Doctors Agree: They Need More Time with Type 2 Diabetes Patients


 

Have you ever wished you could get a little more time with your doctor? You’re probably not alone. In fact, your doctor likely feels this way, too.

In a recent survey, nearly 1,000 healthcare professionals (HCPs) agreed: being able to spend more time with patients with Type 2 diabetes would mean they could help those patients see greater improvements in their health. But the problem is bigger and more complicated than simply having more time to spend with each patient. 

The specialists you might see for other health issues (like high blood pressure or kidney disease) also feel there isn’t enough communication between each specialty regarding each patient’s care. More than 80 percent of endocrinologists (diabetes specialist), cardiologists (heart specialist), and nephrologists (kidney specialist) wished they were able to track each patient more closely overall as they see these different specialists.

The survey results also highlighted the alarming fact that many specialists say they aren’t given any information about a new referral prior to their first appointment, demonstrating a significant flaw in the health records and communications process within the medical system.

The survey was conducted by The Harris Poll on behalf of Boehringer Ingelheim and Eli Lilly and Company (NYSE: LLY), as part of the Unleashing the Truth About Diabetes and Heart Disease® campaign. The overall goal of this survey is to increase both patient and primary healthcare awareness of these diabetes-related specialties.

“The majority (80% of nurse practitioners, 79% of nephrologists, 73% of endocrinologists, 69% of primary care physicians and 63% of cardiologists) agree they would call another specialist to help treat these patients if they had the resources,” explained the press release.

“Diabetes is a complex condition, and each specialty should be prioritizing their patients’ overall health and developing treatment plans in collaboration with other specialists without worrying of overstepping,” said Javed Butler, M.D., Chairman, Department of Medicine, University of Mississippi. “When our specialties collaborate, we give our patients the best chance of success.”

People with Type 2 Deserve More Time with Diabetes Educators

Unfortunately, many people with Type 2 diabetes are also never referred to a diabetes educator which then increases their risk and likelihood of developing diabetes-related complications down the road.

Despite research demonstrating that working with a diabetes care and education specialist (ADCES) leads to a 1% reduction in HbA1c levels, the insurance coverage for diabetes education and ongoing support is extremely limited compared to the coverage for people with Type 1 diabetes.

For example, people on Medicare or Medicaid are offered coverage for 10 hours of initial diabetes education in their first year after being diagnosed, and a maximum of 2 hours per year with a diabetes educator going forward, explained a 2016 joint statement from the American Diabetes Association (ADA), the American Association of Diabetes Educators (AADE), and the Academy of Nutrition & Dietetics (AND).

But many new Type 2 diabetes diagnoses never meet with an ADCES at all.

Instead, their diabetes is often managed by a primary care physician (PCP) or nurse practitioner. While your primary care team is certainly a critical part of your health management, they are not usually well-versed in the variety of diabetes medications and treatment options.

“Diabetes self-management education (DSME) is the process of facilitating the knowledge, skill, and ability necessary for diabetes self-care,” explained the joint statement.

“Diabetes self-management support (DSMS) refers to the support that is required for implementing and sustaining coping skills and behaviors needed to self-manage on an ongoing basis.”

When the treatment plan for a person with Type 2 diabetes is being managed by a PCP or a specialist in cardiology or nephrology, for example, they’re being given prescriptions for medications by someone who simply does not specialize in how these medications work. 

“The vast majority of healthcare professionals agree that it is the responsibility of all specialists involved in the treatment of Type 2 diabetes to prescribe the best treatments available regardless of specialty area,” explained the recent press release regarding the survey results. 

“Although endocrinologists and PCPs report being confident prescribing these classes of medication, around 20 to 40 percent of nephrologists and cardiologists say they are hesitant to prescribe them, since they are outside their primary area of expertise.”

Hopefully, this survey will lead to a significant overhaul of how the care and treatment of a person with Type 2 diabetes are managed between different specialties.

If your healthcare team has never offered to set up an appointment for you with a diabetes educator, ask for one. If your insurance refuses to cover it, appeal and fight for your right to receive diabetes support and education from a healthcare professional who specializes in diabetes management.

WRITTEN BY Ginger Vieira, POSTED 04/05/21, UPDATED 04/05/21

Ginger Vieira is an author and writer living with type 1 diabetes, Celiac disease, fibromyalgia, and hypothyroidism. She’s authored a variety of books, including “When I Go Low” (for kids), “Pregnancy with Type 1 Diabetes,” and “Dealing with Diabetes Burnout.” Ginger’s also written for Diabetes Mine, Healthline, T1D Exchange, Diabetes Strong and more! In her free time, she is jumping rope, scootering with her daughters, or walking with her handsome fella and their dog.