'Reading your comments in this thread and some others I get really angry. The number of disparaging remarks about your doctors and nurses is astonishing. Talking about educating them?!?!? Who the hell do you think you are? If you are so sure of your ways, why are you going to your doctor, nurse, etc. Go and treat yourselves and don't waste the professionals time which could be spent on other patients.'
Hopefully they are people who want to manage effectively their condition.
I have been a HCP for over 40 years, and I am amazed at the arrogance of a lot of other HCP. When you walk away from the bed or the patient walks out of the consulting room door, they are left to manage their life and their condition. Often there is not space to ask questions or they ask closed questions, so effectively no real response is required.
This is not only in diabetes care, they do not want to hear what does not fit in with what their mental check list a ticked and has jumped to the end bypassing any input from the patient. Of course when the planned care does not achieve the results its because the patient is not compliant not that the plan was based on incorrect assumptions
I attended a course last year and it was stressed throughout was the importance of listening, and taking a history. Some of my favourite questions after I have suggested a plan, but does make sense to you and is there anything you think we should change?
If someone does not follow my plan but the objective is achieved but they are too intimidated to tell me how does that help? The patient is unsupported and I am patting my self on the back for something I had no hand in, or the worse case scenario something catastrophic happens I do not know why.
My pet hate is the tinkering with insulin which appears to have no basis in the patients real life and diet, so the patient is left with hypo's or hypers because they either can not eat enough, or the is just a complete lack of understanding of how much carb they are eating. I seem to spend most of my time telling people to check the total carb content on the back of the packet. No seems to have suggested they do this, but they did get told to cut out sugar.
If you are HCP you are supposed to read around a subject, things change and the chances are dietary advice is about to change.
https://www.ncbi.nlm.nih.gov/pubmed/29269890
'CONCLUSIONS:
Reducing dietary carbohydrate may produce clinical improvements in the management of type 2 diabetes. Further research is needed to understand the true effect of dietary carbohydrate restriction on HbA1c independent of medication reduction and to address known issues with adherence to this dietary intervention. Clarity is needed regarding appropriate classification of a low-carbohydrate diet.'
Evidence based practice is good but if something works but there is not the will or the money to do the random trials how to you get the evidence?
The news today about the predicted increase in Type2 perhaps the money will follow because what ever we are doing now its not working.
As to disrespect. I got a f*****g c**t last night by a patient. My first though was not that they were disrespectful, but what caused that?