Chronic Diseases

According to the Centers for Disease Control, chronic diseases have become the leading cause of death and disability in the United States, account for 7 out of every 10 deaths and affect the quality of life of 90 million Americans. Chronic diseases are among the most common and costly health problems, though they also are among the most preventable.

It is a daily struggle for healthcare providers to care for patients who cannot cope with the reality of their condition, manage their medications properly, or adapt their diets appropriately. Time is a barrier for healthcare providers in providing support or advice they can provide to combat the psychological and emotional barriers to chronic disease management. A patient newly diagnosed with a chronic disease such as diabetes, will most likely be expeirence a combination of emotions and support is crucial.

Many certified diabetes educators (CDEs) say fear can often manifest patient resistance to lifestyle changes such as losing weight and quitting smoking, as well as vital medical interventions such as daily blood glucose testing or blood pressure monitoring. These individuals are isolated and overwhelmed by their conditions. As a result, they feel highly victimized by diabetes, and may either completely ignore the information, advice and recommendations of their healthcare provider or only half-heartedly follow their instructions.

There are four known stages where patients are likely to experience feelings of helplessness and vulnerability. It is at these intervention points where we may have the most impact.

When the patient is first diagnosed. Initially, the patient is in shock or emotional distress when they receive their diagnosis. It is at this beginning point, where support, advice and patience are greatly needed. However, the patient's struggle with the disease is just beginning. Often the counsel, education and instructions they receive at initial diagnosis is forgotten within weeks or months—they are simply too overwhelmed to absorb everything at the outset.
When the honeymoon is over. Sometimes the diagnosis of a chronic disease is not accompanied by actual symptoms. This can be especially true with diabetes. Once the disease begins to manifest itself as physical symptoms, patients may feel a sense of foreboding that it will only get worse. Again, at this time, appropriate counseling and advice are greatly needed for patients to feel in control of managing their illness.

When the disease progresses. As diseases progress, so does the daily impact on a patient's life. With diabetes this can mean advancing to the need for daily insulin injections, more frequent blood glucose tests or other common complications of diabetes like carpel tunnel syndrome or pain in the feet or hands. These are all opportunities for dialogue and counsel.

When the disease reveals its full potential. Once diabetes is in its most advanced stages, patients need to turn to someone to discuss next steps in care, how to alleviate pain or which procedure will best help their situation.

With nearly 21 million Americans living with diabetes and another 41 million believed to be pre-diabetic, this chronic disease has reached epidemic proportions. Yet about two-thirds of people diagnosed with diabetes are not actively seeking treatment for their condition.

To affect the diabetes epidemic and other major chronic diseases, the entire healthcare industry—professionals (including specialists and educators), payers (including specialists and educators), and the patients' network (their family and friends)—must work together to overcome the emotional and psychological issues that prevent appropriate treatment.