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Objectives for Improving Compliance to a Diabetic Diet

Nov 30, 2011 | By Sydney Hornby, M.D.
Objectives for Improving Compliance to a Diabetic Diet
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If you are trying to improve your compliance to a diabetic diet, the first step is identifying why you are falling short. According to Alan M. Delamater, a researcher at the Miller School of Medicine at the University of Miami, when doctors advise patients on chronic disease management, patients comply with instructions about half the time. The reasons for this are complex. Solving the problem requires extra effort from both you and your physician.

Question Whether You're Ready for Change

You may be familiar with the five stages of grief. Less well known are the six stages of change: precontemplation, contemplation, preparation, action, maintenance and relapse. In "Joslin's Diabetes Mellitus," Dr. Elliot Proctor Joslin writes that understanding your stages helps to create realistic expectations for managing your diabetes. Gretchen L. Zimmerman describes the stages in the March 1, 2000 issue of "American Family Physician." In the contemplation stage, you don't think about change and may be in denial about your condition. You evaluate the pros and cons of change during the contemplation stage. In the preparation stage, you may attempt small changes. You effect change during the action stage. If you can maintain the change for six months or more, you have reached the maintenance stage. The relapse stage is normal, but may bring with it feelings of failure.

Obtain Culturally Specific Education

Ask your physician to direct you toward diabetes education designed for your specific culture. In the Spring 2008 issue of the "Journal of Health Disparities Research and Practice," G. Dean Cleghorn writes that providing culturally sensitive and language-appropriate education provides the social support critical for successful adherence to a diabetes lifestyle. For instance, in Massachusetts, the incidence rate for diabetes in Caribbean Latinos was 76 percent higher than the general population in the state. After studies discovered that Caribbean Latinos typically ate diets high in saturated fat and often consumed a second meal after dinner, Massachusetts health professionals created a culturally specific educational program for Caribbean Latinos. Taught in Spanish, the program included diabetes education, but participants also worked with a dietitian who incorporated foods typical of the Caribbean diet. Participants were also offered peer support and individualized case management by a nurse.

Ask Your Spouse for Help

If you are married, obtaining spousal support can help you better manage your diabetic diet. Your spouse can provide encouragement when you are following your diet closely and warning when you waver. In the September 2010 issue of "Family Systems and Health: the Journal of Collaborative Family Healthcare," Mary Ann Stephens, a researcher at Kent State University, writes that receiving encouragement from a spouse helped diabetic patients adhere to diets better than warnings or criticism.

Communicate With Your Physician

Communicate with your doctor and ask for additional help or guidance if you need it. Some physicians expect perfection from their patients when it comes to adhering to a diabetic diet. This is simply not reasonable. In her book, "Health Psychology: An Introduction to Behavior and Health," Linda Brannon writes that doctors' focus needs to change from diabetes compliance to diabetes management and that physicians should form a "cooperative alliance" with their patients. If you are having trouble following your doctor's instructions, tell him and explain why. Your doctor may offer an alternate solution or refer you to a professional who specializes in diabetes education.

References

Article reviewed by GlennK Last updated on: Nov 30, 2011

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