PATIENT CENTRED

APPROACH TO DIABETES
Dr.Wasi Ahmed Siddiqi
Email: drwasiahmedsiddiqi@gmail.com
 Consider patient as a person.
Assess the disease by history,examination and

investigations.
Know the beliefs and expectations of the

patient and the knowledge regarding his

particular disease specially diabetes.
Take history about family

context,community,social & cultural context;

family history of
diabetes,hypertension,dislipidemia.
 Explain pathophysiology of the disease,provide
disease knowledge and reality of diabetes that yhere
is no curative treatment but it is
preventable,controllable and manageable.Advise
motivational counselling.
Encourage self management education and support :
Healthy eating
Being active
Monitoring of blood sugar & BP. Care of
feet.
Taking medication.
Solving the problems espicially hypoglycemia
and/or hyperglycemia.
Healthy coping.
Reducing risks
Emphasis on patient clinician relationship and
promotion of shared responsibility.
Treatment plan : Diet & exercise alone,or addition of
one or two oral hypoglycemic drugs and/or insulin.
Medical nutrition therapy : Knowledge about food
choice,eating pattern & portions.
Physical activity : Reduce sedentary time,start
aerobic activity ,walk.
Smoking cessation : Counselling & quit plan.
Psychological assessment and care : Depression &
anxiety screening and treatment
 Immunization against
influenza,pneumococcal and hepatitis B
infections.
Glycemic goal : HBA1C < 7%
Blood pressure goals : 130/80mmHg
Lipid goals : HDL > 40mg/dl , LDL <

100mg/dl Triglycerides < 150 mg/dl

Weight reduction : Set goals for 5-10%

weight loss to reach according to BMI

Assess risks and set goals for prevention or

delay the complications , arrange referrals

to the concerns.
Arrange follow ups.