How to help patients manage diabetes

Diabetes is common in the United States. Nearly 12% of Americans live with the condition, and another 38% have prediabetes, according to the Centers for Disease Control and Prevention (CDC). As the most accessible healthcare professionals, pharmacists play a valuable role in helping patients manage their condition. Wondering how to support someone with diabetes? There are lots of ways, from offering diabetes medication management sessions, immunizations, or even diabetes education for patients.

How to support your patients with diabetes

Research shows that pharmacists can improve diabetes patient outcomes. A 2019 study aimed to assess whether a telephone-based pharmacist intervention could improve A1C in patients with poorly controlled diabetes through negotiated interviewing and shared decision-making. Patients who experienced the pharmacist intervention showed significantly improved diabetes control compared to those who did not receive the intervention. If you’re unsure where to start, use these ideas to start helping your patients with diabetes.

Be an empathetic listener

One of the best ways a pharmacist can help support patients with diabetes is simple: be an empathetic listener. Receiving a diabetes diagnosis can be life-changing for patients and their caregivers, especially with Type 1 diabetes. Research from Stanford University illustrates this, finding that people living with Type 1 diabetes make an average of 180 health-related decisions per day.

Be mindful of your word choice when speaking with people about their diabetes. Put yourself in their shoes and offer the encouragement that you would want to receive if the roles were reversed. Never say things like “It could be worse” or “It’s just diabetes; so many people have it.” Also, avoid commenting on the patient’s weight during your conversation, which can be offensive and make them less inclined to want your help.

Likewise, resist describing long-term complications such as chronic kidney disease, vision loss, heart disease, or amputations as scare tactics to motivate your patients to control their diabetes. The diagnosis is a mental burden in itself, and using language like this could do more harm than good. Data shows that when physicians use scare tactics with their patients with diabetes, this negatively impacts diabetes management and can ultimately cause more harm to the patient.

RELATED: Type 1 vs. Type 2 diabetes

Offer patient counseling

When visiting the pharmacy to pick up diabetes medications or supplies for the first time, patients and caregivers may benefit from some extra time and help from their pharmacist. It can be overwhelming to learn how to take new medications, inject insulin or use an insulin pump, and use a blood glucose monitor.

First-fill counseling is an opportunity for pharmacists to offer education and increase adherence. Below are some important counseling points to keep in mind for patients getting diabetes prescriptions for the first time:

• Oral medications: Go over the dosage of diabetes medications and what side effects the patient might expect, along with ways to manage them. For example, most patients newly diagnosed with Type 2 diabetes start with metformin. Metformin can cause severe abdominal discomfort and diarrhea, but point out that taking it with food can help.
• Insulin: Assist patients with their first insulin injections and help them understand the difference between long-acting and short-acting insulin. Discuss proper insulin storage, the importance of rotating injection sites, and how to dispose of used needles safely.
• Glucagon: Glucagon injections and nasal sprays are used for severe hypoglycemia, often characterized by loss of consciousness. When someone picks up a glucagon prescription, educate patients and their household members about when and how to use glucagon. Emphasize that this medication is intended for rescue use only and is not intended for self-administration by the patient.
• Blood glucose monitors: Have the patient check their blood sugar at the pharmacy while you observe, assist (with gloves), and offer suggestions. This hands-on help can go a long way in helping patients become comfortable with and succeed in using their blood glucose monitors. Ensure that patients know what times of day to check their blood sugar, what to do if they get high or low readings, and explain the importance of handwashing before each use.
• Continuous glucose monitors (CGMs): CGMs can reduce the need for finger sticks, but patients still need to keep a traditional glucose monitor on hand for situations where their reading may not match their symptoms. You can guide patients on how to wear CGMs properly, set up the app on their phone or transmitter device, and review a patient’s medication record to check for interactions. For instance, steroids can drastically raise blood glucose levels.

Recommend money-saving options

The new expenses of these medications and supplies may be a financial burden. You can help patients save money on healthcare costs and prescriptions by connecting them with patient assistance programs, manufacturer coupons, and other resources. Pharmacists can also help by recommending lower-cost alternatives and, when appropriate, communicating with other healthcare team members on the patient’s behalf.

Offer a referral

Sometimes, you may need to refer patients for more acute or specialized care. For example, if a patient presents with dangerously high or low blood glucose or has signs of diabetic ketoacidosis (DKA), send them to the closest emergency room or call 911. Likewise, if you perform a point-of-care blood test in the pharmacy and the results are abnormal, you can refer the patient to their primary care healthcare provider or specialist for management.

Provide medication management sessions

A systematic review published in 2022 also suggests that pharmacist-delivered medication therapy management sessions can significantly improve outcomes for patients with diabetes. Promoting medication management in patients with diabetes lets you identify deficits in education, gaps in care, and factors that are getting in the way of optimal diabetes management.

Promote needed immunizations

Patients with diabetes have a higher risk of developing certain conditions and infections due to a compromised immune system and difficulty controlling blood sugar levels during illness. You can help prevent hospitalizations and illness in these patients by recommending vaccinations for preventable diseases.

In addition to routine vaccinations, the CDC recommends recommends the following vaccines for people with diabetes:

• Pneumococcal vaccine series
• Hepatitis B vaccine series
• Annual influenza vaccine

Bottom line

Pharmacists play an important role in patients living with diabetes. Whether through empathetic listening, providing education, medication therapy management, administering vaccines, or helping patients navigate the financial burden of diabetes, pharmacists can greatly influence successful management in patients with diabetes.