Provider communication and patient participation in diabetes self-care.

Objective: To determine the effect size of provider communication about self-care and the provider's following treatment guidelines on the self-care behaviors of people with Type 2 diabetes (T2DM).

Methods: Data were from the TRIAD telephone surveys of Michigan patients in managed care with T2DM (n=1438). The survey asked about the patients' self-care and provider communication about blood glucose monitoring, exercise, foot care, flu vaccination and annual retina screening.

Results: After controlling for patient socio-demographics and disease severity, remembering having received provider information on these activities more than doubled the odds of performing blood glucose monitoring, and performing foot examinations. It also significantly increased the amount of exercise the patient performed. Provider modeling had a strong association with foot care. Counseling by a diabetes educator was positively and significantly associated with having an annual retina examination and receiving an influenza vaccination.

Conclusions: Remembering self-care information is associated with increased home based self-care by patients and their families. Consulting with a diabetes educator can substantially improve patient self-care.

Practice Implications: Health care providers should encourage patient education. However, physician time is costly and most nurses do not specialize in patient education; one solution is to refer patients to a diabetes educator.