Diabetes 2009 ver- sion of Association’s Diabetes is one of the most difficult chronic dis- Standards of Medical Care in Diabetes eases to manage, because it presents with an recommends strategies for improving diabetes overwhelming array of behavioral challenges and care, several of which target changes at the because optimal control requires a large amount nexus of care between physicians and patients of patient initiative. Currently experts feel that and include the following: 95% of treatment for diabetes is carried out by the patient or their family members. An important A management plan should be formulated as as- pect of treatment for diabetes is an individual therapeutic alliance among the communication patient, family, physician, and other members between the physician and the patient.18 of the health care team. Ongoing education and development of prob- Studies have shown that enhancing patient- lem-solving skills must be a constant aspect provider communication has resulted in improved of the disease management strategy. health outcomes such as: The goals of the treatment plan established by the patient and physician must be reason- Greater patient satisfaction, able. Adherence to treatment plans, Diabetes self-management education Higher self-reported health status, (DSME) is an integral component of patient Better emotional health, care.20 Greater symptom relief, and Physiological measures of disease control. Studies have found that keeping A1c at normal levels in people with diabetes can greatly reduce A large survey study determined that a multifac- cardiovascular disease and other comorbidities eted disease management program that incorpo- associated with diabetes. However, another study rates a focus on patient self-management was has found that despite recent trends toward im- promising. The findings illustrated that physician proved glycemic control, about 40% of U.S. dia- efforts at providing information to patients about betics fail to maintain good A1c control (<7%). their illness and treatment plans were the main Continued development of new pharmacological determinant of how well patients self-managed options is needed, in combination with efforts in- their diabetes. The results controlled for age and tended to support patient self-management.21 health status, which were both found not to influ- ence a patient’s self-management.19
Diabetes is one of the most difficult chronic dis- eases to manage, because it presents with an overwhelming array of behavioral challenges and because optimal control requires a large amount of patient initiative. Currently experts feel that 95% of treatment for diabetes is carried out by the patient or their family members. An important as- pect of treatment for diabetes is communication between the physician and the patient.18 Studies have shown that enhancing patient- provider communication has resulted in improved health outcomes such as: Greater patient satisfaction, Adherence to treatment plans, Higher self-reported health status, Better emotional health, Greater symptom relief, and Physiological measures of disease control. A large survey study determined that a multifac- eted disease management program that incorpo- rates a focus on patient self-management was promising. The findings illustrated that physician efforts at providing information to patients about their illness and treatment plans were the main determinant of how well patients self-managed their diabetes. The results controlled for age and health status, which were both found not to influ- ence a patient’s self-management.19 Diabetes Association’s 2009 ver- sion of Standards of Medical Care in Diabetes recommends strategies for improving diabetes care, several of which target changes at the nexus of care between physicians and patients and include the following: A management plan should be formulated as an individual therapeutic alliance among the patient, family, physician, and other members of the health care team. Ongoing education and development of prob- lem-solving skills must be a constant aspect of the disease management strategy. The goals of the treatment plan established by the patient and physician must be reason- able. Diabetes self-management education (DSME) is an integral component of patient care.20 Studies have found that keeping A1c at normal levels in people with diabetes can greatly reduce cardiovascular disease and other comorbidities associated with diabetes. However, another study has found that despite recent trends toward im- proved glycemic control, about 40% of U.S. dia- betics fail to maintain good A1c control (<7%). Continued development of new pharmacological options is needed, in combination with efforts in- tended to support patient self-management.21
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