Myths in diabetes are common among patients suffering from the disease, but myths can also affect the clinicians managing these individuals. Understanding myths and misconceptions about the care of patients with diabetes is important in optimizing outcomes. Here are some common myths held by clinicians and some potential solutions to overcome potential barriers:

Myth: “My patients aren’t interested in or concerned about making the changes they need to make in order to control their diabetes.”

Solution: In general, people are not opposed to change but resent when others try to change them. While it can be discouraging when patients don’t take advantage of sound advice, it’s critical that physicians make every effort to understand diabetes from their patient’s perspectives. Most people want to live long, healthy lives, and every person has the ability to make changes. Management of patients with diabetes is not one-size-fits-all.  Asking patients what is hardest or most concerning will help you understand what is motivating for them. It’s a good way to engage them in their care.

Myth: “I don’t have the time to get everything addressed in one office visit.”

Solution: Time constraints can have a significant impact on physicians, and no one expects that you can do it all. There are other options to help your patients. The use of a multidisciplinary team improves outcomes. Office staff can handle some of the simpler issues for patients, such as linking them to trusted diabetes information on the internet or connecting them with diabetes self-management educators. They can search community diabetes support groups and create simple handouts to guide patients to these groups. Taking a few extra steps to get patients the help they need early can save time down the road.

Myth: “My patients won’t be happy taking insulin, so I want to avoid using it.”

Solution: Findings from the Diabetes Attitudes, Wishes, and Needs study indicate that insulin is often viewed as a last resort by both patients and clinicians. As a result, many practitioners use insulin as a threat to motivate patients to lose weight and exercise. Unfortunately, threats are not effective in the long term. A more useful approach would be to talk about the continuum of treatment. Be up front with patients and inform them that their treatment will change until an effective approach is found. Educating patients about the progression of therapy from the beginning is a useful approach to overcome the myth that insulin is a last resort or a failure on the part of the patient. Treatments will change over time, so patients won’t be on the same regimen their entire life.

Myth: “My patients won’t understand the directions and information I give them.”

Solution: Health literacy is a problem for many patients, but keep in mind that literacy isn’t a measure of intelligence. Some of the wisest patients are not the best educated. To avoid potential bias, find what sparks a patient’s interest and talk to them in a way that they can understand what they’re being told. A simple approach is to have a patient tell the provider what they’ll tell their family when they get home from the doctor’s office. This so-called “teach back” method can demonstrate patient understanding on the directions they’ve received. Taking an extra minute to perform this exercise can increase patient understanding and avoid potential harm.

References

American Diabetes Association. Diabetes Myths. Available at: http://www.diabetes.org/diabetes-basics/diabetes-myths/.

Meece J. Dispelling myths and removing barriers about insulin in type 2 diabetes. Diabetes Educator. 2006;32:9S-18S. Available at: http://tde.sagepub.com/content/32/1/9S.full.

Anderson RM, Funnell MM. Patient empowerment: myths and misconceptions. Patient Educ Couns. 2010;79:277-282.

Adler E, Paauw D. Medical myths involving diabetes. Prim Care. 2003;30:607-618.

Pearce LC. New evidence-based diabetes nutrition recommendations: correcting myths and updating practice. Home Healthc Nurse. 2003;21:249-257.

Alberti G. The DAWN (Diabetes Attitudes, Wishes, and Needs) study. Pract Diabetes Int. 2002;19:22-24.