Abstract
Primary care providers deliver more outpatient diabetes management than any other group of health care professionals. However, primary care providers are faced with several challenges in providing diabetes education. Time restraints, high patient volumes, and other medical issues that must be addressed are just some of the many factors that may impede effective diabetes education. Solutions to these issues include involving the entire outpatient office staff in the diabetes management of the patient; focusing on issues of most concern to the patient; providing basic, “survival” skill education; and referring, when appropriate, to other specialists, including endocrinologists and diabetes educators.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Preview
Unable to display preview. Download preview PDF.
References
American Diabetes Association. Standards of medical care in diabetes. Diabetes Care 2008; 31:S12–S54.
Brown S. Effects of educational intervention in diabetes care: a meta-analysis. Nursing Res 1988; 4:223–230.
Center for Disease Control and Prevention. Preventative care practices among persons with diabetes. JAMA 2002; 288:2814–2815.
Leontos C, Geil PB. Individualized Approaches to Diabetes Nutrition Therapy: Case Studies. Alexandria: American Diabetes Association 2002:657.
Pichert JW, Schlundt DG. Assessment: Gathering information and facilitating engagement. In: Mensing, C. The Art and Science of Diabetes Self-Management Education: A Desk Reference for Healthcare Professionals. Chicago: American Association of Diabetes Educators 2006:578–595.
Anderson R, Patrius R. Getting out ahead: The diabetes concerns assessment form. Clin Diabetes 2007; 25:141–144.
National Heart Lung and Blood Institute. Clinical guidelines on the identification, evaluation and treatment of overweight and obesity in adults: The evidence report; Obes Res 1998; 6:51S–209S.
Camp KK. Being active. In: Mensing, C. The Art and Science of Diabetes Self-Management Education: A Desk Reference for Healthcare Professionals. Chicago: American Association of Diabetes Educators 2006:670–688.
Bardsley JK, Ratner RE. Pathophysiology of the metabolic disorder. In: Mensing, C. The Art and Science of Diabetes Self-Management Education: A Desk Reference for Healthcare Professionals. Chicago: American Association of Diabetes Educators 2006:143–161.
Hinnen D, Nielsen L, Waninger A, Kushner P. Incretin Mimetics and DPP-IV Inhibitors: New Paradigms for the Treatment of Type 2 Diabetes. J Am Board Fam Med. 2006; 19: 612–620.
Monnier L, Lapinski H, Colette C. Contributions of fasting and postprandial plasma glucose increments to the overall diurnal hyperglycemia of type 2 diabetic patients: Variations with increasing levels of HbA(1c). Diabetes Care. 2003; 26:881–885.
Gerich JE. Clinical significance, pathogenesis, and management of postprandial hyperglycemia. Arch Intern Med. 2003; 163:1306–1316.
American Association of Clinical Endocrinologists/American College of Endocrinology Diabetes Recommendations Implementation Writing Committee. ACE/AACE Consensus conference on the implementation of outpatient management of diabetes mellitus: Consensus conference recommendations. Endocr Pract. 2006; 12:(Suppl 1): 6–12.
American Association of Clinical Endocrinologists. Medical guidelines for clinical practice for the diagnosis and treatment of dyslipidemia and prevention of atherogenesis. Endocr Pract. 2000; 6:162–213.
Ohkubo Y, Kishikawa H, Araki E, et al. Intensive insulin therapy prevents the progression of diabetic microvascular complications in Japanese patients with non-insulin-dependent diabetes mellitus: A randomized prospective 6-year study. Diabetes Res Clin Pract. 1995; 28:103–117.
UKPDS Group. Intensive blood glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33). Lancet. 1998; 352:837–853.
DCCT/EDIC Group. Retinopathy and nephropathy in patients with type 1 diabetes four years after a trial of intensive therapy. N Engl J Med. 2000; 342:381–389.
DCCT/EDIC Group. Intensive diabetes treatment and cardiovascular disease in patients with type 1 diabetes. N Engl J Med. 2005; 353:2643–2653.
Nathan DM, Buse JB, Davidson MB, et al. Management of hyperglycemia in type 2 diabetes: A consensus algorithm for the initiation and adjustment of therapy. Diabetes Care. 2006; 29:1963–1972.
Nathan DM. Finding new treatments for diabetes—How many, how fast…how good. N Engl J Med. 2007; 365:437–440.
Skyler JS. Insulin treatment. In: Lebovitz HE, ed. Therapy for Diabetes Mellitus and Related Disorders. Alexandria: American Diabetes Association 2004:207–223.
Hirsch IB, Bergenstal RM, Parkin CG, et al. A real-world approach to insulin therapy in primary care practice. Clin Diabetes. 2005; 23:78–86.
Riddle MC, Rosenstock J, Gerich J. The Treat-to-Target Trial: Randomized addition of glargine or human NPH insulin to oral therapy of type 2 diabetic patients. Diabetes Care. 2003; 26:3080–3086.
Gavin JR. Practical approaches to insulin therapy. Diabetes Educ. 2007; 33:66S–73S.
Mullooly CA. Physical Activity. In: Mensing, C. The Art and Science of Diabetes Self-Management Education: A Desk Reference for Healthcare Professionals. Chicago: American Association of Diabetes Educators 2006:297–319.
Polonsky WH, Fisher L, Guzman S, et al. Psychological insulin resistance in patients with type 2 diabetes. Diabetes Care. 2005; 28:2543–2545.
Pergallo-Dittko V. Removing barriers to insulin therapy. Diabetes Educ. 2007; 33:60S–65S.
Peyrot M, Rubin RR, Lauritzen T, et al. Resistance to insulin therapy among patients and providers. Diabetes Care. 2005; 28:2673–2679.
Fleming, D, Jacober SJ, Vandenberg MA et al. The safety of injecting insulin through clothing. Diabetes Care. 1997; 20: 244.
Singh S, Yoon K. Loke YK, Furberg CD. Long-term risk of cardiovascular events with rosiglitazone: A meta-analysis. JAMA. 2007; 298:1189–1195.
Nissen, SE, Wolski K. Effect of rosiglitazone on the risk of myocardial infarction and death from cardiovascular causes. N Engl J Med. 2007; 356: 2457–2471.
American Diabetes Association. A Resource Guide. Diabetes Forecast January, 2008: RG11–RG14.
Zgibor J, Peyrot M, Ruppert K. Using the AADE outcomes system to identify patient behavior change goals and diabetes educator responses. Diabetes Educ 2007; 33:840–41.
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2009 Humana Press, a part of Springer Science+Business Media, LLC
About this chapter
Cite this chapter
Mensing, C., Hinnen, D. (2009). Making the Most of the Outpatient Visit. In: Weinger, K., Carver, C.A. (eds) Educating Your Patient with Diabetes. Contemporary Diabetes. Humana Press. https://doi.org/10.1007/978-1-60327-208-7_5
Download citation
DOI: https://doi.org/10.1007/978-1-60327-208-7_5
Publisher Name: Humana Press
Print ISBN: 978-1-60327-207-0
Online ISBN: 978-1-60327-208-7
eBook Packages: MedicineMedicine (R0)