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Diabetes Discoveries & Practice Blog

Diabetes Care: Finding Common Ground with Guiding Principles


In this video series, experts share their major takeaways from the publication “Guiding Principles for the Care of People with or at Risk for Diabetes” and discuss how health care professionals can use it to provide the best care possible for patients with diabetes.

In this teaser video, get a preview of our new series, “Diabetes Care: Finding Common Ground with Guiding Principles” and hear from the following experts:

  • Carol M. Mangione, MD, MSPH, FACP, from the University of California, Los Angeles: "Diabetes Care and Older Adults"
  • Scott Kahan, MD, MPH from the National Center for Weight and Wellness: "Obesity Management in People with Diabetes"
  • Jay H Shubrook, DO, from the Touro University California College of Osteopathic Medicine: "Diabetes Prevention and Management in the Primary Care Setting"

Download the Guiding Principles for the Care of People with or at Risk for Diabetes, updated in August 2018, to learn more about existing guidelines that have been synthesized to help primary care providers and health care teams to deliver quality care to adults with or at risk for diabetes.

What I love about the Guiding Principles from the National Diabetes Education Program is it’s largely endorsed by many organizations. It's got very simple, actionable items that we can work on, and I think quite honestly, it's one of the many resources that I think primary care should utilize to provide the best care possible for their patients with diabetes.


And the document that came out of this process has 10 guiding principles. They're very practical.


It gives the relevant evidence-based information in a digestible format with the key topics that primary care providers and other health care providers would benefit to know to help their patients.


In primary care, there’s a lot of challenges to do good diabetes care and I think part of it is that the system is set up in such a way that we really focus on volume of care. We're seeing a lot of patients, it's focused around the chief complaint, and we know that diabetes as a prototypical chronic disease requires lots of attention to detail and a long-term plan, not just a short-term plan.


Clinicians often are quite hesitant to address obesity and weight management in practice, and I think a big part of that is feeling overwhelmed. There's so much to do in counseling on obesity. Often, we don't know where to start, and it seems like we should just move on to other areas of medicine. I think that's a mistake.


Geriatricians face a lot of challenges when providing diabetes care, and the challenges really stem from the fact that most older adults don't just have diabetes. They're likely to have hypertension, many of them may have chronic renal disease, but they also may have things that aren't directly related to their diabetes, such as osteoarthritis, chronic pain from other problems. You really have to take a very holistic approach to the person you're treating and, as much as possible, you need to engage them in shared decision-making.

About the Experts

Dr. Carol Mangione

Carol M. Mangione, MD, MSPH, FACP, is the Division Chief of General Internal Medicine and Health Services Research and Professor of Medicine at the University of California, Los Angeles. Dr. Mangione’s areas of expertise include diabetes, diabetes prevention, health disparities, aging, health insurance benefit design, preventive services, and public health policy.

Scott Kahan, MD, MPH, is the Director of the National Center for Weight and Wellness. He serves on the faculties of the Johns Hopkins Bloomberg School of Public Health, the George Washington University School of Medicine, and the George Washington University School of Public Health and Health Services. In addition to his clinical practice, Dr. Kahan also works as a public health physician specializing in nutrition and obesity policy. He serves as the Director of the Strategies to Overcome and Prevent (S.T.O.P.) Obesity Alliance, on the Board of Directors for the American Board of Obesity Medicine, and as Chair of the Clinical Committee for The Obesity Society.

Dr. ay Shubrook

Jay H. Shubrook, DO, is a board-certified family physician and diabetologist. He is a professor in the primary care department at the Touro University California College of Osteopathic Medicine, where he also serves as the director of clinical research and director of diabetes services. He is the chair of the Primary Care Advisory Group for the American Diabetes Association. He strives to better prepare primary care providers to provide exceptional care for patients with diabetes, and his research interests focus on type 2 diabetes prevention and early intervention.


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