Physicianʼs Role in Diabetes Self-Management

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Abstract
Diabetes self-management refers to the many tasks in which patients must engage on a regular basis to manage their diabetes (e.g., soli-monitoring of blood glucose, medication adjustment, diet, and exercise). This multitude of complex and often interrelated tasks can overwhelm lm patients and frustrate practitioners. This paper reviews the behavioral science literature on diabetes self management and offers practical suggestions regarding; the application of this information to the busy practices of endocrinologists and others who see patients with diabetes. Three points are emphasized: 1) diabetes self-management is not an ''all or none'' behavior; patients who have difficulty with one aspect of the regimen may do well with other aspects; 2) diabetes self-management has multiple influences, including patient factors, hearth care team factors, and social/environmental factors, all of which need to be addressed to assist patients in successfully managing their diabetes; and 3) to have a significant and lasting impact, we need to take a population based approach involving office systems to provide prevention, monitoring, and reinforcement of self-management behaviors, These activities can be accomplished in feasible, low-cost ways, and examples are provided.