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The Patient's Perspective
(Vol 2 No 1 - Spring 2016)

Living well with diabetes involves a significant number decisions, from day-to-day management of the disease, to choices that are influenced by events outside of our immediate control. Through Audience Perspectives, we visit the true meaning of the word "difficult," successes and challenges in diabetes education, and an overview of how the Affordable Care Act is working for people with diabetes. Research and review articles highlight the daily physiological and psychological challenges faced by people living with diabetes and include recommendations for improving patient outcomes. Articles in “Moving Forward” conclude the issue with a discussion about the importance of understanding the illness experiences of patients living with diabetes and other chronic conditions.

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Paying More at the Pump

Letter from Editor Martin Wood, MSLIS, AHIP

The decisions for how we live well with diabetes, and what therapies and technologies we need to do that, should be made between the person with diabetes and their trusted health care professionals. Insurance should be a partner in achieving these goals, not a barrier. In order to do that, we must give preferential treatment to the patient at the center of business and health care, hold those entities accountable who get it wrong, and reward those who get it right.

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Original Research Articles

Perceived Benefits and Barriers to the Diabetes Prevention Program

L. Nicole Johnson, DrPH, MPH, MA; Stephanie T. Melton, PhD, MPH, MA

Diabetes prevention interventions have a proven positive affect on health outcomes. The goal of this project is to understand the factors that motivate and deter people with prediabetes from utilizing evidence-based education programs, such as the Diabetes Prevention Program (DPP).

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The Fakebetes Challenge: A Pilot Study of the Patient as Educator

Michelle Litchman, PhD, FNP-BC

Healthcare providers do not typically fully understand what it is like to live with a chronic condition. One strategy to help healthcare providers better understand the day-to-day challenges of living with diabetes is to practice being a patient. The purpose of this study was to understand the experiences of healthcare providers and patient educators who participated in the Fakebetes Challenge.

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Transitioning from Pediatric to Adult Diabetes Care

L. Nicole Johnson, DrPH, MPH, MA; Stephanie T. Melton, PhD, MPH, MA; Ashley N. Wingert, MPH, CPH

The clinical transition from pediatric to adult diabetes care is often challenging for both young adults with type 1 diabetes (T1D) and the health care providers (HCPs) who care for this population. This study presents insights into the perceptions and needs of both patients with diabetes and HCPs during the clinical transition.

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Audience Perspectives

The Difference a CDE makes

Jess Buchanan

Over the years, my endocrinologist and my CDE have both helped me with my diabetes management, but in different ways. My endocrinologist helped me maintain my physical health. Meanwhile, my CDE helped me with the mental aspects such as diabetes math, searching for patterns, and even discussing burnout.

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Redefining Difficult

Renza Scibilia

I frequently refer to myself as ‘the difficult child’ – not so much in my family setting, because there I am clearly the perfect daughter (just ask my sister!). But professionally, I am sometimes difficult because I have been known to ask a lot of questions, and to think outside of the square. I am a risk taker.

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The Real Cost of Diabetes Education

Mike Hoskins

Whether we are patients, clinicians, or researchers, it’s easy to agree that more education about the best practices and strategies of managing diabetes of all types is preferable to ignoring actions that can lead to positive results. Now more than ever, research and reputable sources are confirming that diabetes education is beneficial to long term success with all types of diabetes.

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Will the Affordable Care Act Deliver?

An Interview with Marshall Kapp, JD, MPH

Marshall Kapp, JD, MPH, is an authority when it comes to the intersection of medicine and law. Presently he is the Director of the Florida State University Center for Innovative Collaboration in Medicine and Law, where the PLAID team had the opportunity to chat with him about how the Affordable Care Act (ACA) is impacting people living with diabetes.

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Review Articles

Preoperative Glycemic Control for Adult Diabetic Patients Undergoing Elective Surgery

Tristan B. Weir, BS; Larry C. Deeb, MD

As the prevalence of diabetes continues to increase in the United States, a higher proportion of elective surgical candidates will require specific preoperative education and guidelines to maximize patient outcomes and reduce the costs of care. The purpose of this article is to review the current literature to determine how preoperative glycemic control affects the lengths of hospital stays, postoperative complications, and mortality in people living with type 1 and 2 diabetes.

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Narrative inquiry in diabetes research: Illuminating the psychosocial aspects of diabetes

Lisa M. Acuff, MS; Trena M. Paulus, PhD

Diabetes self-care is integrally and holistically connected with everyday life, but research prior to 2008 primarily used surveys and interviews to understand the psychosocial aspects of the illness experience. Narrative research methods, in contrast, can give greater attention to connection and context.

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Moving Forward

The Patient’s Perspective: Medicine’s New True North

"e-Patient Dave" deBronkart

“e-Patient Dave” deBronkart, cancer survivor and patient advocate, discusses the changing nature of the patient-physician relationship, with the patient becoming an active contributor and partner in their care. Engaged and empowered patients, “e-patients,” can help raise levels of consciousness about complex health problems.

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Building a Bright Future for Diabetes Care and Management by “Writing Where It Hurts”

Alexandra C.H. Nowakowski, PhD, MPH; J. E. Sumerau, PhD; Lain A.B. Mathers, BS, MA

Getting insight into the illness experiences of people with highly prevalent chronic conditions like diabetes is positively critical for all of us in the health world, whether we’re more on the clinical care side or more on the research side or experiencing things from the patient or family perspective. To illuminate these complex interplays between clinical and community elements of living well with diabetes and other chronic conditions, we need narratives and critical analysis of all aspects of illness experience.

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