Diabetes Reflection

By: Maria Valle Rodriguez, PharmD candidate 2020

Through the past weeks of my rotation at Turning Points I’ve learned a very important
lesson about diabetes: It’s a big deal and it has a lot of complications. Coming from a family that
has a medical history of diabetes, I can say it’s a life-changing chronic disease, but I never got
that close to see all the complications the disease entailed. While we hear about how to prevent
it on the health news, we are also bombarded by TV commercials, Facebook adds, tweets and
Instagram posts that promote the consumption of unhealthy food. Even a person’s
circumstances (e.g. being homeless, not being able to afford healthier food, lack of time due to
work and other responsibilities) play a main factor in people’s choices to eat as well. Genetics
are another factor. Many patients, including myself, have a genetic predisposition to diabetes
type II. In the end, no matter the cause of the diabetes, it has to be treated or its complications
can be fatal to patients.

As soon as I got my blood glucose meter kit and my Metformin 1000 mg BID, for the
“Diabetes week project” I felt like it was going to be easy task. I’d say to myself: “just get your
blood glucose checked twice daily and take your metformin with food. How hard can that be?”
Well, to start with I missed a Metformin dose in the whole week I had to take it. I was not taking
it at the same hours as I was not eating at the same hour every day. On day 2 I was already
delaying the hour of my metformin dose and I’d just say to myself: “as long as you take both
pills, you’re being compliant”. However, on day 4 I missed the evening dose… and I stopped
being 100% compliant. Not only that, I was also having issues with checking my blood glucose
as I’d not get enough blood to get it checked (E-2 in my screen ) and/or was checking my PPBG
after the 2 hour limit because I kept forgetting I had to do it in the afternoon as well. At that
precise moment, I was reminded of the many patients at the clinic that’d say that they were not
compliant with their “afternoon metformin” and checking their blood glucose for their own
reasons. And I, not only understood the why, but also put myself in their shoes and would feel
what they feel when they are not compliant. They want to be compliant; I am sure. But all days
are not the same and they have to deal with that and being diabetes patients.

When taking care of a diabetes patients, we are not here to judge but to help and
understand. It is our duty as pharmacists to make sure they’re compliant and make any dosage
adjustments. But we are also here to understand that we are treating a patient, not lab numbers.
We need to understand patients have weekends where they eat cake at their friend’s birthday
and it’s not sugar free because most people in the party aren’t diabetic. We have to understand
that many patients were used to have their favorite sodas, desserts, foods in general that were
delicious and now they want to have the same but can’t. Our duty is to counsel them on weight
control, food portions, carbohydrate counting and anything that has to do with their
medications. Not being strict to extreme of telling them they won’t ever be able to eat some of
the things they used to love, but to tell them it’s a balance. They can have a small portion of what
they used to have once weekly or every two weeks.