Getting Out Ahead: The Diabetes Concerns Assessment Form

There are many challenges facing patients and providers in caring for diabetes. One challenge that often frustrates both patients and providers is the pressure on providers to accomplish more in less time. Trying to deal with all the issues during a 10- or 15-minute visit virtually guarantees that there will not be adequate time to discuss all the important issues related to diabetes care. The competing pressures on providers to contain costs and adhere to evidence-based treatment guidelines further exacerbate this already difficult situation. In such an environment, reviewing patients' “numbers” and making appropriate medication adjustments are quite likely to consume the entire visit.

While this may seem efficient, this type of visit can lead to dissatisfaction and frustration by both health care professionals and patients. Health professionals feel frustrated by patients' seeming inability to manage diabetes effectively. And patients sometimes feel that they are just a blood glucose number to their provider.

Diabetes care is largely a self-care disease. In fact, people with diabetes provide > 90% of their own care. To be successful, they need to incorporate diabetes into their lives. For them, diabetes is about much more than the numbers. It affects virtually every aspect of their daily lives because of the number of diabetes-related decisions they need to make. Addressing only the numbers is a short-sighted view of diabetes and one that is doomed to fail. The Diabetes Attitudes, Wishes, and Needs study¹ demonstrated that patients who are more satisfied with their relationship with their provider have better outcomes. Thus, going beyond the numbers is not just a nice thing to do; it is part of quality diabetes care. The issue is how to address the …