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Diabetes Educ. 2010 Sep-Oct;36(5):828-34. doi: 10.1177/0145721710378539. Epub 2010 Aug 20.

Are patients' initial experiences at the diagnosis of type 2 diabetes associated with attitudes and self-management over time?

Author information

The Department of Psychiatry, University of California, San Diego (Dr Polonsky)
Behavioral Diabetes Institute, San Diego (Dr Polonsky, Dr Guzman)
Department of Family and Community Medicine, University of California, San Francisco (Dr Fisher)
Department of Family and Preventive Medicine, University of California, San Diego (Dr Sieber)
Inner Solutions for Success, LLC, San Diego (Dr Sieber)
Scripps Whittier Diabetes Institute, La Jolla (Dr Philis-Tsimikas)
Division of Endocrinology and Metabolism, University of California, San Diego, and Veterans Affairs Medical Center, San Diego (Dr Edelman)


Objective The purpose of this study was to investigate patients' experiences when diagnosed with type 2 diabetes and diabetes-related distress and self-management years later. Method One hundred seventy-nine adults with type 2 diabetes, 1 to 5 years after diagnosis, completed a questionnaire assessing what they were told and what was recommended at diagnosis as well as current diet, physical activity, and diabetes distress.


Most patients (60%) expressed confidence in their health care provider (HCP) at diagnosis, but 30% reported that a clear action plan was not communicated. Current diabetes distress was significantly lower among those who reported being reassured at diagnosis that diabetes could be managed successfully and had developed a clearer action plan with their HCP. Patients' current dietary behaviors were significantly better among those receiving a clearer action plan at diagnosis.


Patients' retrospective reports of reassuring HCP messages when diagnosed, along with the presentation of a clear action plan, are associated with less diabetes distress and better self-management at 1 to 5 years after diagnosis. Practical implications Findings suggest a long-lasting impact on patients' attitudes and behaviors when the diagnosis of type 2 diabetes is delivered clearly, a sense of hope is provided, and a specific care plan is put forward.

[Indexed for MEDLINE]

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