Discovery Logic

High glucose levels damage a variety of organs, such as eyes and kidneys, but low blood glucose can be dangerous as well. Healthy people can rely on physiological mechanisms to keep blood glucose within bounds. Patients with diabetes lack these homeostatic mechanisms. To maintain healthy glucose levels, they must deliberately manage their lives to keep blood glucose under control. When diabetics have flawed mental models, their attempts at self-management won't work.

Our approach is to equip patients to make good self-care decisions. We do this through scenarios and feedback that enable patients to discover how they can keep blood sugar levels within bounds. Each patient has his or her own tolerance levels and reaction patterns. Instead of teaching general rules, we guide patients in learning how their bodies react, and how to apply this knowledge to achieve control. While this method cannot work for all patients, it can be effective for many.

Who should teach this discovery method? Healthcare clinics, patient support groups, medical insurers, and other organizations that aim to reduce the complications of diabetes and the personal and societal cost of this disorder. Teaching of rules and procedures fails most diabetic patients. The use of mental models and macrocognitive processes can make the difference. For one patient, a former pilot, the realization that diabetes was like a malfunction in his automatic pilot made all the difference. He decided he was just going to have to fly on manual control the rest of the way and so he started looking for functional relationships and mechanisms.

This discovery approach can help patients with type 2 diabetes manage their blood glucose. The macrocognitive discovery approach would also be useful for other conditions that depend on patients' self care such as asthma and coronary problems