COMPREHENSIVE APPROACHES

TO DIABETES CARE &

COLLABORATIVE MANAGEMENT
CHARISSE DULDULAO
SHEILANI ABDULHARI
MA CLARIBEL GERODIAS
 Monitoring

DM
Management

Technology Treatment
 Shared decision
making

Integration of
Patient Motivational
Interview
Techniques Dynamic Model of
Centered Diabetes Care Delivery
holds in reaching
Strategies Shared Medical
Appointments
GLYCEMIC TARGETS AND
IMPROVE PATIENT’S
QUALITY OF LIFE

Multidisciplinary
Team
Collaboration
 1. INSULIN
 Selection of insulin regimen is influenced by a variety of factors
including but not limited to :
Modern  Cost
Advances in 

Patient or family preference
Balancing number of injections each day with flexibility of schedule
Diabetes Care  Local diabetes center resources
 Prescribing patterns
 Pragmatic considerations such as availability of support throughout the
day to supervise insulin administration.
Modern 2. CGM - Continuous Glucose Monitoring

Advances in 3. CSII - Continuous Subcutaneous Insulin Infusion

Technology that allows for more accurate and timely monitoring of
Diabetes Care glucose levels.
 Updated Glycemic Targets

GUIDELINES In recognition of the inverse relationship between glycemic

control and onset of diabetes related complications , the American
FOR Diabetes Association (ADA) recently updated A1c targets < 7.5%
for all pediatric age groups, which is in accordance with the
DIABETES recommendations of other national and international diabetes
organizations
CARE These new guidelines continue to highlight individualization of
blood glucose and A1c targets with the goal of achieving the best
control possible for the individual, while minimizing risks of severe
glucose variability
Guidelines for Diabetes Self-Management Education (DSME) and Diabetes Self-
Management Support (DSMS)
Self- updated ADA guidelines highlight the importance of ongoing
culturally sensitive and developmentally appropriate
Management individualized
Education and Effective diabetes education and support that helps to integrate
diabetes care with other daily activities is a valuable component of
Support comprehensive diabetes care
MULTIDISCIPLINARY  To refine the multidisciplinary clinical care delivery system.
APPROACHES TO  Team members may collaborate during routine team meetings to
DIABETES CARE discuss the patient, decide on appropriate referrals, and plan for
patient care
 endocrinologists/
nurses
diabetologists

Multidisciplinary diabetes
dieticians
Diabetes Team educators

psychologists or
social workers
 Advantage
Diabetes care However, if
Multidisciplinary providers working multidisciplinary
effectively in services are not unified
Diabetes Team conjunction with
multidisciplinary team
within a team
approach, it may lead
members have the to fragmented care or
potential to strengthen lack of consistency

Disadvantage
clinical care. between providers
COMMON
PROBLEM:
Financial barriers to access services or increased medical costs for patients that utilize
multidisciplinary services.
Inter-
Disciplinary
Approaches to COMMUNICATION
COORDINATION

Care SHARED RESPONSIBILITY

Patients’ Experiences
of Multidisciplinary
Diabetes Care
 CHALLENGE IN DIABETES CARE MANAGEMENT:
complex, time-consuming process, and one that requires
MANAGEMENT understanding of each patient’s individual behaviors and the
influence these behaviors have on clinical outcomes.
OF DIABETES NEEDED:
 PATIENT CENTERED CARE APPROACH
PATIENT-
CENTERED
APPROACH
TO DIABETES
CARE
DIABETES Diabetes
MANAGEMENT Diabetes
Management at
Diabetes
Management in
Management:
Costs and
BETWEEN Home: Focus on
Technology
the Schools Economic
Considerations
VISITS
  Despite significant advances in diabetes treatment regimens and
technology, providers, patients, and families continue to
encounter challenges to achieving optimal glycemic control. The
CONCLUSION global consensus for lower glycemic control targets may be
AND FUTURE daunting to all involved in diabetes care, particularly when
considering the challenges of achieving prior, higher A1c targets.
DIRECTIONS  Updated guidelines may create an impetus to improve the clinical
care delivery system to help patients and families achieve these
goals, extending far beyond the adjustment of insulin regimens.