Close gaps in patients’ diabetes care

New Project (67)

Offer new methods to help your patients control their diabetes 

In brief:

  • One identical approach to caring for all patients with diabetes won’t address the varying needs of these diverse patients
  • Identify different segments of patients based on their different situations, behaviors and needs
  • Close care gaps by diversifying the interventions your pharmacy provides


Who are you missing in diabetes care?

Focusing only on the big picture—that 1 in 10 Americans has diabetes and 1 in 3 prediabetes—misses important details that can help you better target care.¹ That’s because rates of diagnosed diabetes vary greatly by race and ethnicity.²

  • 7% of American Indians/Alaskan Natives
  • 5% of Hispanics
  • 7% of non-Hispanic Blacks
  • 2% of Asian Americans
  • 5% of non-Hispanic Whites

Even within groups there can be a wide difference. For example, among Hispanics, while 14.4% of Mexican Americans have diabetes, the rate is only 6.5% among Cuban Americans. Or, among Asian Americans, Asian Indians (12.6%) are more than twice as likely to have diabetes as Chinese Americans (5.6%).

Understanding the diverse populations your pharmacy serves and precisely targeting outreach and education can make your interventions more effective. For example:

  • Adapt dietary recommendations. Food is an important part of every culture. Make sure that your diabetes nutrition information reflects the diverse tastes and customs of your patients.
  • Hire bilingual pharmacists. Would you want to discuss your health through a translator? Patients are more comfortable with direct conversations with someone who speaks the same language.


Help diabetic patients improve their self-care

Less than one third of patients with diabetes (only about 30%) regularly complete all four self-care recommendations of:³

·         Daily blood glucose monitoring

·         Regular foot checks

·         Annual eye exams

·         Cholesterol checks

Overall adherence is lowest among individuals without health care coverage (only 16%), but adherence to specific recommendations varies. For example, individuals with less education are less likely to get an annual eye exam and individuals who are underweight or normal weight are less likely to do foot checks.

Differing behaviors among different segments of patients shows why it is essential to take time to explain to every patient why each of these recommendations is important, and make sure they understand the recommendation and know how to do the recommended self-care.

For some patients this may mean explaining health care options they didn’t know were available, such as if your state has expanded Medicaid eligibility or if a community nonprofit will help cover exam costs.

If you already track patients’ A1C history and check for missing immunizations, start asking other questions, such as, “When did you last have an eye exam?” That can lead to conversations about the importance of self-care and potential consequences of neglect.


Whom else should you involve?

Extend diabetes education beyond the patient.

  • Involve caregivers. For young patients with diabetes, this obviously includes parents, but in some situations might include grandparents or older siblings. Include them in education.
  • Tap the power of peers. For school- or college-age patients, look at connecting patients with a team of peer mentors.4 This might involve helping form a group in your community or connecting young adults with online resources.


What new technology could help?

Don’t overlook emerging tools to help with education and management.

  • Telehealth. With less in-person education during COVID-19, many pharmacies began offering online diabetes education, a trend that is likely to continue after the pandemic.
  • Continuous glucose monitors can be more convenient for many patients and can result in better glycemic control.5
  • “Smart” insulin pens are Bluetooth-enabled devices that can track and share data, sound an alarm if someone may be forgetting a dose and even do the calculations to recommend a dose.6

Among the most important ways to close gaps for patients with diabetes is through consistent personal pharmacist intervention, which has been proven to be effective.7 Through one-on-one engagement, pharmacists can:

  • Educate patients and caregivers
  • Enroll patients in medication synchronization to ensure all prescriptions are filled on the same date each month
  • Complete or provide a referral for A1C tests
  • Provide all recommended immunizations or refer patients accordingly
  • Educate and support patients in using statin medications
  • Work with diabetic patients on tobacco cessation

Through all of these actions—segmenting patients, personalizing interventions, advising and supporting patients with self-care, taking advantage of new technologies and more—pharmacists can help close the gaps in care and improve and sustain the health of patients with diabetes.


[1] “National Diabetes Statistics Report, 2020,” Centers for Disease Control and Prevention, Feb. 11, 2020.
[2] “Statistics About Diabetes,” American Diabetes Association.
[3] “Diabetic Preventive Practices Are Variable Among Patient Populations,” Jonathan Alicea, HCP Live, Jan. 26, 2021.
[4] “Young People with Type 1 Diabetes Say YES to Novel Behavioral Intervention,” Laura Cowen, Medicine Matters, June 13, 2020, and “Positive Health Benefits of Peer Support and Connections for College Students With Type 1 Diabetes Mellitus,” Jennifer Saylor et al., Diabetes Education, August 2018.
[5] “What Is a CGM (Continuous Glucose Monitor) and How Do I Choose One,” Greg Brown, Healthline Diabetes Mine, Sept. 30, 2020.
[6] “The Rise of ‘Smart’ Insulin Pens for Diabetes Care,” Mike Hoskins, Healthline Diabetes Mine, Oct. 7, 2020.
[7] “Minnesota Pharmacists Successfully Intervene to Close Care Gaps for Patients with Diabetes,” Medical Alley, Dec. 9, 2020.