Aims
Majority of type 2 diabetes patients are not at HbA1c goal
Reaching glucose goals is important to reduce microvascular complications
Retinopathy and nephropathy1 -4
present in ~1 in 5 patients at diagnosis
leading causes of blindness and end-stage
renal disease

Neuropathy
present in ~1 in 8 patients at diagnosis1
affects ~70% of people with diabetes5
a leading cause of non-traumatic lower
extremity amputation6

Reaching glucose goals is important to reduce macrovascular complications

Overall, 75% of people with type 2 diabetes die
from cardiovascular disease1,2

Barriers to achieving good glycemic control
Considering the patient perspective
Some misconceptions about diabetes
Challenges in improving patient understanding
Challenges in increasing adherence
Need for shared responsibility/ common philosophy for achieving glycemic goals
Establish a partnership between patient and healthcare professional
The need to establish a good rapport
Motivating patients to achieve and maintain glycemic control
This is great news.
Continue with the good work and keep your blood sugar under control -you’ ll feel better for it!

Use a patient-centered approach
Initial consultation: where to start?
What does type 2 diabetes mean:
to you?
to your family/friends?
What are your fears/expectations?
How will type 2 diabetes affect:
your everyday life?
your family?
your job?
your social life?
What can we do about it together?
Subsequent consultations
How are you?
Have you been regularly monitoring
sugar levels?
You are not yet at goal -how can I help?
Discuss options and reach mutual decision
Agree when and how to review options
Apart from diabetes, what else is new?
Helping patients to accept their condition
Motivating and supporting patients to change their lifestyle
Provide practical and realistic advice on implementing and sustaining lifestyle change
Discuss steps that can be implemented now
Where possible, involve other members of the diabetes care team, particularly family and friends
Role of the multidisciplinary team
The multidisciplinary team: core members
The multidisciplinary team: additional members
Key function of the multidisciplinary team
Additional functions of a multidisciplinary team
Provide input at diagnosis of condition and continually thereafter to:
agree standards of care
discuss rational therapeutic suggestions
monitor guideline adherence and short-term outcomes
avoid early complications or provide timely intervention to decrease diabetes-related complications
Enable long-term patient
self-management
The multidisciplinary team requires
Common goals
Supportive/nurturing approach
Commitment to principles of self care
Good interpersonal skills of team members
Clear definition of specific and shared responsibilities of team
Tailoring of team members according to setting and resources
The multidisciplinary team: shared responsibility for education
Impact of implementing an educational program via a multidisciplinary team
Impact of a multidisciplinary team on glycemic control and hospital admissions
A multidisciplinary team can reduce costs
Other benefits of a multidisciplinary team approach to type 2 diabetes care
How can expertise be best utilized in diabetes management?

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