Published 29 July 2025

A couple enters my consultation room. Both are living with diabetes. Both are obese. He walks with a crutch, living with chronic back pain and on a disability grant. She works at a local preschool, cooking meals for the children.

Their blood sugars are poorly controlled, despite being on high doses of insulin. He was recently admitted to the district hospital with a urinary tract infection — but they didn’t bring his discharge letter, or their home glucose readings. I feel that familiar tug of frustration. It’s hard to make clinical decisions with so little information.

As I page through his notes, I notice a previous doctor has labelled him non-compliant — and scheduled his follow-up for a year later.

Something in me pauses.

How often do we use that label as a placeholder for our own helplessness?

What effect does it have — not just on the patient, but on the relationship?

What does it do to our own motivation, when we start to give up?

Instead of sending him away, I ask him to return later in the week — this time with his discharge letter and his medications. I print a simple form for recording his blood glucose at home. He agrees.

A few days later, he’s back — letter in hand, medications neatly packed, and a detailed record of his sugar levels. We adjust his treatment plan together. A month later, he returns again with another beautifully kept chart.

It reminds me that behaviour is not fixed — and neither is trust.

It grows in relationship, in small acts of engagement.

Sometimes what looks like “non-compliance” is simply a story we haven’t heard yet.