October 3, 2006

What Can YOU Do to Help People With Type 2 Diabetes?

We all know the feeling, that combination of helplessness and fury we feel when we watch someone we know who has Type 2 diabetes eating the "healthy" meal their doctor has recommended to them that we know is robbing them of health.

For me, the defining moment was when I watched a diabetic friend shovel down a pile of pasta with a drizzle of low fat tomato sauce followed by an apple-laden dessert, only to hear her tell the waitress, "No sugar in the coffee, please, I'm diabetic!"

So what can we do?

I've given this a lot of thought and have come up with what I hope might be a solution. It's a simple support group format that combines methods from two very successful support formats I've been involved in over the years.

The first element in this approach is to teach participants the approach you'll find on Jennifer's Advice for Newbies (The Jennifer who wrote this piece of brilliance is NOT me, BTW!)

It works brilliantly, and even better, because it respects that each person is different and that the diet that works for each person will be different it appeals to people who are put off by any suggestion that they follow any particular diet.

The other element I've drawn on is the support group format pioneered by LaLeche League, a group which has taught women how to breastfeed successfully ever since the days when doctors and hospitals actively discouraged breastfeeding by promoting institutional practices which made it fail. LaLache League pioneered a technique that contradicts what doctors tell their patients without sparking conflict and which appeals to people who don't see themselves as radicals.

LaLeche's technique is to run a cycling sequence of four meetings each one of which puts across a single topic and which leaves room for plenty of interaction between the experienced participants and those who are new to the group. Participants are exposed to the data that shows that their approach is far healthier for mother and baby. Then they are given simple techniques that start them off on the path to success. The basic meeting structure focusses on the essentials. More complex issues are resolved in discussion and by support newbies can get by calling successful peers.

With these successful approaches in mind, the cornerstone of this diabetes support group approach is to focus on the essentials: Teach people what a normal blood sugar is and what the research shows about what blood sugar levels lead to complications. Teach people how to use their meter to find out what the foods they are currently eating are doing to their blood sugars. Suggest to people that if their blood sugar is too high after meals, they can bring it down by lowering their carbohydrate input in whatever way works for them.

Simple, but VERY effective. There's nothing like the look of wonder on someone's face when they report "That oatmeal I ate for breakfast pushed my blood sugar up to 230!" or "Wow! I guess bananas are off the menu from now on!"

Some other, very important basic ground rules, adopted from other very successful support group formats, is that everyone in the group must understand that it is essential for the group's success that no one in the group ever tells anyone else what they should do. What people can and should do is describe their own experience with the focus on what improved their health.

Another important point is to be sure that a "weak leadership" model prevails. The preset format--rotating through the 4 topics--ensures that no one needs to take a strong leadership role and avoids the political infighting which can destroy any group.

Over time, people who have been successful in controlling their own blood sugars may volunteer to mentor newcomers if the newcomers would like someone they can call for help, on the model of the 12 Step Programs.

Here's the complete package:

Start Your Own Effective Type 2 Diabetes Support Group

I'd love to hear your comments!