Prioritizing Patient Experiences in the Management of Diabetes and Its Complications: An Endocrine Society Position Statement Rita R. Kalyani, 1 Myriam Z. Allende-Vigo, 2 Kellie J. Antinori-Lent, 3 Kelly L. Close, 4 Sandeep R. Das, 5 Phyllisa Deroze, 6 Steven V. Edelman, 7 Nuha A. El Sayed, 8 David Kerr, 9 Joshua J. Neumiller, 10 and Anna Norton 11 1 Division of Endocrinology, Diabetes, & Metabolism, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA 2 Endocrine Section, University of Puerto Rico, San Juan 00936, Puerto Rico 3 UPMC Shadyside, Pittsburgh, PA 15213, USA 4 Close Concerns Inc, San Francisco, CA 94117, USA 5 Division of Cardiology, UT Southwestern Medical Center, Dallas, TX 75390, USA 6 dQ&A, The Diabetes Research Company, San Francisco, CA 94117, USA 7 Division of Endocrinology, Diabetes & Metabolism at the University of California at San Diego, San Diego, CA 92103, USA 8 American Diabetes Association, Harvard Medical School, Boston, MA 02215, USA 9 Director of Digital Health, Diabetes Technology Society, Santa Barbara, CA 94010, USA 10 Department of Pharmacotherapy, College of Pharmacy and Pharmaceutical Sciences, Washington State University, Spokane, WA 99202, USA 11 DiabetesSisters, #180, 1112 W Boughton Road, Bolingbrook, IL 60440, USA Correspondence: Rita R. Kalyani, MD, MHS, Division of Endocrinology, Diabetes, & Metabolism, Johns Hopkins University School of Medicine, 1830 E Monument St, Ste 333, Baltimore, MD 21287, USA. Email: rrastogi@jhmi.edu. Abstract Diabetes can be an arduous journey both for people with diabetes (PWD) and their caregivers. While the journey of every person with diabetes is unique, common themes emerge in managing this disease. To date, the experiences of PWD have not been fully considered to successfully implement the recommended standards of diabetes care in practice. It is critical for health-care providers (HCPs) to recognize perspectives of PWD to achieve optimal health outcomes. Further, existing tools are available to facilitate patient-centered care but are often underused. This statement summarizes findings from multistakeholder expert roundtable discussions hosted by the Endocrine Society that aimed to identify existing gaps in the management of diabetes and its complications and to identify tools needed to empower HCPs and PWD to address their many challenges. The roundtables included delegates from professional societies, governmental organizations, patient advocacy organizations, and social enterprises committed to making life better for PWD. Each section begins with a clinical scenario that serves as a framework to achieve desired health outcomes and includes a discussion of resources for HCPs to deliver patient-centered care in clinical practice. As diabetes management evolves, achieving this goal will also require the development of new tools to help guide HCPs in supporting PWD, as well as concrete strategies for the efficient uptake of these tools in clinical practice to minimize provider burden. Importantly, coordination among various stakeholders including PWD, HCPs, caregivers, policymakers, and payers is critical at all stages of the patient journey. Key Words: diabetes, complications, patient experiences, communication, navigating treatments, therapeutic inertia, self-management, hypoglycemia, technology, psychosocial conditions, telehealth Abbreviations: ACC, American College of Cardiology; ACP, American College of Physicians; ADA, American Diabetes Association; ADCES, Association of Diabetes Care and Education Specialists; ADE, adverse drug effect; AGP, ambulatory glucose profile; AHA, American Heart Association; AHRQ, Agency for Healthcare Research and Quality; ASCVD, atherosclerotic cardiovascular disease; BP, blood pressure; CDC, Centers for Disease Control and Prevention; CDCES, Certified Diabetes Care and Education Specialist; CGM, continuous glucose monitors; CKD, chronic kidney disease; CVD, cardiovascular disease; DSMES, diabetes self-management and education support; EHR, electronic health record; ES, Endocrine Society; GLP-1RA, glucagon-like peptide-1 receptor agonist; HbA 1c , glycated hemoglobin A 1c ; HCPs, health-care providers; LDL, low-density lipoprotein; MI, myocardial infarction; PWD, people with diabetes; QoL, Quality of Life; RAS, renin angiotensin system; SDoH, social determinants of health; SGLT2i, sodium-glucose cotransporter 2 inhibitor; T1D, type 1 diabetes; T2D, type 2 diabetes; UACR, urine albumin-to-creatinine ratio; UKPDS, United Kingdom Prospective Diabetes Study. Received: 11 December 2023. Editorial Decision: 15 December 2023. Corrected and Typeset: 21 February 2024 © The Author(s) 2024. Published by Oxford University Press on behalf of the Endocrine Society. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com The public health effect of diabetes is staggering. Globally, more than 500 million people live with diabetes (1). According to the US Centers for Disease Control and Prevention (CDC), not only do an estimated 37.3 million peo- ple have diabetes in the United States, of whom almost one- quarter have undiagnosed diabetes, an additional 96 million The Journal of Clinical Endocrinology & Metabolism, 2024, 109, 1155–1178 https://doi.org/10.1210/clinem/dgad745 Advance access publication 21 February 2024 Position Statement Downloaded from https://academic.oup.com/jcem/article/109/5/1155/7608757 by guest on 25 July 2024