Managing diabetes can be a challenging journey for both patients with diabetes (PWD) and their caregivers. Despite the uniqueness of each person’s experience with diabetes, common themes emerge in navigating this chronic condition.
However, the perspectives of PWD have not always been fully integrated into the implementation of recommended standards of diabetes care, according to a recent Endocrine Society position statement published in The Journal of Clinical Endocrinology & Metabolism.
“Although many evidence-based treatment algorithms can now help guide HCPs in managing diabetes and its microvascular and macrovascular complications (3-7), few guidelines have fully considered patient experiences to inform how to best implement the recommended standards of diabetes care. The relative paucity of voices of PWD in important clinical decisions and research remains a substantial barrier to achieving optimal health outcomes,” wrote Rita R. Kalyani, MD, MHS, and co-authors.
The position statement summarized insights from multistakeholder expert roundtable discussions. The discussions aimed to identify gaps in diabetes management and highlight tools to empower clinicians and PWD seeking to address these challenges. Delegates from professional societies, governmental organizations, patient advocacy groups, and social enterprises participated in the roundtables.
Each section of the discussion presented a clinical scenario as a framework for achieving desired health outcomes, along with resources for clinicians to deliver patient-centered care in practice. As diabetes management continues to evolve, developing new tools to support clinicians in assisting PWD is crucial, the authors wrote. Moreover, strategies for the efficient adoption of these tools in clinical settings are needed to minimize provider burden.
The statement lists the following targets as priorities in diabetes management:
❯ Effective communication during clinical interactions
❯ Addressing the emotional and psychosocial needs of PWD and their caregivers
❯ Ensuring timely and effective referrals to DSMES programs
❯ Effectively navigating available therapeutic options together and explaining complex regimens to PWD
❯ Minimizing therapeutic and clinical inertia
❯ Discussing strategies for hypoglycemia assessment and risk reduction
❯ Improving cardiovascular and renal outcomes using therapies as clinically indicated
❯ Using telehealth in the appropriate clinical settings
❯ Integrating diabetes technologies into routine management
In addition, coordination among various stakeholders is essential at all stages of the patient journey.
“To facilitate optimal implementation of currently recommended standards of diabetes care in real world settings, it is critical that [clinicians] acknowledge the breadth of PWD’s experiences and use them to inform the management of diabetes and its complications,” Dr. Kalyani and colleagues concluded.