So, how do we end up here?
What causes insulin resistance?
Well, there's no known risk
factors for insulin resistance.
That is a good thing.
You know, why?
Because when we know
what the risk factors are
we can help mitigate
those risk factors.
We can help patients come up
with a plan and a strategy
to minimize the effect
of these risk factors.
So these are the same risk factors that we
discussed for developing type ll diabetes.
So the risk factors
for insulin resistance
are the same ones that we've discussed
in this series for type ll diabetes.
Now, we have modifiable ones.
Those are on the left lifestyle and
associated medical conditions are events.
And non-modifiable ones
that you see on the right
race and ethnicity
or family history.
Ones on the left are the ones we
really can focus on with patients
to help them make
That's kind of a funny
title for that one, is it?
The Road to Type ll Diabetes.
Sounds like a trip you'd want
to go on but really it is not.
Let's review what we know.
Remember the beta cells in the pancreas,
will they can kind of secrete insulin?
But the insulin released by
the pancreas is variable.
Sometimes it's a lot, sometimes
it's not enough as it's wearing off.
That's because the insulin
resistance is likely present.
So, this is a patient, we need them
to monitor their blood sugar regularly
and we need to change
their meds as required.
Now as this disease progresses that decides
what the treatment plan needs to be.
So initially it may be able to be treated
with lifestyle or lifestyle plus oral meds.
if the disease is allowed to progress
and we don't delay the onset,
the patients eventually going
to need the use of insulin.
That's when the pancreas can no longer put
out insulin and the body cannot use it.
So we can help.
But do we really?
I put this title in here because I
wanted you to pause for just a minute.
We've talked about a lot
about the physiology.
Now, I want to talk
about the psychology.
Because see my role
as a nurse is to use,
use the spirit of
See I'm not supposed to give the patient
a list of things that they should
and shouldn't do.
My role as a health care provider and
educator is to help them understand.
Hey, what are the things that are
most important to you in your life?
Let me show you how making some
simple choices can help you get there.
See if your type ll diabetic or
on your way to type ll diabetes,
you're not going to
have as much energy.
So what are the things
you really like to do?
Sometimes we get so judgmental about
things like excess body weight.
We think about smoking, about lack of
regular exercise or not enough sleep.
These are all factors
that can contribute.
But the conversations that we have
with patients about these factors
have to be therapeutic.
They need to come from
a level playing field.
Acknowledge these are
difficult habits to tackle.
If someone has struggles with body
weight, that's very personal.
It's also difficult for
them to change smoking.
Oh my, I have never had
this challenge in my life.
But man, I can imagine
it is really difficult.
Your brain loves nicotine.
Lack of regular exercise,
not getting enough sleep,
these are classic problems
of a busy society.
So without judgment but with empathy and
developing a therapeutic relationship,
help your patient recognize
what is the next best small step
they can take in making
progress in those areas?
Because see, we are modifiers.
We're not people that are in authority
that tell them what they can and can't do.
we come alongside the patient
and help them recognize the
value of making small changes
and when they're
successful in that change,
we celebrate with them and help
them make the next changed.
Always keeping in mind,
it's the patient's right
to choose how they want
to care for themselves.
So how do you help them
take the next step?
Well, you want to recognize
that simple changes to diet
and food choices can
make a big difference
and remember on
a cellular level.
We want to find them ways to help
increase activity that are positive.
Oh, there's so many programs,
if this person has not been active at all.
Look for programs that will reward them
for taking a certain amount of steps a day
or look for simple ways for
them to just become more active.
Now, have them work towards
decreasing the amount of smoking.
Very difficult habit to me.
So don't criticize
them, don't judge them.
Recognize and acknowledge where they are
validate, that this is a difficult choice
but give them the support
they need to take the steps.
So help them identifying new patterns
that will help increase their sleep.
Maybe turn that cellphone off a little
earlier decreasing the screen time.
There's lots of simple things that
you can do to help to increase sleep
we really can make a difference.
We can help a patient reduce the risk
factors for developing insulin resistance.