Clinical pearls and strategies to optimize patient outcomes.

Full Abstract

Increasing evidence suggests that a large proportion of patients with type 2 diabetes do not meet glycemic targets. Early diagnosis, realistic goal setting, improved patient adherence, and a better understanding of the pharmacotherapeutic treatment options are crucial to improving diabetes treatment outcomes in the United States. There are many reasons why patients do not achieve glycemic control. Barriers faced by clinicians, such as clinical inertia, lack of education time, and inappropriate use and titration of medications, need to be overcome to improve patient care. At the same time, patients are challenged by lifestyle management, lack of understanding of therapeutic options, and failing to see themselves as partners in their own care. Successful diabetes management programs incorporate several key features, including proactive reminders, consistent follow-up procedures, and use of clinical information systems to improve patient adherence and overall quality of care. Both clinicians and patients face barriers to advancing to injectable medications. Patients' attitudes may include fears of injections, technical challenges, and "punishment" for "failing" treatment. Clinicians have concerns about inadequate resources to address the needs of patients, patient nonadherence, and hypoglycemic events associated with certain injectable medications. Many of the strategies to overcome these barriers are reviewed.

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Author information

Author/s: Joy, Scott V (SV);

Affiliation: Division of General Internal Medicine, Duke University Medical Center, North Carolina, USA. joy00002(-atsign-)mc.duke.edu

Journal and publication information

Publication Type: Journal Article

Journal: The Diabetes educator (Diabetes Educ), published in United States. (Language: eng)

Reference: -2008 May-Jun; vol 34 Suppl 3 (issue ) : pp 54S-59S

Dates: Created 2008/06/05; Completed 2008/08/13;

PMID: 18525065, status: MEDLINE (last retrieval date: 11/6/2008)

Sourced from the National Library of Medicine. Abstract text and other information may be subject to copyright.

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MeSH headings (categories)

This article was linked to the MESH Headings shown below.

Blood Glucose - metabolism
Diabetes Mellitus - blood; psychology; therapy
Hemoglobin A, Glycosylated - metabolism
Humans

Injections, Subcutaneous
Insulin - administration & dosage; therapeutic use
Motivation
Patient Compliance

Associated Chemicals: Blood Glucose (0) ; Hemoglobin A, Glycosylated (0) ; Insulin (11061-68-0)

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