Steven V. Edelman, MD


July 16, 2015

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There are so many tools in our toolbox now to treat people with both type 1 and type 2 diabetes, but especially type 2: nine classes of oral agents, newer insulins, and glucagon-like peptide 1 (GLP-1) receptor agonists. But why is the number of patients under glycemic control not improving?

I never thought I would say this, but we do have a lot of tools and we may not need too many more. What we have to do is get these new medications into the hands of people, but more important, we need to educate and motivate them about how these medications will help them live longer and healthier lives, which in turn will benefit their family members.

To me, this big issue of "adherence" and how so few patients take their medications continuously over the course of a year really boils down to education and motivation. There is no rocket science to this. You need to spend some quality time with your patients, get their trust, and make small changes slowly. Until we really engage our patients and spend some quality time with them, the adherence numbers will be poor and the A1c levels in this country will not improve dramatically.

You can bring all the new medications you want in the world, but we have to educate and motivate our patients to be their own self-advocates and work with their doctors to get the best care possible.


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