Wellness iNPractice Diabetes

Engaging Patients to Build an Individualized
Diabetes Management Plan

Helping patients with self-management of diabetes requires a comprehensive picture of not only a patient’s health, lab results, and treatment plan, but also their understanding of and capacity for self-care. Even if patients understand the importance of glucose monitoring and adherence to their prescribed medications for keeping their blood glucose levels under control, they may be facing circumstances or have limitations that affect their ability to carry out all the different aspects of self-management. These can include:

  • Scheduling issues – patients may find it difficult to fit glucose testing, taking medications, and daily exercise into an already busy schedule
  • Low literacy – patients may have trouble understanding basic concepts about diabetes
  • Language barriers – patients may have a high health literacy, but still find it difficult to understand instructions given in a non-native language
  • Cognitive impairment – some patients may have difficulty understanding and following self-care instructions
  • Psychosocial issues – many patients with diabetes suffer from depression or lack sufficient emotional support from their family members or community
  • Lack of transportation – getting to and from appointments can be difficult to impossible for some patients
  • Lack of access to healthy foods – disparities in food access can make it hard for some patients to find the healthy foods they are being asked to eat in order to manage diabetes
  • Obstacles to physical activity – starting and maintaining a program of daily activity can be difficult for anyone, and patients with diabetes may not know where to start or how to fit it into their schedule
  • Cultural issues – certain cultures may include foods that do not match up with the nutrition recommendations patients receive, or they may hold beliefs about the healthcare system or medication efficacy that could undermine their treatment plan
  • Financial obstacles – the inability to pay for medications and glucose testing supplies can impact continuity, and ultimately the success, of a patient’s management plan

Available in both English and Spanish, you can use the Icebreaker Flashcards to start the conversation with your patient and determine which issues are most important to them.

Interviewing patients in depth after they have received a diagnosis and then periodically throughout the course of treatment can help you understand how much patients know about diabetes, their treatment plan, and the various aspects of self-management. Interviewing patients can also allow you and your patient to determine how each self-management activity best fits into their daily schedule and identify and anticipate any potential obstacles that might arise.

The Patient Interview Guide will help you construct a clear picture of the patient’s clinical status as well as their personal perspective on their diagnosis and how it will affect their life. It can also give you a framework for building the patient’s daily schedule using the My Daily Schedule planner. You can use the results of the patient interview to determine the best tools and resources for your patient to ensure effective diabetes self-management. The Overcoming Barriers section contains additional online resources for you to review and share with your patients as appropriate, including:

  • Information about referring patients for diabetes self-management education given at the appropriate literacy level and in the language they are most familiar with
  • Links to resources for financial support
  • Links to information about auxiliary services (e.g., transportation, mental health, home health)
  • Tools to help patients track blood glucose or incorporate diabetes care into their daily schedule