Surprising Interview with a Joslin Researcher

At this weekend’s annual ADA Conference, I had the
privilege to sit for an hour just chewing the fat (or, um, chatting…)
about the state of diabetes care with Dr. Richard Jackson of the Joslin Diabetes Center. Jackson_04
Dr. Jackson has the dubious title of “Director of
Field Outreach, Strategic Initiatives,” but his personal passion is talking
with patients about how diabetes affects their life.
For new patients, his biggest edict is, “You are
not doomed. People with diabetes are doing better and better all the
“When patients come in I ask, ‘How are you doing?’
Often they slump down in their seats and say, ‘I don’t know.’ So I say, ‘NO,
how are you doing?’” he told me.
The point is: How do you feel? Physically?
Mentally? The only way to achieve well-being is
to be in touch with your own state of affairs, this doctor says.
Here are Dr. Jackson’s top tips for getting a
handle on your own diabetes and getting the most out of your doctor/educator visits, as he
related them to me this week:
* Find Out Where You Are
out by getting your numbers: your A1C (at least every 3 months), and your blood pressure, cholesterol, and microalbumin test
results (all annually). Also, make sure you see an opthamologist annually to be armed with
the data on your eye health. Never go in to see your diabetes doctor without knowing
what your health starting point is, Jackson says, or the visit will be unproductive.

And don’t get caught up on some stringent number-goals. Some people do quite well with A1C’s of 7+, or even up to 9, he says.

* Decide What to Focus On
It is
ridiculous to think you have to tackle everything at once. Look at your health records, and decide which ONE or TWO things you
will work on in the coming months.
Instead of making vague resolutions like, “I’ll eat
better,” focus on very specific things like lowering your A1C by checking more
often so that you can react immediately to highs.
Or maybe you’ll focus on blood pressure instead of
the diabetes-specific stuff. “If a Type 2 gets his/her blood pressure down from 150 to
140, they can gain as much health-wise as by lowering their A1C,” the doctor

* Think
of Your Diabetes as a Small Business, and Your Care Team as Your

Go in to your appointments with information on where
your “business” stands, and clear goals and/or questions. Have them advise you on
these specifics to get the most “bang for your buck.” And remember that these people work
for you. Sometimes you might want an A1C more often than every 3 months. If they
push back, insist.
“If you ask, your doctor will likely do it. You
just have to ask!” Jackson says. (He also notes that Metrika’s home A1C testing kit for under $20 at the drugstore is a good
* Make Sure You See the

This is why you need regular testing. Get your older and
newer test results side-by-side and compare your numbers. You can see
that you have made a difference!
Reward yourself in some positive way, and then set
new goals for your next triumph. The ability to see the difference you have made is
key. It’s a rush, like improving your SAT scores or video game scores — whatever
turns you on.
If you do all this, there’s no way for nasty
complications to sneak up on you, Jackson says. You’ll be on top of it and won’t allow
problems to progress. “Remember, nothing ever happens suddenly with
Thank you, Dr. Jack, I feel better

7 Responses

  1. Bill Braithwaite
    Bill Braithwaite June 14, 2005 at 7:28 pm | | Reply


    i’ve been trying to lower my high blood pressure.

    & my cholesterol.

    & keep my blood sugars closer to “normal”
    ;) )

  2. Jo's Cafe
    Jo's Cafe June 15, 2005 at 4:33 am | | Reply

    Diabetes Notes

  3. Jo's Cafe
    Jo's Cafe June 15, 2005 at 4:33 am | | Reply

    Diabetes Notes

  4. Jo's Cafe
    Jo's Cafe June 15, 2005 at 4:33 am | | Reply

    Diabetes Notes

  5. Living With Diabetes
    Living With Diabetes June 24, 2005 at 8:15 pm | | Reply

    Diabetes Care

    Amy, you did a really good job on this interview, but I do want to do back to the source at some point. Has he published his suggestions on the internet? In case anyone is wondering, one of my hobbies…

  6. AmyT
    AmyT June 24, 2005 at 9:37 pm | | Reply

    I am not the first to interview Dr. Jackson. See these links for a few:

    What appears to be new is his targeted focus on behavioral issues.

  7. Andrew Spark
    Andrew Spark March 24, 2006 at 2:10 am | | Reply

    Health care is a great importance to many individuals and we need to work on improving health care for all.

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