Virtually Better Diabetes Care?

Despite growing awareness of the problem, the diabetes epidemic shows no signs of abating and continues to pose a public health problem of grave concern (1).

Nonpharmacologic interventions focused on lifestyle modifications, including diet and exercise, remain a major component of therapy. Individualized nutrition therapy has been shown to be effective for improvement of the metabolic profile and weight loss. However, most studies of popular diets are usually of short duration and have high attrition rates (15–50% within 1 year) (2). Adherence to any prescribed diet is a real challenge, especially when we are surrounded by easily accessible, processed food of high caloric and low nutritional value. It is therefore not surprising that lifestyle modification often fails, and as health care providers (HCPs), we find ourselves compelled to add more and more pharmacotherapies and often recommend metabolic surgery to achieve therapeutic goals. Indeed, despite significant advances in pharmacotherapy, there has been no significant change in the percentage of people who achieve therapeutic goals (3).

A key question that needs to be addressed is how HCPs can help patients adhere to a treatment plan that will enable them to achieve and sustain improvements in metabolic control. One of the most essential components of diabetes care is access to an HCP. There is a significant shortage of primary care providers and endocrinologists in the United States, with the rising number of patients with diabetes outstripping the number of HCPs (4).

Endocrinologists are asked to see more patients in less time, and new patients may have to wait for months to be seen. The problem is even worse for patients in remote areas, who must travel long distances to be seen. It is also commonly observed that patients …