“The best treatment for someone with type 2 diabetes is motivating them; walk in their shoes”

Erik was 38 when he was diagnosed with type 2 diabetes. He is a very active person with a demanding job as a manager, responsible for compliance, human resources and risk assessment, and the news came as a shock. "I knew I had to change my lifestyle, and I feared I would miss out on activities that make my life enjoyable," he says.

On diagnosis, he was given a 5-minute explanation and some medication and battled on for the next 3 years with the serious side effects they caused. Then he was told he had to switch to insulin and was relieved. But, again, he was on his own: he was sent home with the insulin and had to try to understand, by himself, how to inject it. "I followed the treatment protocols as best as I could and tried to integrate the regime into my life. I made my colleagues at work aware that I might have a hypo and what they should do. A hypo is hypoglycaemia; it's when your blood sugar gets too low. You get shaky, confused and irritable and if you don't eat or drink something sugary very quickly, it turns into an emergency. So it's good when your colleagues are aware. If you feel a hypo coming on, you need to be able to leave a meeting, and know that your colleagues can take over with no fuss. So we take it in our stride and manage my condition. Luckily, my wife was training to be a practice nurse specializing in diabetes, so this helped enormously."

What works best

With a natural curiousity and practical approach, Erik embarked on finding out as much as he could about his condition, including possible therapies, to see what might help, and particularly how he should improve what he ate. "Everyone is different, but for me what works best is a low carbohydrate diet, mostly vegetarian, but with some meat and fish. Now I eat almost no processed food. It is all cooked at home. And no sugar. Some exceptions are there, of course, but I banned most of the sugar out of my life."

His life improved enormously when he became an early user of a continuous glucose monitor. He had to pay for it himself because he was not considered sick enough to get it free! He hopes that the devices will become smaller and more sensitive soon, but recognizes that technology has changed his life, giving him more control and more peace.

Totally alone

"People with type 2 diabetes are totally alone. My advice to health-care professionals is to treat people with type 2 diabetes as a person with needs and not as a protocol. Every person with type 2 diabetes is different: different in job, culture, background, work, and social environment. I'm not a statistic. Support is essential for people with type 2 diabetes because, basically, you are totally alone, apart from a couple of half-hour appointments a year. The best treatment is motivating people, starting with how they are living and how they can change their lifestyle. Walk in their shoes: are they happy, sad, fearful? What could benefit them? It's all about empathy and understanding, not just the numbers. I would say, use protocols as guidelines, and help people with type 2 diabetes to integrate their condition into their life."

Empathy and person-centred care, which Erik so values, is part of the approach taken by the recent WHO/Europe publication "Therapeutic patient education: an introductory guide". This publication aims to help policy-makers and health professionals provide effective therapeutic patient education for all patients living with chronic conditions. The goal is not only to improve decision-making about clinical care by involving the patient through education, empowerment and support, but to help them live a more meaningful life.

Background on diabetes: what are WHO Member States committed to?

In 2022, WHO Member States first supported the creation of global targets for diabetes, as part of recommendations to strengthen and monitor diabetes responses within national noncommunicable disease (NCD) programmes.

WHO/Europe and the International Diabetes Federation Europe have agreed to accelerate progress to meet or exceed these global diabetes targets for 2030:

• 80% of people living with diabetes to be properly diagnosed;
• 80% of people with diabetes to have good control of glycaemia and their blood pressure;
• 60% of people with diabetes, and who are aged 40 or over, to receive statins; and
• 100% of people with type 1 diabetes to have access to affordable insulin and blood glucose self-monitoring.