An elderly woman looks at a medical professional who holds a blood glucose meter.
Many people have diabetes, but don’t know they do. Here’s what you need to know about why you should get tested. (For Spectrum Health Beat)

Making decisions about our health can be tricky.

We don’t want bad news, but we don’t want to pass up a solution to a medical problem, either.

Submitting to a diabetes test is one example of such a difficult decision. Of the 29 million Americans who have type 1 or type 2 diabetes, about one in four don’t even know they have it.

Why? Because they’ve never been tested, according to the American Diabetes Association.

How many of these untested people suspect they may have diabetes because of family history or lifestyle, but have been reluctant or unwilling to see a diabetes professional?

“Making a decision to get examined is the same as examining the good and bad components of a job change or changing where we live,” said Kiran Taylor, MD, division chief of psychiatry and behavioral medicine for Spectrum Health Medical Group. “We have reasons for making the choices we do make. What are our fears or expectations?”

Those reasons may include our own past behavior or view of the future. We may even make a decision based on the example set by our parents as they handled their own health issues.

“People are different. We have different thresholds,” said Dr. Taylor, who also serves as Spectrum Health’s medical director of Oncology Supportive Care Medicine.

Of course, almost all of us will go to a doctor if our motivation is high enough. In the abstract, it’s easy to say that eating unhealthy foods, smoking—or even delaying a medical test—isn’t a good idea.

“Very few people will intentionally ignore their health or act detrimentally to their own well-being,” she said.

But with diabetes, sometimes the symptoms aren’t so obvious. If we’ve been functioning pretty well in the short-term, then perhaps we won’t have an urgent desire to get the test.

“One of the worst things we can do is to feel guilty about our choices,” or to make others feel guilty about their choices, Dr. Taylor said. Feeling guilty about an unhealthy behavior is counterproductive because it may delay a proper next step toward better health.

Still, getting new medical information can be another source of stress, and medical professionals can help us sort out our options. Dr. Taylor cites Spectrum Health’s “team-based care,” in which patients have a built-in support network to help reduce worry and “the sense of being alone that can prevent a person from seeing their medical professional to begin with.”

Reducing that worry can come through education. Learning more about diabetes or other chronic conditions gives patients more perspective and helps them realize that the quality of their lives won’t change as much as they feared, Dr. Taylor said.

Spectrum professionals use what is called motivational interviewing: sitting down with a patient and trying to understand where they are in life, Dr. Taylor said.

Testing for diabetes might seem like an obvious option to a doctor, she said, but patients may worry about cost, risk or other factors that make it harder to move ahead. It’s up to the professionals to explain the impact of treatment, or ways to reduce costs, she added.

Your doctor’s care team is on your side, Dr. Taylor said. They want to help lower your stress by taking you through the pros and cons of your situation, and objectively reviewing your options.

They’ll help you move ahead—when you’re ready.

“We can’t control that we have a disease or condition,” she said, “but we are in control of the decision to do something about what we have.”