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Diabetes Developments - A blog on latest developments in diabetes by David Mendosa

Punishing Noncompliance

June 25th, 2012 · 2 Comments

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In America our doctors and nutritionists talk about their noncompliant patients who have diabetes. In Hungary they are beginning to do something about those people.

You know when your medical advisors think you aren’t doing your best to manage your diabetes. Every time you go to their office they’ll tell you that your blood sugar level is too high. Or even when your level is fine, they’ll tell you that you are eating wrong.

They might give you a dirty look or two. They might tell you to shape up. But they won’t tell you to ship out.

When doctors and nutritionists do that, they are forgetting their place. The doctor-patient relationship is a status thing. While medical professionals usually earn more money than we do, they work for us. We are the ones who make them well off, if not rich.

I generalize here. Not all doctors and nutritionists are so difficult. In particular, I am blessed to have a wonderful doctor who also has diabetes and follows the same very low-carb diet that I do.

But few of us are so lucky. And if you think that you have it bad, consider the plight of adults in Hungary who have type 2 diabetes.

On July 1 a new decree will go into effect there. People with diabetes whose A1C levels are too high won’t be able to get analog insulin and will have to pay more for the treatment that they do get.

This is such an extreme example of punishment for perceived noncompliance that when I first read about this on the Internet that I was ready to dismiss it as yet another urban legend. But Snopes doesn’t have anything about it.

Eventually I discovered an article in the New York Daily News about it. “Hungarian diabetics who fail to stick to their diet will be deprived of more modern treatments,” according to this article.

Finally, I found the statement of the International Diabetes Federation that confirms that this is what Hungary plans to do. The government of Hungary spends 8.6 percent of its healthcare budget on the 7.6 percent of adult Hungarians who have diabetes.

The government apparently hopes to save money in the short term by punishing some of its half million citizens who have diabetes. The International Diabetes Federation says that the plan won’t work.

Eventually Hungary’s plan will backfire with higher costs for the government and more complications for its citizens. Punishing people with diabetes for noncompliance is not only shortsighted but also is a classic case of blaming the victim.

And if the prescribed diet there is similar to the high carb diet that American doctors usually recommend, people in Hungary are caught in a double bind. If they follow the prescribed diet, their blood glucose levels are sure to be too high. If instead they follow a low-carb diet, and make the mistake about talking about it, their doctors and nurses will label them as noncompliant.

As far away that the plight of people with diabetes in Hungary may seem to the rest of us, we can apply this lesson to our own lives here. Some people might see this as an argument against government health insurance, but even the U.S. government or either of our two political parties couldn’t be as dumb as Hungary’s government.

No, the lesson as I see it is that we have to remember that we choose our doctors and nutritionists. They are the ones who have to learn to be compliant.

This is a mirror of one of my articles that Health Central published. You can navigate to that site to find my most recent articles.

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Posted in: Psychosocial

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2 responses so far ↓

  • 1 tess // Jun 25, 2012 at 9:22 am

    “even the U.S. government or either of our two political parties couldn’t be as dumb as Hungary’s government.”

    you haven’t been keeping up with politics here in the US, have you? start with TX…. ;-)

  • 2 David Mendosa // Jun 25, 2012 at 9:27 am

    Dear Tess,

    Or maybe Arizona?

    David