ST. LOUIS — Teaching type 2 diabetes patients about how to take care of themselves isn't enough; they need to be motivated to follow through, according to results of a survey of 3,867 patients.
Yet discussions with patients remain primarily educational rather than motivational. “There is a huge gap between knowledge and behavior. We, as educators, have to get away from simple knowledge, or we have to target our audiences better,” Debbra D. Bazata, R.D., a certified diabetes educator at St. Luke's South Primary Care, Overland Park, Kan., said in an interview held at the annual meeting of the American Association of Diabetes Educators.
In a poster that was coauthored by Dr. Andrew J Green, who is with an endocrinology practice in Overland Park, the two also advised that “physicians and other health care professionals should negotiate with their patients in setting weight, exercise, and medication goals with specified timelines.”
The survey asked a series of questions related to knowledge, attitudes, and behaviors pertaining to diabetes, exercise, and eating. Respondents had a mean age of 60.2 years; 58% were women, 85% were white, and 64% had at least some college education. Nearly two-thirds (62%) were obese, with a mean body mass index (kg/m
A majority had been advised to change their lifestyle habits, with 56% receiving recommendations to change their diet and 63% being urged to exercise more. And they displayed healthy attitudes, with 87% agreeing that “obesity can aggravate or contribute to the onset of other chronic diseases,” whereas 78% said that they tried to make healthy food choices. Only 17% agreed with the statement “I prefer taking medications for my health problems rather than changing my lifestyle.”
Most respondents were knowledgeable about diabetes, with only 22% agreeing that “type 2 diabetes is not as serious as type 1 diabetes.” They were a high-utilizing group, making an average of 11 total health care visits in the past year. Of those, a mean of 3.8 visits per year were to endocrinologists, and 4.0 were to a nutritionist/dietician/health educator.
They also reported a mean of 17.1 visits per year for rehabilitation/physical therapy, and 8.2 visits for psychiatric care, along with 4.9 visits per year for primary care/general practice, Ms. Bazata and Dr. Green reported.
Yet despite all that knowledge and access to care, only 26% said they exercised regularly and only 21% had performed vigorous activity in the past 7 days. Only 33% followed a prescribed eating plan. And although 70% tried to lose weight, only 34% actually maintained a desired weight.
During the interview, Ms. Bazata acknowledged that these findings can't necessarily be extrapolated to groups other than the predominantly older, white, female population that responded to the survey.
However, “we learned a little about this target audience. They know what to do, they know they should [do it], and they even want to…. But they aren't.”
The questionnaire was part of the 5-year longitudinal Study to Help Improve Early Evaluation and Management of Risk Factors Leading to Diabetes (SHIELD), sponsored by AstraZeneca Pharmaceuticals L.P.