Hope's perspectives piece appears at the end of an Endocrine Today article;
It’s heartening to see this consensus statement published jointly from leading diabetes organizations, including AADE, and to see the science with which to widen our lenses to include clinically meaningful outcomes beyond our tunnel-vision focus on HbA1c.
But two questions arise.
The first: Why limit the statement scope to type 1 diabetes? Aren’t these measures and the litany of quality of life patient reported outcomes just as critical to health care providers and people with type 2 diabetes? Many people with type 2 diabetes, though fewer than should, take insulin, and far too many, studies show, continue to take sulfonylureas. Both increase the risk for hypoglycemia. And don’t we know enough now about the challenges of the HbA1c measure to recommend that clinicians and people with type 2 diabetes go beyond HbA1c as they choose therapies and make management decisions? It’s high time to erase this increasingly pathophysiologically-false divide between type 1 and type 2 diabetes!
The second question, though challenging to measure as the statement suggests: Should our lens on the list of patient reported outcomes widen even further to consider more quality-of-life measures under the banner of helping people with any type of diabetes live life holistically? I believe so.
To increase our diabetes care goal to achieve clinically meaningful measures, it’s important for us to keep asking the person wrestling with their diabetes, “What makes it easier for you to manage your diabetes?” The uniquely qualified care providers to ask these questions and assist in patient management and management plan adjustments are diabetes educators. Yet, the monotherapy of Diabetes Self-Management Education and Support (DSMES), often covered by health care plans (including Medicare), continues to be woefully underutilized and underappreciated. Let’s jointly work on increasing the referral rate to DSMES!
The compete article can be read here