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25-03-2020 | Mental health | View from the clinic | Article

Glycemic happiness: Is there more to ‘good’ glucose control?

“Ever since I started diabetes medication, I haven’t been able to relax. There’s always something or the other to be worried about.”

Anamika, 47-year-old woman living with diabetes

“My son has type 1 diabetes, and I continually fret about him.”

                Matritva, 37-year-old mother of a child with diabetes

“I try my best to stay calm, but I feel like I will develop blood sugar and blood pressure problems from the stress of caring for ungrateful and non-cooperative patients.”

Dr Sehat 50-year-old in diabetes care professional

With advances in our understanding of diabetes and its complications, we focus upon glycemic targets more than ever before. Similarly, with an ever-increasing list of glucose-lowering medications available, we also feel that there is no excuse not to achieve strict targets. In some healthcare systems, healthcare professionals are paid according to the outcomes of their work. This quality is measured only by glycated hemoglobin (HbA1c) target achievement.

This view is myopic and disregards the holistic definition of health, which calls for a state of physical, mental, and social wellbeing, as opposed to mere absence of disease or infirmity. This attitude also hinders our pursuit of health within the diabetes care ecosystem.

Happiness in the diabetes care clinic

A broader assessment of our targets, the tools we use, and the techniques we employ to achieve these targets is needed to ensure optimization of diabetes care. In my clinic, patient happiness is considered a target of diabetes management. Happiness is also a means of achieving this target, and a technique to ensure effective use and acceptance of therapies, pharmacological or otherwise. Happiness is a thank-worthy emotion, which is reinforced when we thank patients for bringing happiness into our daily routine. Happiness is also a trick for troubleshooting, used to calm disgruntled patients, and a glue for teamwork, utilized to keep all stakeholders together.

Happiness in people with diabetes

People with diabetes seek healthcare support for a variety of reasons. While some people expect preventive and promotive care, others require symptomatic management. For some, hyperglycemia is the main reason for medical care, while for others it may be a complication or comorbid condition. All, however, expect an improvement in health, including emotional health. Happy people, we have seen, tend to adhere to suggested treatment, and continue consultation within the same diabetes care system. This is true for family members and individuals close to people with diabetes. A happy environment at home and work facilitates good glucose control.

Happiness in professionals

Happiness is as important for the diabetes care professional as it is for the person living with diabetes. We use the concept of “glycemic happiness” to prevent compassion fatigue and burnout in ourselves and our colleagues. Attention to our own mental and emotional health can help us be more empathic and sensitive to our patient’s requirements, and to respond better to their needs.

Happiness in communication

Just as it is important for people living with diabetes and their healthcare providers to be happy, it is important for the patient–physician communication to be marked by happiness. Establishing friendly communication between both parties completes the loop of glycemic happiness and facilitates a happy healthcare experience along with the promotion of overall health.

Begin within happiness

Once we integrate happiness into our thoughts, speech, and actions, we begin to radiate it. This is contagious, and may spread to co-workers as well as patients and their families. Happy patients find it easier to navigate the complexities of diabetes care, and are therefore able to achieve optimal health targets. Once in place, good glucose control kick-starts a virtuous cycle that helps to ensure better health. This concept, backed by evidence, has been given the name metabolic memory, glycemic legacy, or metabolic karma.

Employing the principles of glycemic happiness in my daily practice has helped me to improve the quality of care that I deliver and increased the satisfaction level of the patients I treat. Now Anamika is able to relax while living with diabetes, Matritiva doesn’t have to fret too much about her son, and I am able to work happily and enjoy my vocation.

About the author

Sanjay Kalra

Sanjay Kalra, MBBS MD DM (AIIMS New Delhi), is an endocrinologist based at Bharti Hospital, Karnal, India.

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