Ask the Experts
November is American Diabetes Month, 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.
How do you approach diabetes with your patients?
I always start by telling them the facts. According to the American Diabetes Association, over 30 million children and adults in the U.S. have diabetes, and if the trend continues, as many as one in every three adults worldwide will have this disease by 2050. Also, recent data shows that pre-diabetes — a condition that puts you at great risk for developing diabetes — exists in more than 86 million Americans. I also tell them that diabetes affects nearly every part of the body, so it is important to be proactive with selfmanagement and make lifestyle changes to either prevent diabetes from developing or to better control other existing conditions such as heart or kidney disease.
How do you convince patients to make the necessary changes? Lifestyle changes are typically hard to make and sustain, even with the best intentions.
I encourage my patients to focus on small, achievable changes to improve quality of life. Rather than ask a patient to focus on large weight-loss goals, we’ll agree on smaller weightloss goals over the long term. All of a sudden a seemingly insurmountable task becomes manageable. For patients who don’t exercise, I encourage them to take a brisk half-hour walk around the block just once or twice a week to start, and build up from there.
These seem like such small changes — do they actually work?
Yes! Because they are doable. Even the smallest changes can make a difference in a person’s health. 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 the physician and patient can get behind. This adds a level of accountability — and studies show that people have better success achieving goals when they have a partner on board.
Switching gears to the bigger picture of diabetes as a health epidemic, what is Stony Brook Medicine doing to effect change in Suffolk County?
Stony Brook Medicine is the leader in diabetes care in Suffolk County. We continue to expand access to our nationally recognized diabetes education program and are developing novel approaches to secondary prevention, education and outreach. One of our priorities also includes strengthening ties to the community and partnering with local organizations to provide resources and support to people touched by diabetes.
What is available for the community?
We sponsor many educational seminars and a support group to address the all-important psychosocial impact of diabetes, and engage patients and families in proactive ways. You can often find our experts at your local library or community center. We continue to expand our American Diabetes Association-recognized education program as well.
If someone is concerned about their risk for diabetes, what would you tell them?
1. Have a conversation with your doctor about your concerns and ask if you should be screened.
2. Understand that every effort toward a healthier lifestyle will have an impact. Then build on these successes for even greater, sustained change.
3. Share your goals with your doctor and your loved ones on how you plan to stay healthy in both the long and the short term. Otherwise, you’ll be in a bubble and change will be more difficult to achieve.
Individual and group education program recognized by the American Diabetes Association, led by our team of certified diabetes educators:
Individual education: Sessions by appointment, call (631) 444-0580.
Group education: Daytime and evening sessions offered monthly. Call (631) 444-9954 for information.
For more information about Stony Brook Medicine, call (631) 444-4000.
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