A new position statement published today in the Endocrine Society’s Journal of Clinical Endocrinology & Metabolism states that diabetes care is more effective when the patient experience is taken into account when formulating a treatment plan. This approach, which moves beyond simply taking into account the clinical numbers and focusing only on a patient’s glucose numbers, gets patients more connected and engaged in managing their disease.
The position statement was developed from a range of sources including roundtable discussions from past Endocrine Society meetings, with participation from the American College of Cardiology, American College of Physicians, American Diabetes Association, Association of Diabetes Care & Education Specialists, Diabetes Technology Society, the U.S. Centers for Disease Control and Prevention, diabetes research organization dQ&A, and patient advocacy organizations DiabetesSisters, Close Concerns, and Taking Control of Your Diabetes.
Greater engagement is vitally important as managing diabetes requires the patient to perform daily tasks to manage their disease such as blood glucose monitoring, dietary and exercise management, preventive care scheduling, and medication management. Fostering two-way communication between people with diabetes and their health care team builds trust and helps provide a shared understanding of the disease itself and the goals of treatments.
Further, the position statement points out, by acknowledging and discussing potential treatment barriers, patient satisfaction with their care and outcomes improve. This is especially true when health care providers take into account the patient’s level of health literacy and cultural background when discussing care options and goals.
“Many existing educational resources are available to help health care providers think through ways they can discuss diabetes treatment in a neutral and nonjudgmental way and practice using those strategies,” said Rita R. Kalyani, MD, a professor of Medicine at Johns Hopkins University School of Medicine, who chaired the position statement and represented the Endocrine Society during the consensus roundtables. “However, in the ever-changing landscape of diabetes and its management, both health care providers and people with diabetes will continue to need new and evolving tools to help address the common challenges they face.”
To help guide care givers, each section of the position statement starts with a common clinical scenario that illustrates identified gaps in diabetes care and provides graphics and tool that can be used in the clinical setting to deliver more patient-centered care.
It provides a framework that draws upon the experiences of people living with diabetes to optimize care in several areas to include:
- Use of person-centered language in the health care setting.
- Ensuring that referrals to diabetes self-management and support service programs are timely and accessible to all people with diabetes.
- Effectively navigating available therapeutic options together and explaining complex regimens to people with diabetes to encourage them to take medication as prescribed.
- Considering ways to adjust an individual’s treatment plan in a timely manner if they aren’t meeting therapeutic goals to prevent therapeutic inertia.
- Discussing strategies for assessment of hypoglycemia—low blood glucose episodes that can be dangerous—as well as prevention and treatment of hypoglycemia.
- Improving cardiovascular and renal outcomes using newer therapeutic options.
- Using telehealth in the appropriate clinical setting.
- Using and incorporating diabetes technologies such as insulin pumps and continuous glucose monitoring systems into the diabetes management plan, when appropriate.
