Interdisciplinary approach to diabetes management is vital for patient outcomes

Article by Associate Professor Matthew Leach, Deputy Director of Education at the National Centre for Naturopathic Medicine at Southern Cross University.

Diabetes is a disease that affects around 1.2 million people in Australia, and 422 million people globally, and something that I have been researching over the past decade. In particular, I have been exploring new, patient-centric solutions to managing the condition.

In light of this year's National Diabetes Week campaign, which highlights awareness for diabetes and mental health, including diabetes-related distress, anxiety and burnout, I want to delve into one of my areas of research focus – best practice diabetes care.

A body of research that I have contributed to looks beyond the current model of care, from what has traditionally been a small team of one to three practitioners, to what should be provided to deliver best practice diabetes care. What we found was the need for diabetes care to be delivered by an interdisciplinary team of up to 18 different professions.

This research shows that the management of diabetes requires involvement of a health care team with a broad skill mix in order to better address the diversity of patient populations and to improve patient outcomes.

In order to improve patient outcomes, we need to understand the patient as a whole being, not just as a range of symptoms to treat.

In this case of diabetes management, the team needs to look not only at the management of biological factors such as normalising blood glucose levels, but also at the psychosocial factors that impact a person’s capacity to manage their care, such as stress, mental health, and health literacy.

As diabetes is a self-managed condition, it is important that the diabetes care team work closely with the patient to identify and manage factors that not only de-stabilise blood glucose levels, but also empower the patient to take control of their condition.

This proposition was further supported in our recently published case of a female patient with type 1 diabetes and chronic stress, which showed that integrating a range of therapies may have a positive impact on patient outcomes.

The patient in this case was experiencing high levels of physical, psychological and social stress, and explicitly identified stress as a contributing factor of her poor glycaemic control.

Following three months of management using a range of therapies - including the use of botanical medicines, meditation, breathing exercises, physical exercise, social support and dietary management - the patient reported improvements in perceived stress as well as a consistent improvement in blood glucose levels.

An interdisciplinary approach to diabetes management, which addresses the many biopsychosocial factors that impact blood glucose control, represents an important direction for future diabetes care and research in Australia.