As calls for reforms in diabetes care mount, advocacy organisations are calling for a change in the
language used by healthcare practitioners.
Diabetes South Africa says that labelling diabetes a lifestyle disease creates stigma against patients and leaves many blaming themselves for testing positive for diabetes.
“There is a sense of judgment and condemnation patients feel when they hear that their lifestyle is what led them to being diabetic”, says Margot Mc Cumisky, national manager at DiabetesSA.
Speaking to Health-e News at the sidelines of the Diabetes Summit held this week, she says a language shift starts with education about the different types of diabetes and their causes.
“There is no mention of genetics and they play a huge role in one developing diabetes. You also have doctors and nurses who don’t really understand type one and type two, and they talk about mild diabetes and the bad kind of diabetes instead,” she says.
Even though genetics play a role in one’s predisposition to diabetes, with a third of diabetic cases being linked to genes, Professor Ntobeko Ntusi, President of the South African Medical Research Council (SAMRC), says this remains a complex aspect of the disease.
“Most of these are what we call polygenic and this refers to the interaction of multiple genes which are very difficult to target as opposed to when a disease is caused by a single gene.
The other complication are that many people that have familial forms of diabetes, share clustering of environmental risk factors like, the way they eat, the way they live, sedentary lifestyle and all of these things that also impact on both getting the disease and future complications.”
Mc Comisky argues patients need encouragement and positive language to make the change needed to improve their quality of life while they manage the chronic condition.
“It all starts with education to reduce the burden of diabetes. Diagnosing someone with diabetes and not educating them on how to manage it is harmful. That is why our community wellness groups focus on individuals living well with diabetes instead of being support groups, and we are calling on health practitioners to refer patients to us,” she says.
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‘Wrong’ care provided by health practitioners
Lesang Modutwane paints a grim picture of her struggles with accessing adequate diabetes care in the public sector.
In 2022, weighing only 45 kilograms, frail and seriously ill, she was discharged after being diagnosed with type 2 diabetes at Pretoria West Hospital, and readmitted within 24 hours.
She later had to seek care at Odi District Hospital and Dr George Mukhari Academic Hospital.
“At Odi Hospital, when I was too sick to wake up and eat meals, I was not fed at all but the E3 injections kept getting administered because of doctor’s orders, so naturally, I had more emergencies in the hospital than I had at home.
When I was conscious enough to sit up and eat, I would find I was being served high-sugar, high carbohydrate food. I was served peanut butter, potatoes, white rice, generally all foods that were detrimental to my health. I was also handed the wrong medication at Odi when a nurse came to the wrong bed,” she claims.
At George Mukhari she says “irate” nurses refused to answer her questions regarding the medication she was receiving. It took about a year of her being on insulin to realise that it was not a suitable form of treatment for her.
Modutwane now advocates for the training of public healthcare providers to avoid delays and “unnecessary” struggles experienced by patients in need of lifesaving care.
Ntusi says some cases of cardiovascular disease and other complications in people living with
diabetes were found to be related to failures to treat patients adequately.-Health-e News
