There is a diabetes crisis in America and around the world. According to the Centers for Disease Control and Prevention, an estimated 29.1 million people have type 2 diabetes, and another 86 million exhibit signs of prediabetes. There is no sign of these numbers reducing, and it is estimated that one in three people will end up with diabetes at some point in their lifetime.
The costs of controlling diabetes are high, but unfortunately, many of the people diagnosed with the disorder are from low-income populations. Thus, it is important to find ways to treat and control diabetes for patients who might not have the means for more expensive medication and treatments.
Challenges of Diet Therapy
Proper nutrition is an essential area of prevention, treatment and possible reversal of type-2 diabetes. However, there are some impediments to diet therapy in low-income patients. For one, many among this population have inadequate access to fresh fruits and vegetables and other healthy food. They live in a state of food insecurity and have to make choices as to what food to purchase for themselves and their family on their small budget. Unhealthy, processed food is often easier to get and less expensive to purchase than healthier alternatives.
Additionally, many patients are insufficiently educated on the impact that diet has on their condition. Often, diet and lifestyle changes are long-term treatment options that take time to take effect. Patients might give up upon not seeing any changes, especially if they are not well educated on what to expect. There might also be social pressures that contribute to giving up on healthy diet changes prior to any positive effects occurring.
Potential Diabetes Diets for Low-Income Patients
Although there might be challenges to overcome, diet and lifestyle changes remain a key component of any diabetes management program. With low-income patients, it is important to bear in mind their challenges and find diets that work within the limitations they face. Patient education and support play key roles in patient success. There are several types of diets that are promising for diabetes management:
- Mediterranean diet
- DASH diet
- Low-carbohydrate diet
- Ketogenic diet
- Vegetarian/vegan diet
- Low-glycemic diet
What all of these diets have in common is that they emphasize whole, plant-based foods over highly processed options. There is a reduction of the amount of sugar and carbohydrates, especially those that are high on the glycemic index.
For low-income patients, it is best to emphasize the areas they can control — and that fit easily within their budget. This might be to stock up on bulk items, such as whole grains, brown rice, dried legumes and more, that tend to be relatively inexpensive. There are often ways to easily substitute healthier foods into their diet, even with many traditional ethnic dishes. Remind patients that real food is healthy and often cheaper than “diabetic” food. Learn the local areas where patients have access to fresh produce, whether it is at certain food banks or convenient stores, and educate patients on their options.
A long-term solution to diabetes management among low-income patients is to implement community programs that help with prevention and treatment. This includes affordable, easy access health care and screenings. Additionally, there needs to be accessible patient education on diet and lifestyle changes that are important not just for those who have diabetes but also those with prediabetes and children who are at risk of developing the disease in the future.
Additionally, it is essential that measures are developed within the community to increase access to affordable healthy food, whether it is at the local food banks, convenient stores, grocery stores, community programs or something else.
Low Cost Prescription Drugs
Another important component of diabetes management is medication. Depending on the patient, this might include medication for glycemic control and/or insulin sensitivity as well as associated conditions, such as hypertension and hyperlipidemia. The costs have the potential to quickly become a burden on the patient. Finding low cost prescription drug options, such as generic versions, for your patients is one way to increase patient compliance.
The diabetes management program for any patient has its nuances and hurdles to overcome. However, it becomes that much harder when dealing with low-income populations who have restrictions on what they can do to implement positive changes even when the desire is there. Working with the community and providing low cost health care, including prescription drugs through in-office dispensaries like ProficientRx, is a major step towards improving patient care.