I'm Katie Dimon and I'm going to present the next section on engaging patients. So how do you start your discussion about GLP-1 receptor agonists? First, gauge the level of the patient's diabetes knowledge. They might have a lot of baseline knowledge about GLP-1 receptor agonists or have friends or relatives that have already taken the medications. Ask if they are aware of diabetes-related complications. Discuss the comorbidities they already have. Discuss their individualized hemoglobin A1c goal. And then discuss GLP-1 receptor agonist medications and how they are helpful to reduce incidents of chronic kidney disease, coronary artery disease, chronic heart failure, and then leverage motivational interviewing techniques to help patients reach those goals. How can you use motivational interviewing to engage patients? Motivational interviewing is an intervention strategy in the treatment of lifestyle problems and chronic diseases such as diabetes. Motivational interviewing is a client-oriented, directive method for enhancing intrinsic motivation to change by exploring and resolving ambivalence. It is built on four guiding principles. 1. Express empathy 2. Develop discrepancies 3. Roll with resistance 4. Support self-efficacy How can you apply motivational interviewing to diabetes management? This is an excellent graphic from the American Diabetes Association entitled Critical Conversations for Overcoming Therapeutic Inertia in Type 2 Diabetes. Some key points are using a team-based approach, creating personalized diabetes care plans, set shared A1c goals and timeframes, and screen for social and emotional barriers and provide support. Some conversation tips include I take your diabetes seriously, tell me the things that are getting in the way of you managing your diabetes, and I am on your side and will support you in whatever way you need to manage your diabetes well. It's also important to emphasize that the nature of type 2 diabetes is to change over time. Some conversation tips include take diabetes as serious, the more seriously you take it, the better you will do over the long term. And your actions can make a big difference in how well you do. Meeting glycemic goals means fewer symptoms, better quality of life, and keeping complications at bay. And because your diabetes changes doesn't mean that you have done something wrong. It's important to emphasize that the treatment plan will change over time. Some conversation tips include adding medications may be necessary. We have meds to help at each stage along your journey with diabetes. And adding medications, including insulin, does not equal failure. Adding medications could help other aspects of your health besides diabetes, for example lowering your weight, preventing heart and kidney disease, etc. And we will work together to find a treatment plan that works for you. When we're talking about teamwork approach, some conversation tips include work with your care team, family, and friends. Use your diabetes care support team and community resources to help you. And diabetes self-management education and support works. These are all helpful tips to overcome therapeutic inertia in caring for patients with type 2 diabetes. So how can you develop a personalized action plan for your patient with type 2 diabetes? First, you should leverage diabetes self-management education and support. You should work with a diabetes care and education specialist, personalize services to help patients manage diabetes, and create a plan that fits the patient's lifestyle and teaches the Association of Diabetes Care and Education Specialists seven self-care behaviors. Those are healthy eating, being active, taking medication as prescribed, monitoring blood sugar levels, activity, and eating habits, reducing risks to lower the chances of diabetes complications, healthy coping with diabetes and emotional well-being, and problem-solving to find solutions and take action. There are four key times to assess for diabetes self-management education and support needs. One is at diagnosis, two annually or when not meeting treatment targets, three at development of complicating factors that influence self-management, or D, during life and care transitions. There simply is not enough time in a primary care visit to address all the needs of our patients with type 2 diabetes. Therefore, diabetes self-management education and support is critical. All people with diabetes benefit from this service. As we discussed, you want to refer patients at diagnosis when they're not meeting their goals, once a year, when complicating factors develop, or when transitions in life and care occur. The essential components of DSMES is to provide culturally appropriate content, be responsive to individual preferences, needs, and values, use positive strength-based language that puts people first, and consideration of social determinants of health with a focus on health equity. The advantages are it ensures informed decision-making, promotes self-care behaviors, facilitates problem-solving, improved collaboration with the health care team, imparts knowledge and self-care skills, incorporates needs, goals, and life experiences. Its setting could be group or individual visits, could be in-person, telehealth, or on digital platforms. There are proven outcomes, including improved diabetes knowledge, self-care, and quality of life, a lower A1C and self-reported weight reductions, reduction in all-cause mortality risk, acute care and hospital services, utilization, and lower health care costs, an increased use of primary care and preventative services, and positive coping behaviors. The good news is the cost of DSMES is covered by most insurance plans. Medicare Part B covers outpatient diabetes self-management training with a diagnosis. They may cover up to 10 hours of initial training, 1 hour of individual training, and 9 hours of group training. More information can be found on Medicare.gov's website. There are also resources on this slide about locating a local diabetes care and education specialist close to your clinic. I now want to hand over the presentation to a fellow faculty, Debbie Hinnin, to talk about patient-centered communication.

GLP-1 receptor agonists

personalized hemoglobin A1c goals

motivational interviewing

diabetes self-management education

cultural and health equity