Patient empowerment and optimal glycemic control

Curr Med Res Opin. 2012 Jun;28(6):979-89. doi: 10.1185/03007995.2012.677417. Epub 2012 May 9.

Abstract

Objective: This review updates the clinician on strategies of insulin use and educational approaches to empower their patients to use insulin correctly in self-management treatment plans.

Design and methods: A PubMed literature search was conducted to identify peer-reviewed clinical trials published in English in the last 10 years. Search terms used were 'glycemic control', 'insulin', and 'type 2 diabetes'. An additional search to include the terms 'patient empowerment' and 'self-management' was also conducted. Some articles relevant to this review may not have been identified using these terms. Oral antidiabetes agents in conjunction with insulin are not addressed.

Results: A total of 562 articles were initially identified. Papers that did not provide data pertinent to the efficacy and tolerance of insulin types for treatment of type 2 diabetes mellitus (T2DM) were excluded. Based on methodology, results, and clinical implications, 12 clinical trials were included for discussion in this review.

Conclusions: Patients with T2DM who are empowered with knowledge about their disease and treatment can take an active role in their diabetes care, and therefore, are more likely to achieve blood glucose and A1C goals, which can slow progression of their disease and the onset of complications. Although concentrating solely on medical information and physiological facts does not guarantee patient empowerment and self-management, educational strategies such as interactive teaching, problem solving and individualized education can have a positive impact. Insulin titration algorithms can empower patients to manage their therapy, and such algorithms are simple to use for patients treated with insulin analogs. As patients with T2DM become empowered by knowledge and gain more control of their disease, their physicians must then serve as their advisors rather than as their directors or prescribers.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Blood Glucose / drug effects
  • Blood Glucose / metabolism*
  • Clinical Trials as Topic / statistics & numerical data
  • Diabetes Mellitus, Type 2 / blood*
  • Diabetes Mellitus, Type 2 / drug therapy*
  • Humans
  • Hypoglycemic Agents / therapeutic use*
  • Patient-Centered Care / methods
  • Power, Psychological*
  • Self Care* / psychology

Substances

  • Blood Glucose
  • Hypoglycemic Agents