The role of diabetes coaching as a ‘care translator’

Tiny habits have a huge role to play in the management of Type 2 diabetes, according to a researcher in the field.

Diana Sherifali, an associate faculty member of McMaster University’s school of nursing, told the audience at Benefits Canada’s Chronic Disease at Work conference that much of her work in combating Canada’s diabetes epidemic focuses on behaviour modification among individuals living with the condition.

“Were not looking to stop behaviour; we’re not looking to decrease behaviour. We’re looking to create new tiny positive habits,” said Sherifali.

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For example, she said many patients complain that they don’t have the time to walk or perform exercises shown to boost the health of the millions of Canadians living with diabetes. By searching for short windows of opportunity in their existing schedules, Sherifali explained how it’s possible to hit physical activity targets without devoting large chunks of time to them.

“One of best times is first thing in the morning, because we tend to be creatures of routine,” she said, suggesting people can fit in five squats during the five or 10 seconds their shower takes to warm up or perform some deep breathing while their coffee brews.

“You just need a trigger or call to action that will make you think about what you’re doing,” Sherifali added, noting many people also set calendar reminders to prompt a quick workout.

Training on tiny habits forms part of a broader program of diabetes coaching that she said could be a cost-effective way to improve clinical outcomes for patients.

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In the last decade, Sherifali said a consensus has emerged among clinicians about the value of self-management techniques in dealing with diabetes.

“Patients live with diabetes, and they are a shared decision-maker in this journey,” she said.

However, the pendulum may haves swung too far in that direction, creating a need for better support and education for patients about their condition in order to reduce absenteeism and preventable complications, according to Sherifali.

After conducting an analysis that suggested health coaching can be as effective as an oral medicine for diabetes, Sherifali’s team at McMaster led a one-year study that tested over-the-phone advice to patients.

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Study participants, mostly in the range of 50-64 years of age, receive access to a coach once per week for six months and once per month for a further six months. Each call lasts about 15 minutes, allowing coaches to support about 200 individuals with diabetes while mitigating geographical barriers to more traditional consultations.

“Frequent, low-dose interactions are far better than waiting three to six months for a half-hour appointment that is based on someone else’s agenda,” said Sherifali.

While the study is still at a preliminary stage, she said initial results show participants are reporting better clinical and patient outcomes.

“Diabetes coaching is a solution that can address the complex issues related to diabetes,” said Sherifali.

“We see coaching as a care translator, taking the mystique and complexity of diabetes care and translating it to the individual.”