Monitoring of blood glucose, special food, physical activity… To better manage his diabetes on a daily basis, the drugs are not sufficient. Head of the Department of diabetes to the CHU Grenoble, Pr Halimi returned on these boards and the difficulties to follow.
Doctissimo: Is self-monitoring of blood glucose necessary for management of diabetes?
PR. Halimi : In type 2 diabetes (which is not insulin), the question at the bottom that is: “A what is self-monitoring?”. Then, I am absolutely, very favourable to self-monitoring, either I think it is better to do very little or not at all. Why these 2 ideas?
Is done if truly it is used, if the patient is able to understand why it does, that is that it gives it as information, so that he understands why the blood sugar rises or drops, what is the benefit of such situation and as caregivers watch the results and take the teaching time of analysis of things. In these conditions, self-monitoring is useful, helpful and she both improves metabolic outcomes and the quality of life of patients.
If these conditions are not required, it is a self-monitoring is prescribed somewhat automated way, that the doctors or the nurses do not much look… Then at that time, it was published again recently by a British group, was rather a detrimental effect on the quality of life, people have results that them ones, who do not understand why their blood sugar rises unexpectedly, and then at that time, it would be better not be.
Doctissimo: Is the importance of food understood by patients?
PR. Halimi : with regard to dietary compliance, it is by far the thing that patients consider as essential and course have difficulty. But it must be still say, as it has been said by one of my friends already years ago: a diabetic it is never a non-diabetique who needs to look after him, that is, it is not easy for a non-diabetique to do what should be all the time, eating properly, not consume too much alcohol… In fact the diabetic it is a dietary model. He has difficulties but in general finally is much more observing that believed. But he needs clear information. There are a whole series of confusion like this that make that many patients deny eat starches, carbohydrates… While in reality this is what need them!
On the physical inactivity, however, they have a gap of information, and then a difficulty… How to motivate a patient to do physical exercise? On average these patients are not very young so it is not to make the sport.
Doctissimo: Diabetic patients suffer from a negative image. How to correct it?
PR. Halimi : image which has a patient who deserves his disease, which is an irresponsible, obese, sedentary who drinks and who when he is sick to sheet and not treated is completely false! This is exactly the contrary, patients who have fretted deeply about their disease and patients should therefore know help, accompany. Need to organize care and enhance the support of these patients the France has a pretty good system of care that can improve and should especially not to draw down by saying that diabetes is not a serious disease, is not a serious illness, a disease whose patients don’t care… This is false!