Here in the United States, we are in the midst of a crisis. Actually, we are in the midst of several crises. Between the opioid epidemic, diabetes epidemic and obesity crisis, we (as health care providers [HCPs]) are failing our patients. According to the CDC, in 2015-2016, the prevalence of obesity was 39.8% with 93.3 million adults being affected! That is approaching half our population, and that’s not including the children! In the Journal for Nurse Practitioners, an article was written about lifestyle interventions for patients with type 2 diabetes (T2D). Because diabetes, cardiovascular disease and obesity are inter-related, it is important as HCPs to educate the patients on the risk factors and comorbidities of obesity. According to the article, only 42% of primary care providers discuss weight management lifestyle interventions with their patients! My guess is that most of the education comes in the form of a pamphlet or is a quick 5 minute conversation basically stating, “You need to lose weight.” Instead, HCPs must sit down and have that heart-to-heart conversation with the patient. If we truly care about people’s health, then we must be willing to talk the “tough stuff.” Yes, it might be awkward, but overtime, it will become second nature to discuss this topic. We (as HCPs) must act if we are to curb this disastrous epidemic and crisis!
According to the article, a sustained weight reduction of just 5% in overweight patients can reduce cardiac risk factors and improve glycemic control. Consistency is key here on both the patient and the HCP. People must be properly educated in healthy living, and proper exercise technique in order to encourage weight loss. This means teaching them nutrition, not just referring them to a dietician or giving them a paper that says “do this.” Healthcare providers must also practice what they preach, when it comes to nutrition and exercise (I am guilty of the exercise part). It makes me uncomfortable that we teach patients to increase their “greens” and cutback on the fried foods, but then arrive at the hospital cafeteria and get a double patty hamburger with french fries (I’ve seen doctors do this). Another important key to altering type 2 diabetes, HCP must frequently follow up with the patient and encourage them to push forward, despite any set-backs or plateaus in weight.
In conclusion, the article strongly encourages the coordination of a simple office process and engaging the health care team, while providing remote follow-up support can assist with patient adherence to the lifestyle recommendations. In some up coming blogs, I will discuss how diet and exercise has the high potential to alter and potentially reverse type 2 diabetes!
Resources: Anderson, N. T., & Moore, E. P. (2017). A Clinical Practice Lifestyle Intervention for Type 2 Diabetes. The Journal for Nurse Practitioners,13(1), 35-38. doi:https://doi.org/10.1016/j.nurpra.2016.07.021