Providing diabetes technologies that support your patient
Diabetes management has been strongly advanced by technology; however, technologies only work when they are used, and they will only be used if they have a positive impact on people. Diabetes technologies are useful when they are viewed by the person with diabetes as the solution to their problem.
Meters and supportive technologies without motivation may be less helpful. Encourage your patient, ask the non-judgemental question: “I wonder what my blood glucose level is?”
Here is where your self-management advice comes in: providing a psychologically supportive context in which the technology is a support, not a burden. We can expect our patients to be ambivalent; they will agree with your recommendation but there will often be a “BUT”: “but it is challenging”, “but it is hard”, “but it takes time and money”, etc.
As a healthcare provider, if you accept that ambivalence is normal you can help your patient move beyond ambivalence. This is straightforward and involves two steps:
Normalize the patient’s ambivalence; quite literally tell them that what they are feeling (the “but”) is normal and to be expected.
Ask about personal meaningful reasons to do the hard work of diabetes self-management. With a patient who says, “Yes, I know testing more would help but it costs money for strips,” you might say, “Thanks for telling me that. On the one hand testing would be helpful but it costs, I can see the bind that puts you in. Could I ask you, do you have any personal and meaningful reasons why spending money on strips would be worth it to you?”.
To maximize diabetes outcomes, we should account for the ambivalence inherent in living with diabetes. Health behaviours are challenging and technology that can facilitate an empowering experience can go a long way to support your efforts to help your patients make positive diabetes self-management challenges, especially if your patient knows that you are there to help them work through the barriers to adherence.