All strategies to improve blood glucose control will involve patient engagement in diabetes self-management and lifestyle change. Formal diabetes education about diet, physical activity, blood glucose monitoring, pharmacotherapy-related issues, and screening for complications is imperative both at the outset and at regular follow-up intervals. Most health care systems have dieticians and certified diabetes educators for such patient support. These resources are underused. These support services complement and augment the primary care clinician’s role in endorsing the importance of lifestyle behaviours at each visit.

Most patients with diabetes will need to move from lifestyle management alone to lifestyle management combined with pharmacological therapy to reach glycaemic targets. It is important to communicate the progressive nature of the disease process to patients so they do not perceive that their lifestyle “failed” or that they are at fault. Patients with diabetes also require attention to microvascular risks, cholesterol and blood pressure management, and assessment of depression.

With Regards
Amelia
Assistant Managing Editor
African Journal of Diabetes Medicine
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