Living Long & Well with Diabetes

Living With Diabetes

Author: Dr. Tom Elliott

Expectations of longevity change when people are diagnosed with diabetes. This concern is driven by misleading historical statistics suggesting Type 2 diabetes may reduce life expectancy by 5 to 10 years, and Type 1 diabetes by 20 years. The truth is that individuals with Type 1 or Type 2 diabetes under good glucose, blood-pressure, and cholesterol control, without complications can expect nearly-normal life expectancy.  To calculate your life expectancy go to lifeexpectancy.ca  

BCDiabetes mission is to optimize care & improve quality of life & health outcomes for every British Columbian with diabetes. To learn more about our methods go to BCDiabetes.ca

The key to avoiding diabetes complications of heart disease, stroke, blockages to leg arteries, damage to the kidneys (nephropathy), damage to the eyes (retinopathy), and damage to nerves (neuropathy) is optimal of blood sugar, blood pressure and cholesterol, and where applicable, smoking cessation.

BC Diabetes practice model involves a three-fold approach: Exceptional patient care; Research on interventions; and Clinical trials of new drugs. This model ensures patients receive ideal care, with state-of-the-art treatments.

Obstacles to optimal control of blood sugar, blood pressure and cholesterol include previously ignored or little understood factors.  Research carried out at BC Diabetes has shown that at the time of referral to a diabetes specialist patients exhibit a high level of distress and depression potentially resulting in increased A1c and reduced compliance.  BCDiabetes research has recently shown that the use of Diabetes Case Managers who interact directly with patients reduces diabetes distress & lowers A1c. Case management is also associated with improved compliance and treatment outcomes, ensures appropriate monitoring, and facilitates rapid intervention. A physician oversees several Case Managers, allowing him/her to manage the care of many patients, while still providing exceptional care.

To improve compliance and adherence to treatments, we have developed and are testing a smartphone app “myBCD” which facilitates communication between the patient and Case Manager and/or physician, records blood sugar measurements, and allows patients and care providers to see lab results, and request lab requisitions, eye exams and repeat prescriptions.

At BCDiabetes we are researching methods to promote better coping skills to deal with the rigours of diabetes. Our “Mindfulness” study involves another smartphone app that teaches secular meditation techniquies which we believe will indirectly improve diabetes outcomes by providing an enhanced sense of control. Our Love and Support study test the effectiveness of patients attending groups meetings led by a counselor, where they will receive training in “vulnerable communication” techniques, helping them talk in appropriate and productive ways about issues they are facing.  Patients will also be paired to form peer-support relationships. In both studies, patients will be evaluated for reduction in A1c, as well as improvement in distress and depression scores.

In summary it is possible to live a nearly-normal life even with diabetes. The formula is simple: (1) Find forward-thinking care providers; (2) Work with them to to control your blood sugar, and any complications you may develop. (3) Once you have a plan, follow the it as carefully and fully as possible. (4) Continue to work with your care providers, staying open to novel interventions. (5) Remain positive and committed to managing your disease, rather than fearing it.

This article will be appearing in the Diabetes Canada July newsletter