Diabetes, obesity and the effect of education on treatment

“I don’t understand why my tests are so bad. I am doing everything I am supposed to do to take care of myself.” This is a frequent lament from many of my patients with diabetes mellitus, both Type 1 and Type 2, some with obesity, others without issues of weight control.

The impact of both diabetes and obesity has placed an increasing burden on the U.S. healthcare system. Estimated burden from 2012 costs $245 billion with $176 billion as direct costs and $69 billion in indirect cost or reduced productivity. 

{mosads}These costs have only increased in the past several years and will continue to place stress on an already teetering healthcare system. The rise of obesity within our society has only added to the burden.

During the past 20 years, there have been marked advances in technology to assist in treating patients with diabetes and obesity. The need to educate both the patient and medical community has been of utmost importance. Many physicians in clinical practice are not familiar with the additional options at their disposal to assist in the care of their patients.

Advances in blood sugar monitoring include the ability to download meters to a web-based platform, which allows individuals to see patterns. If coordinated with physicians, nurse practitioners and diabetes educators, this can be a powerful educational tool to improve diabetes control.

Using mobile technology is a recent advance, which provides real time information for patient use. These tools can also keep family members or significant others in the loop to assist in the care of patients.

Situations such as low blood sugar can be relayed to the mobile phone of a family member or significant other, thus providing a safety valve to summon appropriate treatment.  These advances are of particular interest to parents of young Type 1 diabetes mellitus patients.  

Schools that previously required students to go to the nurse’s office or infirmary to have blood sugars monitored can now allow these students to remain in class thus eliminating the stigma of being singled out for specific treatment. Both parents and students greatly appreciate that they are one of the group.

Mobile technology is effective for both education and treatment. This modality is genuinely suited for medicine in the 21st century, allowing individuals to have communication with healthcare providers and facilitating care between multiple entities.

Additional advances in the next several years will allow more effective care of patients with both Type 1 and Type 2 diabetes mellitus. Insulin pumps, which communicate with glucose sensing devices, may eventually create an artificial pancreas, thus allowing individuals who require insulin to lead a less restrictive and more productive life.

The treatment of obesity is evolving over the past 2 decades with the advent of new technology, educational techniques and ability to coordinate care with the physician, nurse practitioner, educator or other ancillary individuals.

Numerous entities have touted various dietary regimens, supplements and technologies. A small cottage industry has developed to address the obesity epidemic. It has become exceedingly difficult for the individual to discern what is good science vs. fiction.

The role of health education, whether from the registered dietician, nurse educator, nurse practitioner or physician is now even more significant. Education can facilitate improvement in an individual’s diet and lead to increase weight loss. This will lessen complications from diabetes mellitus and other possible secondary issues such as elevated cholesterol, triglycerides. It will also lower the risk of heart disease and hypertension.

Additional programs are being developed by physician practices to integrate both technology and education for a yearly fee. This concept of one stop shopping has the advantage of providing consistent and continuous care for the individual. Costs and outcomes are generally improved with this particular concept. Individual patients can have one on one education and a specific personalized treatment plan.

Technological advancements in the treatment of obesity have provided numerous treatment options for individuals. There are devices, which require minimal surgical intervention, thus reducing the risks of complications and restrictions to one’s lifestyle.

Technology will continue to improve the treatment of both diabetes and obesity. The answer to the initial lament stated in this article is improvement in the way we as doctors, nurses, educators and other members of the health care team educate our individual patients. 

By providing the proper educational tools, we will facilitate patients taking control of their diabetes and obesity, improving their lives and limiting the burden of complications. This in turn will decrease the health care burden in the U.S. and world in general.

Dr. Alan Schorr is a specialist in consultative Endocrinology, who has been in private practice since 1986 and currently serves on the medical advisory board for Dario Health. He specializes in diseases of the Endocrine and Metabolic systems, with expertise in using state of the art technology (insulin pump therapy, continuous glucose monitoring, dual pump therapy) in the treatment of adults and children with Type 1 and Type 2 diabetes.

The views expressed by contributors are their own and not the views of The Hill.