A little small to read but if we focus on the "shared decision making" part of the matrix it states:

Involves an educated and informed patient (and their family/caregiver)

Seeks patient preference

Effective consultation includes motivational interviewing, goal setting and shared decision making

Empowers the patient

Ensures access to DSMES (acronym for Diabetes Self Management Education and Support)

*** that is a key matrix component that the EXPERTS believe is necessary for total and effective care and management of Type 2

But NOBODY seems tasked to do that.

It is not the doctors "job" - they diagnose and treat. But when they say "Sorry Bob, you have Diabetes, here take this prescription and come back in 3 months" very few also get there "here is where you can go for help understanding what is going on".

And it seems to be really hit/miss AND there is no requirement AND you often need a referral AND your Doctor may not even have a clue that there is some Diabetes Program available in your area. So many fall through the cracks.

@A DiabetesTeam Member Thanks for ADA article. I’ll have a closer look probably after Christmas. However I note that they toe the line re self monitoring of blood glucose that it’s of limited use to non insulin T2s. This is dangerous nonsense and I suspect this is because doctors don’t want to give BG test strips to patients to save money. That’s what happened to me, they stopped my test strips and now I have to buy them.

It’s a false economy doing this and whilst there are a number of T2 diabetics who will waste the test strips - for many they are an essential guide as to what’s happening to their bodies. Without theses guidelines they may suffer complications which then are costly to manage.

And of course ADA recommends that T2s work with their teams. IMO it’s high time that T2s took the management of their diabetes into their hands instead of relying on professionals etc who may have their own agendas that might not be beneficial to T2s.

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A Diabete...

@A DiabetesTeam Member yes the diagram is contained in the 2018 management guidelines.

Here's a link, if I can find the PDF version I will post that link up.

The ADA (US) and EASD (EU including the UK back on the last full update) sponsor a (convention) and use the "guidelines" to write the individual country guidelines for Type 2 management.

Personally believe everyone diagnosed should be given a copy to read - it's the "diabetes for dummies" book used by Family Doc's/Primary Care Doc's to tell them "what to do and when to do it" and it is written in fairly plain english.

Anyhow, here is the link - have a look - well written document which unfortunately ends up sitting on some bureaucrats desk instead of getting widely dissemenated.

https://diabetesjournals.org/care/article/41/12...

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A Diabete...

@A DiabetesTeam Member Be careful of GI diets those recipes can elevate your BGs more than desired. Also it’s important to take Glycemic Load into account. I go by net carbs and the two site I use most for that are:

Nutritionix
https://www.nutritionix.com/

Or google “[enter food] nutrition 100g” When you see the nutrition details subtract the amount of fibre from the carbohydrates to get net carbs.

There’s another called Self Nutrition Data which gives amazing information. Don’t worry if you occasionally get an error message try again. It’s well worth a visit for all the nutrition information it gives for a wide variety of foods.
https://nutritiondata.self.com/

As a footnote all of us must be wary when we read on a label “low in sugars”. Always check the amount of net carbs in a selected food.

One of these days I must write a blog series on what I write here!

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A Diabete...

Great information from everybody.

My take is that the one constant for lowering bg is losing weight. Cutting down on carbs, exercise, getting a good nights sleep and reducing stress are incredibly important as well.