Diabetes Care Based upon Self‐Monitoring and Self‐Treatment by the Patient

Abstract

Successful diabetes care can be effectively symbolized and explained when looking at the Joslin emblem, which depicts the three bases of diabetes therapy in the form of three horses arranged in a Troika-like formation. These three horses, standing for insulin, exercise, and diet are supposed to carry the Troika to victory, i.e. through therapy is a patient's life handicapped to the least possible extent by diabetes. For someone who knows something about horses and/or looks closely at how these animals are depicted by the artist, it is quite clear that they are not only strong, and thus effective, but that they have a distinct tendency to revolt, to break out to the right or the left. Thus, whether or not the Troika can proceed to victory safely in a straight line at speed depends largely on whether the driver is able to balance the forces of these three horses against each other. The main mistake diabetologists have made in the past decade can also be exemplified using this picture: many (if not all) of them have thought that the driver of the Troika represented the physician. This, of course, was a tragic error: it is, without any doubt, the patient who has to run the Troika, and it is the patient who has to lead and balance the wild horses and to keep the carriage on a straight road to victory by constantly being alert and responsible. The physician is not in the picture at all.(ABSTRACT TRUNCATED AT 250 WORDS)