Taking care of your diabetes can be difficult and confusing. You should know that you are not alone in feeling this way. It has been estimated that proper diabetes management requires an individual to dedicate at least 3 ½ hours each and every day. Sometimes this is very hard to do. Also, if the instructions provided are not clear, it can be difficult not only to understand what is being asked of you, but also to know exactly how you are supposed to do it.
In recent years, a significant amount of research has been conducted in the area of why people with diabetes do or don’t do what they should to manage their diabetes. Health care professionals refer to this as why people aren’t people “adherent” or “compliant.”
Perhaps these terms are familiar to you but it is important to understand that these words are not truly interchangeable. ‘Adherence’ is to obey a rule while ‘compliance’ is to act according to a command. These definitions may not sound different, but in health care, we believe that when people understand what is asked of them and why, then they can follow the guidance, or adhere. When people are told to do something, it is often harder to follow the rules, especially if you are unable to understand why or how it is important.
The person living with diabetes is the centre of the diabetes health team, so being able to make decisions about your diabetes care can help with your ability to adhere to your diabetes health plan.
Several areas of diabetes care have been noted to be more difficult to adhere to. Examples include lifestyle intervention, eating healthy and being physically active. It takes money and time to prepare healthy food, and exercise is often avoided due to the energy and time it takes.
Another area where we understand that adherence can be poor is taking medications. Many studies have showed us that the more often someone must take a medication, the harder it is to follow the medication schedule. Once a day medications have a much higher rate of adherence than even twice a day. It is hard to remember later in the day. Also, whenever two medications can be given in one pill, adherence improves.
Why is this? Maybe it is mind over matter, perhaps due to believing that the fewer pills you take, the better your diabetes is. When a study looked at the top ten reasons why people missed injections, nine of these reasons were the same for both health care professionals and the people with diabetes who took injected medications. It was interesting though to note that the health care professionals thought doses were missed because the injections hurt, but the people with diabetes said they just plain forgot.
When does adherence improve? The most powerful tool we have to improve adherence is knowledge. When a person with diabetes has access to information, they can make better-informed choices regarding their diabetes. Knowledge is power.
Understanding your diabetes, your treatment, and who can help you - known as diabetes self-management education and self-management support - has been shown to improve diabetes control in many large-term studies. It is important to be active in receiving information, because if you are unclear about what is being asked of you and why, you may make decisions about managing your diabetes that are not helpful.
What can you do about this? Know your diabetes health team. Understand what is expected of you and why. Have a plan on how to manage your diabetes. Most importantly, when you are unsure, contact your health care team. They are there to answer your questions and support your decisions! Your diabetes health care team wants to help you to take the best possible care of yourself, which includes adhering to medication, lifestyle and treatment.