New ADA Recommendations on language for diabetes care and education

New ADA Recommendations on language for diabetes care and education 

Dr KK Aggarwal

The importance of communication can never be emphasized enough, especially for a doctor. Communication, rather lack of it, or miscommunication is often the root cause of disputes, including those involving doctors and patients.

Avoid the 3 Cs of violent communication: Condemn, criticize and complaint. A positive communication approach is more productive and improves adherence to treatment and patient satisfaction with better therapeutic outcomes. This is very important in cases of chronic diseases such as diabetes. Lifestyle modifications are an integral part of management of type 2 diabetes, which is a lifestyle disorder. Patients have to become accustomed to living with a disease. Therefore, they not only need treatment from their doctor, they also look to them for empathy and support in adjusting to a new lifestyle.

The language that doctors and other healthcare professionals involved in treatment use to discuss the disease may impact both self-perception and treatment outcomes for people living with diabetes.

The American Diabetes Association (ADA) and the American Association of Diabetes Educators (AADE) have published a Consensus Report to help guide the language used by healthcare providers to be positive, respectful, inclusive, person-centered and strengths-based, acknowledging the paradigm shift in diabetes care toward a collaborative approach that includes people with diabetes as the primary member of their care team.

The task force made five key recommendations for discussing diabetes:

1. Use language that is neutral, nonjudgmental, and based on facts, actions, or physiology/biology
2. Use language that is free from stigma
3. Use language that is strengths-based, respectful, inclusive and imparts hope 
4. Use language that fosters collaboration between patients and providers
5. Use language that is person-centered

The Consensus Report titled “The Use of Language in Diabetes Care and Education” is published online October 17, 2017 in the journal Diabetes Care.

(Source: ADA News Release, October 17, 2017)

New guidelines on diabetes self-management education and support

New guidelines on diabetes self-management education and support Management of diabetes is multidisciplinary and a team approach is the basis of care of the patient with diabetes, who is at the center of this team. Diabetes self-management education (DSME) is a very important aspect of management in all patients with diabetes, including those with prediabetes. Optimal control of blood sugar is important; but, it is also important to control other risk factors such as hypertension, dyslipidemia in order to prevent the macrovascular and microvascular complications of diabetes. Because of the need for lifestyle modifications, patients with diabetes are themselves responsible for the day to day management of diabetes, but with the support of the doctor. For the first time, the American Diabetes Association (ADA) and American Association of Diabetes Educators (AADE) have combined education and support (DSMES) and released new standards to help diabetes educators and medical providers establish and sustain patient care models, programs and teams for people with diabetes and their caregivers. These guidelines will be published in the September 2017 issues of Diabetes Care and The Diabetes Educator. These standards relate to organizational structure, participation of community stakeholders, access, program coordination, instructional staff, individualizing diabetes education to the need of each patient, monitoring of patient progress and quality improvement. An up-to-date, evidence-based, and flexible curriculum provides education. These standards emphasize that DSME alone does not translate into effective self care. Ongoing support is very important to improve patient outcomes. The standards defined in these recommendations can be applied to both small solo practices, as well as large, multicenter facilities. (ADA Press Release, July 28, 2017) Dr KK Aggarwal National President IMA & HCFI