Diabetes mellitus (DM) self-care teaching is often provided at point of care, but “clinician-centered” feedback about teaching is lacking. Semi-structured, facilitated interviews of front-line clinicians involved in DM care (e.g., meter, medications, injection technique) were conducted. Clinicians were asked their perspectives on the needs of newly diagnosed DM patients, specifically during transitions of care (e.g., discharge home). Clinicians were also asked to review current DM education materials (training supplies, print handouts) and subsequently developed potential solutions. Interview transcripts were independently coded by 3 coders, using a constant comparative method, to identify themes. MAXQDA software was used. Key themes were additionally audited by a diabetologist.

Eleven sessions were conducted with clinicians (N=14, 2 certified DM educators, 4 endocrinology MD fellows, 3 advanced practice providers, 1 DM nurse, 2 pharmacists, 2 internal medicine MDs). The most commonly identified theme across clinician type was simplified, understandable content (8/11 sessions). Participants identified lack of centralization of supplies and education materials as the most significant barrier (9/11 sessions) to optimal care. Other top themes were insurance coverage for diabetes supplies and medications, need for customization, and limited access to diabetes educators. The most preferred solution was use of patient simulation (repetitive practice) [7/11 sessions], followed by teaching videos (5/11 sessions).

Clinicians preferred comprehensive but simplified, understandable, customizable, diabetes teaching content. The lack of centralization of supplies and content and insurance coverage for supplies/medications are major barriers for clinicians to deliver optimal DM self-care teaching. These data also suggest that use of simulation could facilitate improvement in DM teaching by front-line clinicians.


K. Coyne: None. S. Hakimian: None. T. Pollack: None. S. Karam: None. G. Prince: None. E.K. Touma: None. D.W. Gatchell: None. R. Khorzad: None. B. Ankenman: None. J.L. Holl: None. A. Wallia: Research Support; Self; Eli Lilly and Company, Novo Nordisk Inc., UnitedHealth Group.


American Diabetes Association (1-13-JF-54 to A.W.); Chicago Center for Diabetes Translation Research/National Institute of Diabetes and Digestive and Kidney Diseases (P30DK092949); Agency for Healthcare Research and Quality (5R18HS026143-02)

Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered. More information is available at http://www.diabetesjournals.org/content/license.