Strategies
Dance with diabetes
We all agree that it is necessary to educate ourselves about the target levels of blood sugar, blood pressure, and cholesterol as advised by the Professional Practice Guidelines. Most of us are familiar with the local hospital Diabetes Education Centre that provides group teaching for diabetics. The existing model of diabetes education provides a great deal of information about this complex disease and its treatment. Participants come away knowing that they ought to exercise more and eat less, but things get in the way of accomplishing these goals. There is in each of us a chaos of emotions, cravings, stresses, and other loyalties and priorities that get in the way of making healthy life-style changes. Persons with diabetes often find themselves overwhelmed, frightened, and guilt-ridden, and when they feel this way they cannot make the required changes nor do they accomplish optimal blood sugar control. Care-givers too can often become discouraged with issues of ingrained non-compliance in the patients that they are trying to help. The current method of instruction simply provides information but is not structured to engage the recipient’s response to the information provided. It does not honour the reality of what people believe themselves to be capable of, nor does it teach tools to help modify the chaotic desires and cravings that get in the way of following reasonable advice. One often hears, “Doc, I just can’t….,I’d rather die…,” “Doc, I’ve been bad….” The system breeds a destructive, judgmental, hostility towards the diabetic self, “I fight for control” and “I try to kill the cravings.” Diabetes in Motion endeavours to restructure the system by providing a safe setting that transforms the hostility into a much softer, life-giving “dancing with the diabetes.”
Stay out of Hospital
Persons with diabetes are well-persons, gainfully employed, living in communities with their families. When health resources for this population are tied to hospitals and “the sick,” persons with diabetes get the impression that their problem is less important and less deserving of attention. Having diabetes does not feel “sick,” and diabetes care does not do well when it has to compete with the intense issues of cardiac care, intensive care, obstetrical care, or even with cancer care in the hospital setting. Yet large numbers of persons in hospital Cardiac units and Dialysis units are there as a consequence of neglected diabetes. Diabetes in Motion endeavours to develop a contemporary philosophy of care that builds upon competent medical intervention that is not restricted by the in-hospital model and offers diabetes group programs out in the community.
Build your community
Some persons find themselves waiting a long time before they can get connected with a professional who has some expertise in diabetes management. Some persons do not have a family doctor to refer them to the local Diabetes Education Centre. Some people’s employers and families do not respect the structure that diabetes imposes. There is a sense of carrying an overwhelming burden all alone. Professional persons too can often feel that they do not have adequate resources to service all the many people who require support. Although there are many centres for diabetes education and many professionals who try to care for persons with diabetes, there is a lack of day-to-day supportive care-giver networking. Diabetes in Motion endeavours to allow easy access to support groups for both persons with diabetes and for the professionals who attend them. The process of networking between service providers creates a non-competitive sense of community that is hospitable, rather than hostile, to persons with diabetes.
Contribute to qualitative research
Qualitative data is derived from interviews or written responses to questions about how one is experiencing a disease, an intervention, or a program. Qualitative research happens if we are reflective about what we are experiencing as we go about living our lives. It is not something that we do to another that requires an analysis of risk vs. benefit. By contrast, quantitative data is the customary scientific way of observation; it is based on measuring the outcomes of our living. This could be a measurable blood test (eg. A1c, glucose, etc), a medical image (eg. x-ray or scan), or a body parameter (eg. blood pressure, weight). How persons with diabetes negotiate the chaotic cravings, stresses, and split loyalties that get in the way of healthy life-style changes does not become evident from measuring their blood, or taking a scan-image, nor from their blood pressure. We learn this type of knowledge from interacting with a person face-to-face. The methodology of qualitative research is not well established, but there is evolving interest in the notion of integrating qualitative research into evidence-based medical practice. Qualitative research can contribute to the evidence-base that informs the art and practice of medicine. Diabetes in Motion endeavours to explore and contribute to the integration of qualitative and quantitative medical research by developing a structured way of reflecting upon the process of medical service provision.