help them figure out how to stay in range. Husbands share data with their wives, wives with their husbands, and parents with their children. They are reassured when they know their family members’ glucose levels are in a safe range.
The story of diabetes is a human story of challenges and successes, and burden and diligence. It’s a great example of how technology can be utilized to improve health and life. Now I have to go study for that exam.