Care Provider Ms. X Was a Pre-Diabetic

¶ … Care provider

Ms. X was a pre-diabetic woman with a young teenage daughter. I was asked to treat Ms. X to help her stabilize her blood sugar to reduce the likelihood that she would be dependent upon insulin in the near future. Given Ms. X's unstable lifestyle, I was concerned about her ability to manage an insulin injection schedule. Also, non-drug intervention is always favored as an initial treatment for type II diabetes.

Health promoter

When working with Ms. X, I stressed the positive aspects of improving her health. I pointed out how weight loss would lessen the burden on her joints and make life easier. I also stressed how small steps in eating more healthfully and taking moderate exercise would improve her health incrementally.

Learner

Weight loss and lifestyle changes are difficult, so it is essential to understand the patient's lifestyle rather than merely give a generic prescription to move more and eat less. I learned how Ms. X's work schedule made it difficult to have time to shop for and prepare healthy meals and she felt that she had no time or energy to exercise.

Leader

Despite the 'push back' I received, it was essential for me to show Ms. X how change could be feasible for her. I discussed her taste preferences and suggested healthier options (such as cooking healthy meals on the weekend and freezing them rather than going for take-out). I also talked about her schedule and tried to find ways to integrate more movement into her day, such as taking a walk during her lunch hour, taking the stairs rather than the elevator, and getting up periodically to stretch her legs during her sedentary workday.

Manager

Working with other members involved in the treatment of Ms. X required me to be a manager in terms of 'keeping on top of things' regarding requests for information (such as her current laboratory work) and ensuring her records were kept up-to-date.

Research consumer

To better understand Ms. X's case, I read the most current EBP (evidence-based practice literature) on obesity, given recommendations about how to deal with the condition are changing constantly. I learned that poverty and obesity are strongly correlated in the United States. "Not having enough food to eat may cause obesity, diabetes, high blood pressure, and heart disease" (Hyman 2010). Food insecurity can motivate consumers to buy more unhealthy foods: "For a large portion of Americans floating on or sinking beneath the poverty line this means bingeing on cheap, sugary, starchy, fatty calories in order to avoid hunger" (Hyman 2010). This nuances the issue of 'eating less and moving more:' eating the right foods is also essential. And although my immediate role was to address Ms. X's weight to stabilize her blood sugar, treating her in a long-term fashion also required me to consider such issues as helping her find a better job situation and living conditions.

Advocate

Helping Ms. X better use her funds (such as learning that she could use her EBT benefits at farmer's markets for fresh foods) and exploring other government programs to give her assistance was part of my role as her advocate within the social welfare system.