Abstract
The care of patients with diabetes requires plans of care that make intellectual, practical, and emotional sense to patients. For these plans to fit well, patients and clinicians must work together to develop a common understanding of the patient's problematic human situation and co-create a plan of care that responds well to it. This process, which starts at the point of care, needs to continue at the point of life. There, patients work to fit the demands of their care plan along with the demands placed by their lives and loves. Thought in this way, diabetes care goes beyond the control of metabolic parameters and the achievement of glycemic control targets. Instead, it is a highly individualized endeavor that must arrive at a care plan that reflects the biology and biography of the patient, the best available research evidence, and the priorities and values of the patient and her community. It must also be feasible within the life of the patient, minimally disrupting those aspects of the patient life that are treasured and justify the pursuit of care in the first place. Patient-centered methods such as shared decision making and minimally disruptive medicine have joined technological advances, patient empowerment, self-management support, and expert patient communities to advance the fit of diabetes care both at the point of care and at the point of life.
Highlights
Diabetes care should improve the health-related quality of life of patients with diabetes, both type 1 and type 2 diabetes, and mitigate their risk, morbidity, and mortality from chronic micro- and macrovascular complications
Patient empowerment and patient-centered care are essential for the optimal care of people living with type 1 or type 2 diabetes
Evidence-based diabetes care, to be person centered, demands that clinicians become skilled in supporting shared decision making (SDM) and work toward minimally disruptive medicine (MDM) [12]
Summary
The care of patients with diabetes requires plans of care that make intellectual, practical, and emotional sense to patients For these plans to fit well, patients and clinicians must work together to develop a common understanding of the patient’s problematic human situation and co-create a plan of care that responds well to it. It is a highly individualized endeavor that must arrive at a care plan that reflects the biology and biography of the patient, the best available research evidence, and the priorities and values of the patient and her community It must be feasible within the life of the patient, minimally disrupting those aspects of the patient life that are treasured and justify the pursuit of care in the first place.
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