Diabetes Counseling

Diabetes patients who receive "coaching" reach their target numbers faster than those who don’t.

It’s hardly surprising, yet hugely significant – Recent research from Brigham and Women’s Hospital (BWH) finds that diabetes patients who receive regular counseling reach their target numbers faster than those who don’t.

In this day and age, most of us know what we’re supposed to do to maintain our health – whether we’re trying to dial back the numbers for diabetes or just reach a generally healthy lifestyle. Of course, actually doing what we’re supposed to do is another thing entirely.

To chalk it up to laziness misses the point. The fact is that lifestyle changes are complicated and challenging. Just like an athlete needs a coach to help her identify weaknesses and improve technique, or to push himself to his breaking point in a grueling workout – patients with chronic health conditions like diabetes often need a little lifestyle coaching to pinpoint their weak spots, develop techniques to address those weaknesses, and coax out that hidden strength within them to achieve their difficult goals.

At least, that’s what the BWH research study found. The study involved 30,000 people with diabetes who were treated in a primary care setting over the course of at least two years (with an average follow-up time of almost seven years) and who had elevated blood glucose, blood pressure, or cholesterol.
Here’s what the researchers discovered: The use of counseling reduced the time it took for patients to lower blood glucose, blood pressure, and cholesterol levels. Previous studies had documented the success of counseling in a clinical trial setting, but until now many doctors had questioned whether counseling would be as effective as part of ongoing treatment in a primary care setting, where fewer resources are available and patients may be less motivated.

The study also found that the more frequently patients received counseling, the faster they reached their treatment goals. Those who received face-to-face counseling once a month or more took an average of 3.9 weeks to reach their target goals for A1C, blood pressure, and cholesterol, as compared to 13.5 months for those who received counseling only once every one to six months.

“Clearly it gets people to goals faster than when they are given continued encouragement and information on how to increase physical activity levels, eat properly, and reduce lipids,” notes the study’s senior author Dr. Alexander Turchin, director of informatics research at the BWH Division of Endocrinology, Diabetes, and Hypertension. “Primary care providers should take these findings to heart.”

Because counseling can be time intensive, researchers recommend that working with providers such as nurse practitioners, physician assistants, or dietitians, as well as providing support in group settings, may be more cost-effective ways of providing this necessary support.

However it happens, the lesson is clear: A little extra “coaching” makes it easier to reach the goal.

– Linda W, MMQ

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