'We have to make lives easier'

As an endocrinologist with the Mayo Clinic in Rochester, Minn., Dr. Maria Collazo-Clavell was a proponent of self-management for her diabetes patients before it was fashionable. As a healthcare provider, she says, it's her job to make sure patients have the information and confidence they need to live well with the disease. She spoke to HME News recently about the state of diabetes care and her just-published “Mayo Clinic The Essential Diabetes Book.”

HME News: Diabetes really requires the patient to take an active role in managing the disease.

Dr. Maria Collazo-Clavell: A chronic illness like diabetes affects every aspect of your life. We've always been big proponents of self-management, even 15 to 20 years ago. I don't like the idea of patients depending on someone else to make decisions about how they should live their life. We want to empower patients to feel they can manage this and play a role in protecting their health.

HME: Your new book serves as a how-to guide.

Collazo-Clavell: The idea of the book was to expand our approach beyond the Mayo Clinic buildings. Diabetes is a lifelong process and it requires ongoing effort. Sometimes things go well, sometimes not. We asked, “What are the basic principles that people can work on?”

HME: There have been a lot of technological advances in diabetes self-management tools over the past two decades.

Collazo-Clavell: We have to make lives easier for people with diabetes. When it comes to managing diabetes and living life, people are going to compromise in order to be able to live life. The newer insulins make it easier to eat out; the meters are smaller and faster; the pumps are smaller; and nowadays everybody wears a pager or cell phone on their belt, so pump wearers don't feel singled out.

HME: Unfortunately, not everybody can afford the latest thing.

Collazo-Clavell: We have to figure out what resources a patient has, so we can give good advice. I know patients struggle with many things, like costs. I have to be aware of that and help them come up with a plan using the resources they have.

HME: When will the rising numbers of Type 2 diabetes level off?

Collazo-Clavell: Until we are able to tackle the obesity epidemic, I think we are going to continue to be challenged with Type 2. The rise in the numbers is related to the way we live our lives, but the choices we make are not necessarily ours. One of my pet peeves is: Who decided that a soft drink should go from a 12-ounce can to a 20-ounce bottle?