14 August, 2017
Diabetics & Non-Compliance
Diabetics can develop high levels of glucose in their bloodstreams. Without proper diet, exercise, regular checkups and monitoring of blood glucose levels, high glucose can lead to several complications, including some that are life-threatening. Despite this danger, health professionals find too many diabetic patients don't follow medical advice for controlling their disease.
Medically, noncompliance, also referred to as nonadherence, means not following a physician's recommendations. Typically, diabetics may be directed to follow a specific kind of diet, take prescribed medication and exercise. Physicians and counselors may recommend additional lifestyle changes for the patient's optimal health.
Examples of Noncompliance
A noncompliant diabetic patient may not check his blood glucose levels regularly. He make take his medication incorrectly or not at all. He may fail to lose weight, stop smoking or exercise. His diet may contain too much fat and too many carbohydrates to control blood glucose levels, and he may not visit his doctor for regular check-ups.
Effects of Noncompliance
Diabetics who are noncompliant do not realize or accept that proper self-care will have a positive effect in the long-term. As a result, they are in danger of developing complications that affect the eyes, kidneys, heart, nerves, feet and more. Over time, uncontrolled diabetes can lead to permanent damage of these areas as well as stroke, heart disease and blindness.
Dangers of High Glucose
High blood glucose, or hyperglycemia, occurs when the body doesn't have enough insulin or can't use insulin effectively. Hyperglycemia has a major impact on the complications of diabetes. Diabetic ketoacidosis occurs when the body burns fat instead of glucose for energy. It's a serious condition, affecting primarily patients with Type 1 diabetes, that can lead to coma and even death. Hyperosmolar Hyperglycemic Nonketotic Syndrome is seen mostly in older patients with either type of diabetes. It's usually brought on by illness and infection and eventually leads to seizures, coma and death. These and other conditions can be avoided with regular blood glucose testing, which some noncompliant patients ignore.
Diabetic patients do more than 95% of their own care, notes authors Martha Funnell, M.S., and Robert Anderson, Ed.D., in their article, "The Problem With Compliance in Diabetes," published in the October 2000 issue of "The Journal of the American Medical Association." The authors recommend physicians create a collaborative relationship in which the responsibilities and roles of both parties are defined. When patients, as the main decision-makers for their diabetic care, establish their own goals, they act more responsibly about controlling their diabetes.
- “Harrison’s Principles of Internal Medicine”; Anthony Fauci, M.D., Dennis Kasper, M.D., Dan Longo, M.D. et al.; 2008
- “Tintinalli’s Emergency Medicine: A Comprehensive Study Guide”; Judith Tintinalli, M.D., Gabor Kelen, M.D. et al.; 2004
- American Diabetes Association: Living With Diabetes--Complications
- Jeffrey Hamilton/Lifesize/Getty Images