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Barriers to diabetes management: Patient and provider factors

Nam, Soohyun, Chesla, Catherine, Stotts, Nancy A., Kroon, Lisa, Janson, Susan L.·2011·Diabetes Research and Clinical Practice

DOI 10.1016/j.diabres.2011.02.002

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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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Authors: Nam, S., Chesla, C., Stotts, N. A., Kroon, L., & Janson, S. L.
Affiliations: Johns Hopkins University (US)
University of California, San Francisco (US)
ORCID: Nam, Soohyun
Chesla, Catherine
Kroon, Lisa
Venue: Diabetes Research and Clinical Practice
Publisher: Elsevier BV
Published: 2011-07
Volume: 93
Issue: 1
Pages: 1-9
ISSN: 0168-8227 (ISSN-L)
DOI: 10.1016/j.diabres.2011.02.002
OpenAlex: W1974561455
Cited by: 680
References: 75
Citations by year: 2026: 18 · 2025: 27 · 2024: 38 · 2023: 57 · 2022: 41 · 2021: 58 · 2020: 61 · 2019: 39 · 2018: 61 · 2017: 54 · 2016: 60 · 2015: 61 · 2014: 37 · 2013: 43 · 2012: 20
FWCI: 4.53
Type: journal article
Language: en
Open access: closed
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations: Diabetes Research and Clinical Practice (publishedVersion)
PubMed (publishedVersion)
Funders: California Endowment and American Association of Colleges of Nursing (AACN)
Nurse Faculty Program
Topics: Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
Keywords: type 2 diabetes, diabetes self-management, glycemic control, patient adherence, health literacy, health beliefs, language and cultural barriers, financial barriers, comorbidities, social support, clinician-patient communication, integrated care
MeSH terms: Diabetes Mellitus, Type 2, Humans, Patient Compliance, Patient Education as Topic, Self Care, Social Support, Disease Management

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Barriers to diabetes management: Patient and provider factors

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