Effective Tools for Management of Type-2 Diabetes in Primary Care

Diabetes is a highly prevalent disease associated with many devastating comorbidities. Although there have been significant advances in the testing, diagnosing, and treatment of diabetes, glycemic control continues to be a challenge for practitioners and their patients. The purpose of this state of the science review is to address the multitude of barriers to effective management and identify diabetes treatment strategies. Management barriers identified in the literature can be classified as patient- or practitioner-based. Patient obstacles include lack of engagement, knowledge deficit, lifestyle-based challenges, and financial obstacles. Provider obstacles include lack of education and resources, poor collaboration, and system-wide hurdles. The assessment tools identified in this review help practitioners to quickly and affordably detect potential obstacles to treatment such as patient disengagement and emotional distress. The interventions identified in this review can help practitioners address many of the barriers to effective treatment. The efficacy of these tools depends on a practitioner's ability to gain a meaningful understanding of their patient's individual barriers to treatment and to tailor management strategies to address those barriers. The assessment tools combined with the interventional tools make up a systematic and comprehensive three-step approach to diabetes management.