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A young woman who battled successfully with anorexia in her teens, passed the International Baccalaureate examinations and entered medical school, where during her first year she was asked to write a review of treatment programmes for people with type two diabetes. Although anorexia is said never to go away, the successful survivors learn to live in control of the condition. Older sufferers of type two diabetes are also smitten by an affliction that is permanent and controlled by diet. Given the parallels between the two conditions, is there anything to be learned from the treatment of one that can assist with the treatment of the other? Type two diabetes is a disorder that usually arises in late middle age or later. Although a chronic condition, it generally does not require the daily insulin injections self-administered by the youthful sufferers of type one diabetes. The usual treatment is by means of dietary control. The problem is one of providing effective training to enable the patients to control their own diet. The medical students were set the task or reviewing the available research reports and deciding on the best approach to treat patients they knew from having met them on clinical attachments. In general, the results of training programmes for patients with type two diabetes, studied in the UK and the USA, have been disappointing. Many patients choose not to attend the classes, and those who do, mostly achieve only marginal reductions in blood sugar level. The benefits are not lasting, being much reduced by a year after training. Some patients were so set in their ways that they found it very difficult to make any changes. Many of those who made an effort to attend the training found it rather technical and difficult to apply in practice. Follow-up monitoring by mobile telephone, however, produced better results, perhaps because it provided timely advice and periodical reminders. It has proved difficult to train mature people to control their own diet. Teenage sufferers with anorexia are faced with the same challenge. In both cases, the control of diet is key to survival. Yet the teenage girls are not given a few hours training and left to fend for themselves. They are assigned a consultant dietician who meets them regularly to negotiate the content of every meal, and the patient agrees to stick to what has been agreed, usually with a parent preparing and supervising meals at home and a teacher supervising a prepared lunch at school. Obviously, the full dietary control provided for young anorexia patients would be too intrusive for mature diabetics. However, the detailed negotiation of meal content followed by some form of monitoring should produce better results than leaving meal planning entirely to the patient with her/his limited understanding of the technicalities. Meal preparation would be left to the patient, but s/he would have menus to follow. This should provide all the help that is needed by people who are prepared to help themselves. Article Source: http://EzineArticles.com/9338376
