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Practical Applications of Nursing Inquiry
A Day in the Life of Diabetes: Perspectives from a Provider
Vanessa Hedge, MSN, CPNP-AC - Carilion Children’s Pediatric Endocrinology Several years ago, I transitioned from working as a Pediatric Nurse Practitioner in the inpatient setting to an outpatient position in Pediatric Endocrinology. If you do not know anyone with type 1 diabetes, you may not be aware of how difficult it can be, particularly for children or adolescents. Being a parent of a child diagnosed with diabetes is also highly challenging and frustrating. Many advances in diabetes management help those with diabetes achieve their day-to-day activities; however, the disease persists in the lives of the individual and family. To gain expertise in diabetes technologies, such as continuous glucose monitoring monitors and insulin pumps, I chose to wear each device myself. While I do not have diabetes, choosing to live "a day in the life with diabetes" opened my eyes to the tremendous amount of dedication and commitment required by patients to manage this disease. While wearing the continuous glucose monitor (CGM), I was able to keep a constant watch on my glucose levels and even received alerts on my cell phone if my levels were out of range. While going for a run one day, my CGM alerted me that my glucose was low. Since I do not have diabetes, this likely was normal during strenuous activity; however, I wanted to confirm with a blood sample. Upon returning to my vehicle to check my blood glucose using a standard fingerstick, I suddenly realized the battery on the glucometer was dead. It hit me right then that THIS is "real-life diabetes." For just a moment, suppose I did have type 1 diabetes. During that moment, while trying to maintain a healthy lifestyle with exercise, my glucose became dangerously low, requiring quick-acting glucose to keep me from passing out. But I did not plan for low glucose, so I was unprepared. I did not have glucose tabs to quickly bring my blood glucose up to a safe range, nor did I have an emergency glucagon kit. What if I had passed out? What if I had a hypoglycemic seizure? I was alone, with no one around me knowing why I was on the ground. From the outside, nobody "looks" like they have diabetes. I realized through this experience and all the associated questions it brought that individuals with type 1 diabetes and their family members are constantly burdened by these types of events. While the purpose of "living a day in the life of diabetes" was to gain knowledge in prescribing and recommending diabetes technologies to my patients, I gained much more than that. I realized that having diabetes is a constant and nagging reminder that I had a chronic disease. A disease that I did not ask for and from which I cannot take a break. A disease that has no cure. This experience has allowed me to understand better how difficult it is for children, adolescents, and families to manage diabetes. After my experience of "living with diabetes," interactions with patients have shifted to being more understanding, empathic, and compassionate. As a result, my patients are more open and honest in discussing their care and responsive to finding ways to improve their health.
