Is Self-Management of Type 2 Diabetes Beneficial?
Diabetes impacts each patient differently, which is why there is not a one-size-fits-all approach to self-managing the chronic disease that affects nearly 26 million Americans.
“We really want to promote self-management because it paves the way to better outcomes,” says Michael Mendoza, M.D., M.P.H., Medical Director of Highland Family Medicine. “But we need to be mindful that there are limitations. More is not always better.”
Dr. Mendoza and Tziporah Rosenberg, Ph.D., L.M.F.T., examined research that evaluated the effectiveness of self-management tactics. They published a review of their findings, “Self-management of type 2 diabetes: A good idea – or not?,” in the May 2013 edition of The Journal of Family Practice.
Dr. Mendoza and Dr. Rosenberg found that for some patients, frequently checking blood sugar levels – a mainstay of diabetes self-care – is not always beneficial.
“Self-monitoring is not as simple as we previously thought,” Dr. Mendoza says. “If people check their blood sugars too much, they may become overwhelmed or even depressed. For a lot of people, self-monitoring is the thing they fear the most, and so we want to be careful before making recommendations.”
Patients with type 1 diabetes or patients on insulin for type 2 diabetes should check their blood sugar levels regularly, according to Dr. Mendoza. However, there is no clear evidence that suggests glucose monitoring has a positive long-term outcome in patients with type 2 diabetes who are not taking insulin.
“We need to evaluate patients on an individual basis,” Dr. Mendoza says. “It’s important for physicians to elicit what the patient’s goals are and work with them to ensure self-management recommendations match their needs and wants.”
The review also emphasizes the importance of partnerships among physicians and patients with diabetes educators, nutritionists and behavioral therapists.
“The behavior changes associated with any illness are tough,” Dr. Rosenberg says. “Individual and family therapy can help patients with diabetes manage the physical, psychological and relationship changes that diabetes can bring.”
Dr. Rosenberg talks about the emotional impacts of diabetes
“Leveraging the strengths of patients and their families is critical in making a difference in diabetes care,” Dr. Mendoza says. “If we give patients the education and individualized care they need, they will know how to manage this disease. Then we have a head start with them when they come see us in the office or when we visit them in their communities.
“Our goal is for our patients to be more empowered.”