Small steps may help when dealing with a growing diabetes problem, expert says

With those devastating statistics -- and with November being National Diabetes Month -- it is an increasingly important time to raise awareness about this disease as it reaches epidemic proportions. Endocrinologist and diabetes expert Joshua D. Miller, MD, MPH, takes a unique approach with his patients, advocating for small, achievable changes that can make a big difference.

"I always start off by giving my patients the facts," says Dr. Miller. "The number of Americans with diabetes is astounding and I think shocking to most people. The second thing I tell them is that diabetes affects nearly every system in the body and every other disease."

Dr. Miller says that it is important to be proactive with self-management when it comes to diabetes and that making lifestyle changes to either prevent diabetes from developing or to better control an existing condition is key.

"I encourage patients to focus on small, achievable changes to improve quality of life," says Dr. Miller. "I help patients identify ways to make seemingly insurmountable tasks such as weight loss and physical activity become more manageable."

And for his patients that do not exercise, Dr. Miller encourages them to take a brisk walk around the block -- starting with just once or twice a week. "These small steps help because they are doable. Even the smallest changes can make a difference in a person's health. "

Studies show that people have better success achieving goals when they have a partner on board, which also adds a level of accountability. "When I consult with a patient with diabetes, I also emphasize the problem-solving nature of self-management and ask them to work with me and their other doctors, on achievable, shared goals that both physician and patient can get behind," says Dr. Miller.

"At Stony Brook, we have looked into novel approaches to secondary prevention, education and outreach for both type 1 and type 2 diabetes including one-on-one nutrition counseling available; supporting self-managed diabetes care for patients hospitalized for other conditions; and creating diabetes discharge tools," says Dr. Miller.

Learning about your disease and available treatment for it is another step. "It's important for patients and their loved ones to have informative conversations about the various medication and lifestyle options with their doctors to help identify the best treatment with the greatest chances of success," says Dr. Miller. "The number of new medications available to treat type 2 diabetes including newer insulins for people with both major types of the disease is growing exponentially. Endocrinologists are recognizing more and more that treatment for patients with diabetes should be individualized as each patient is unique."

Stony Brook Medicine has made diabetes a priority and have taken the lead in population health initiatives in Suffolk County to overhaul the management of chronic conditions in the Medicaid population. On the fourth Monday of the month, Stony Brook holds free seminars in the hospital's cafeteria on all kinds of topics -- from the latest research to the best approaches to individualized self-management.

"If someone is concerned about their risk for diabetes, I would tell them to have a conversation with their doctor and ask about screening," says Dr. Miller. "Then start making small changes, every little bit helps."