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Prioritize patient experience in diabetes care

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a new position statement This Endocrine Society program is designed to help clinicians prioritize patient experience and optimize outcomes in diabetes management.

This statement was made at the conclusion of two virtual roundtables held in 2022 with representatives from the American Diabetes Association, American College of Cardiology, American College of Physicians, Association of Diabetes Care Educators, and Centers for Disease Control. is reflected. Especially prevention.

“Over the past decade, many new classes of drugs and many new technologies have been introduced in the treatment of people with diabetes, but what our clinical guidelines recommend for achieving optimal health and “There remains a huge gap between results and what can actually be done in practice,” said Rita R. Kalyani, M.D., chair of the writing committee. Medscape Medical News.

The roundtable focused on the importance of recognizing the experiences of people living with diabetes, addressing existing gaps in diabetes care and the tools available to support patient-centered care in practice. said Kalyani, a professor of medicine in the department of endocrinology. Diabetes and Metabolism, Johns Hopkins University School of Medicine, Baltimore, Maryland. “What is most important to them? What are the challenges they have in their daily lives? And what is being communicated and understood?”

The statement is aimed at all those involved in the care of people with diabetes, including endocrinologists, primary care providers, specialists such as cardiologists and nephrologists, pharmacists, nurses, educators and dietitians, he noted. did.

When asked for comment, David T. Ahn, M.D., director of diabetes services at the Mary and Dick Allen Diabetes Center at Hogue in Newport Beach, California, said, “This statement is a sign that patients with diabetes cannot be optimally supported.” “It’s important to emphasize that it’s about the whole patient experience.” “It’s not just about blood sugar performance. People with diabetes are truly the biggest stakeholders in diabetes management, and their perspective should matter.”

On February 21, 2024, Journal of Clinical Endocrinology and Metabolismthis statement covers the following topics in separate sections:

  • The importance of effective communication between patients and healthcare providers during diagnosis and consultation
  • Addressing emotional and psychosocial needs, including helping people through diabetes distress and ‘burnout’
  • Refer patients to diabetes self-management education and support
  • Navigate available treatment options and explain complex treatments to patients
  • Minimize therapeutic and clinical inertia
  • Reduce the risk of cardiovascular, renal, and other complications, including the use of new drugs.
  • Discuss strategies to minimize hypoglycemia If relevant
  • Use telemedicine if necessary
  • Integrating diabetes technology into daily diabetes management

Each section begins with a clinical patient description. For example, describe his 42-year-old man as follows: type 2 diabetes basically insulin Those who have experienced high blood sugar levels during illness. His health care provider advised him to significantly increase his insulin dose, but he did not do so because he remembers that his father had severe hypoglycemic episodes at that time. . The man was hospitalized with dehydration and kidney failure.

In other cases, doctors are reluctant to share test results with patients during telehealth visits because family members are in the same room. During the same consultation, the patient was unable to show his swollen leg to the doctor because “if you move from this location, you lose your internet connection.”

Dr. Ahn says, “I like the structure of this statement because the case-based format helps clinicians better identify potential blind spots in their practice. The vignette is very realistic and the discussion around it is very detailed, with practical suggestions for improvement. There were many.”

There are also graphics scattered throughout the document to help you visualize the content. The table includes a list of common psychosocial conditions in diabetes, a list of questions to ask people to determine whether they need additional psychosocial screening or resources, and information on personal hypoglycemia risk and telemedicine. A questionnaire is included to assess suitability.

However, Professor Ang also said, “I agree with all the main recommendations in this statement. Unfortunately, as the authors point out, it is difficult to implement all the recommendations in this article in practice.” , which may not be feasible for traditional, busy clinics, especially for primary care providers doing administrative work.” We have to juggle multiple acute and chronic conditions…The biggest challenge is whether we have the time and resources to actually implement these recommendations. ”

Kalyani said, “Tools that support patient-centered care should not be a burden to people with diabetes or to healthcare providers who already have limited time to be effective. New drugs, new recommendations, new technologies. We will continue to develop new tools and resources.”

This position statement summarizes the discussions held at two 2022 consensus roundtables supported by educational grants to the Endocrine Society from Abbott, Medtronic, Novo Nordisk, and Vertex. However, this position statement has been prepared independently by the authors. Kalyani had not disclosed anything. Ann is a consultant for Lilly Diabetes and Ascensia Diabetes Care and is on speaker bureaus for Abbott, Ascensia, Insulet, Lilly, Mannkind, Novo, and Xeris.

Miriam E. Tucker is a freelance journalist based in the Washington, DC area. She is a regular contributor to her Medscape, and her other work has also appeared in the Washington Post, NPR’s Shots blog, and Diatribe. You can find her on her X (formerly Twitter) @MiriamETucker.

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