Role of family in diabetes management "Hi doc. I am not able to understand why my father's sugars have shoot up in hospital" a young techie women almost shouted while keeping her ipad aside. Her father was having diabetes for long duration. He had stooped medicines for quite long time because of depression. He was staying alone and neglected. He was admitted with wound in the leg which was infected. His 3 months average sugar was 18. All these were risk factors for his high sugars. And as expected he had very high sugars at the time of admission to the hospital. This was her second interaction with me. In the very first interaction I had briefed her about the reasons why his sugars were elevated. " We have just discussed it yesterday Mam.After starting insulin it takes little time to control. As compared to yesterday today's sugar readings are showing decreasing trend. Within couple of days with adjustment of dosages of insulin he will be on stable dosages of insulin. " I replied without giving significance to her shouting. " See Doc I cant afford to stay longer. I had flight tomorrow. " The tone was same. " You need not have to stay in hospital. With written instructions you can adjust dosages of insulin at home." " No Doc. I don't have time. I am at very big position in company and I cant look after him. You put him on tablets. I know insulin is scam ." She yelled. The arrogance, allegations and shouting was testing my patience. Still I had to be soft spoken. This is how doctor needs to be. (c) Dr Milind Patil. So I asked her "what is the role of family in diabetes management?" This question was totally unexpected for her. Without waiting her reply I continued. " Mam family need to understand the need of patient with diabetes. They should look after patients diet, exercise. They should also look after whether patient is taking medicine or not. If you could have done it before he would not have landed in hospital with bad sugar and infected wound. I am doctor and not magic healer. Based on his condition he will need insulin for some time. If you could not give time its your problem. Don't blame on doctor and be responsible" Without waiting for her reaction I left the room. Many times patient's relative fail to understand their responsibility. Their responsibility is manifold. First they should look at patients diet. They need to ensure that patient takes proper diet and proper time. They should encourage patient for doing regular exercise. They need to look whether patient is taking medicines at proper time or not. They should have positive and supportive attitude towards patient care. In addition they need to detect diabetes early in other family members. Type 2 diabetes the most common variant has strong tendency to run in family. Many patients will not have all the classic symptoms. Nearly 50% diabetes patient are asymptomatic. So timely screening is important. This world diabetes day spread the message that family has very important role in diabetes management. Share unedited (c) Dr. Milind Patil Consultant Endocrinologist & Diabetologist For more info log on to
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