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      Barriers to diabetes management: patient and provider factors.

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          Abstract

          Despite significant advances in diagnosis and treatment, the persistence of inadequate metabolic control continues. Poor glycemic control may be reflected by both the failure of diabetes self-management by patients as well as inadequate intervention strategies by clinicians. The purpose of this systematic review is to summarize existing knowledge regarding various barriers of diabetes management from the perspectives of both patients and clinicians. A search of PubMed, CINAHL, ERIC, and PsycINFO identified 1454 articles in English published between 1990 and 2009, addressing type 2 diabetes, patient's barriers, clinician's barriers, and self-management. Patients' adherence, attitude, beliefs, and knowledge about diabetes may affect diabetes self-management. Culture and language capabilities influence the patient's health beliefs, attitudes, health literacy, thereby affecting diabetes self-management. Other influential factors include the patient's financial resources, co-morbidities, and social support. Clinician's attitude, beliefs and knowledge about diabetes also influence diabetes management. Clinicians may further influence the patient's perception through effective communication skills and by having a well-integrated health care system. Identifying barriers to diabetes management is necessary to improve the quality of diabetes care, including the improvement of metabolic control, and diabetes self-management. Further research that considers these barriers is necessary for developing interventions for individuals with type 2 diabetes.

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          Author and article information

          Journal
          Diabetes Res Clin Pract
          Diabetes research and clinical practice
          Elsevier BV
          1872-8227
          0168-8227
          Jul 2011
          : 93
          : 1
          Affiliations
          [1 ] Johns Hopkins University, School of Nursing, Department of Health Systems and Outcomes, 525 North Wolfe Street, Baltimore, MD 21205-2110, United States. soohnam@gmail.com
          Article
          S0168-8227(11)00051-9
          10.1016/j.diabres.2011.02.002
          21382643
          8f854893-0414-4d64-a589-871655f434c4
          Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.
          History

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