Primary care falls short on helping people with diabetes to help themselves

June 18, 2000

Physicians often neglect to counsel diabetic patients on how to self-manage their illness, suggest the results of a study.

"The important new message to primary care practices is that good diabetes management involves working with patients, not just sending them to the lab," said study author Russell E. Glasgow, PhD, of the AMC Cancer Research Center in Denver, CO.

Self-management counseling for type 2 diabetes -- a complex and challenging chronic illness requiring numerous lifestyle changes -- is recommended by the American Diabetes Association as part of their treatment and provider recognition program measures.

Such measures of delivery of important preventive services have become increasingly popular for treatment of chronic illnesses such as diabetes. Studies have shown that comprehensive disease management can reduce diabetes complications as well as deaths. Also, managed care organizations have recognized the high treatment costs of diabetes and want to increase quality of treatment, according to the study.

To examine how closely physicians adhered to diabetes treatment guidelines, the researchers surveyed a total of 435 type 2 diabetes patients, under the care of 47 physicians. They found that medical and laboratory test-related guidelines were more frequently followed than patient counseling-related guidelines. The study results appear in the July issue of the American Journal of Preventive Medicine.

Tests of blood pressure, lipids, and glycated hemoglobin (long-term blood sugar levels) were the most frequently reported recommended practices, while smoking cessation and nutrition counseling and self-management goal setting were the least. Only 3-5 percent of patients reported receiving all 11 of the provider recognition program recommended services, the researchers found.

"Given that most of the recommended prevention activities must be accomplished or initiated during the time-limited primary care visit, it is understandable that many of these activities are performed at substandard levels," said Glasgow.

Another finding was that patients who reported taking advantage of community resources to help manage their illness received the most medical and counseling-related services from their physicians. "The results suggest the importance of assisting patients to take advantage of their choice of community resources," said Glasgow.

While the frequency of blood pressure, lipid, and glycated hemoglobin testing was encouraging, more doctor-patient collaborative activities are needed, according to the researchers. "Such activities -- including setting mutually agreed-upon goals, incorporating the patients' social environment into the treatment plan, and problem-solving to overcome anticipated barriers -- characterize effective disease-management programs for diabetes," said Glasgow.

This research was supported by grants from the National Institute of Diabetes and Digestive and Kidney Diseases.
The American Journal of Preventive Medicine, sponsored by the Association of Teachers of Preventive Medicine and the American College of Preventive Medicine, is published eight times a year by Elsevier Science. The Journal is a forum for the communication of information, knowledge, and wisdom in prevention science, education, practice, and policy. For more information about the journal, contact the editorial office at (619) 594-7344.

Posted by the Center for the Advancement of Health < >. For information about the Center, call Petrina Chong, < > (202) 387-2829.

Center for Advancing Health

Related Diabetes Articles from Brightsurf:

New diabetes medication reduced heart event risk in those with diabetes and kidney disease
Sotagliflozin - a type of medication known as an SGLT2 inhibitor primarily prescribed for Type 2 diabetes - reduces the risk of adverse cardiovascular events for patients with diabetes and kidney disease.

Diabetes drug boosts survival in patients with type 2 diabetes and COVID-19 pneumonia
Sitagliptin, a drug to lower blood sugar in type 2 diabetes, also improves survival in diabetic patients hospitalized with COVID-19, suggests a multicenter observational study in Italy.

Making sense of diabetes
Throughout her 38-year nursing career, Laurel Despins has progressed from a bedside nurse to a clinical nurse specialist and has worked in medical, surgical and cardiac intensive care units.

Helping teens with type 1 diabetes improve diabetes control with MyDiaText
Adolescence is a difficult period of development, made more complex for those with Type 1 diabetes mellitus (T1DM).

Diabetes-in-a-dish model uncovers new insights into the cause of type 2 diabetes
Researchers have developed a novel 'disease-in-a-dish' model to study the basic molecular factors that lead to the development of type 2 diabetes, uncovering the potential existence of major signaling defects both inside and outside of the classical insulin signaling cascade, and providing new perspectives on the mechanisms behind insulin resistance in type 2 diabetes and possibly opportunities for the development of novel therapeutics for the disease.

Tele-diabetes to manage new-onset diabetes during COVID-19 pandemic
Two new case studies highlight the use of tele-diabetes to manage new-onset type 1 diabetes in an adult and an infant during the COVID-19 pandemic.

Genetic profile may predict type 2 diabetes risk among women with gestational diabetes
Women who go on to develop type 2 diabetes after having gestational, or pregnancy-related, diabetes are more likely to have particular genetic profiles, suggests an analysis by researchers at the National Institutes of Health and other institutions.

Maternal gestational diabetes linked to diabetes in children
Children and youth of mothers who had gestational diabetes during pregnancy are at increased risk of diabetes themselves, according to new research published in CMAJ (Canadian Medical Association Journal).

Two diabetes medications don't slow progression of type 2 diabetes in youth
In youth with impaired glucose tolerance or recent-onset type 2 diabetes, neither initial treatment with long-acting insulin followed by the drug metformin, nor metformin alone preserved the body's ability to make insulin, according to results published online June 25 in Diabetes Care.

People with diabetes visit the dentist less frequently despite link between diabetes, oral health
Adults with diabetes are less likely to visit the dentist than people with prediabetes or without diabetes, finds a new study led by researchers at NYU Rory Meyers College of Nursing and East Carolina University's Brody School of Medicine.

Read More: Diabetes News and Diabetes Current Events is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to