Patient discussions

The American Diabetes Association recommends that all patients are provided with individualised, goal-oriented Diabetes Self-Management Education and Support (DSMES) to facilitate positive health behaviours and engagement with their diabetes management and care decisions.[1]​ This may be delivered remotely (e.g., via telehealth or digital interventions) according to patient preferences and to address barriers to access. DSMES should be provided annually, and as indicated by change in diabetes management, health status or psychosocial circumstances.[1]

Blood glucose and blood pressure (BP) should be monitored at home. The patient should be encouraged to stop smoking (including e-cigarettes) if applicable, exercise regularly, and adhere to prescribed drug treatments. Use of non-prescription drugs or complementary medicines should be avoided until they have been discussed with a physician. Communication of cardiovascular (CV) risk to patients has been shown to lead to small but significant reductions in the CV risk score at 6- to 12-month follow-up, as well as reductions in mean BP and cholesterol, and should be considered in routine consultations.[237]

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