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Linda Siminerio Part 2, Diabetes Treatment in the Past

In part 2 of this Exclusive Interview, Dr. Linda Siminerio talks with Diabetes in Control Publisher Steve Freed during the ADA meeting in San Diego, California, about communication with diabetes patients then and now.

Dr. Linda Siminerio RN, PhD is a Professor of Medicine at the University of Pittsburgh and Executive Director of the University of Pittsburgh Diabetes Institute.

Transcript of this video segment:

Steve: Your presentations, “Shared decision making, why does this matter and what do we know?” and “Shared decision making: then and now,” which is what we were basically talking about. You know, 20 years of diabetes translation. So if you’re sitting with a patient back in 1972, we know that your conversation would be, very basic and probably having to teach the patient a lot more, because with technology now it makes it a lot easier. What would you say are the major changes?

Dr. Siminerio: You’re absolutely right. We had a lot of skills teaching to do. I think it’s still burdensome, but it was certainly more invasive and harder to do back then. But the way we did it, and I’m speaking of physicians that I worked with, nurses, dieticians, whomever was working with the patient, we had this notion that if we told them to do it, that’s what they were going to do. So, if you saw a patient and said, “you know you can’t eat donuts anymore” we just thought our advice meant everything and that everyone went home and did exactly what we asked them to do or told them to do. And over the years we realized, especially through these big studies, we learned a lot in the studies. One is that we needed a team. It takes a village to help people with diabetes, it can’t just be one healthcare provider. And  that we needed to understand what the person’s personal goals were and what their challenges were.

Steve: So, it’s more patient-centered? Is that the major difference?

Dr. Siminerio: Absolutely. That’s the big thing now, patient-centered, quality, patient at the center of the team and that’s the way it should be. I don’t go home with the patients, they live with it. And to be honest 98% of diabetes care is managed by the patient. They see us 4, maybe 6 times a year, which is unusual to think about all the hours they are doing it on their own. It’s got to be their decision.

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