title: Time requirements for diabetes self-management: too much for many?
abstract: BACKGROUND
  In Crossing the Quality Chasm, the Institute of Medicine laid out principles to improve quality of care and identified chronic diseases as a starting point. One of those principles was the wise use of patient time, but current recommendations for chronic conditions do not consider time spent on self-care or its impact on patients' lives.
  
  
  OBJECTIVE
  To estimate the time required for recommended diabetes self-care.
  
  
  METHODS
  A convenience sample of 8 certified diabetes educators derived consensus-based estimates of the time required for all self-care tasks recommended by the American Diabetes Association.
  
  
  RESULTS
  For experienced patients with type 2 diabetes controlled by oral agents, recommended self-care would require more than 2 extra hours daily. Elderly patients and those with newly diagnosed disease, or those with physical limitations, would need more time. Exercise and diet, required for self-care of many chronic conditions, are the most time-consuming tasks.
  
  
  CONCLUSIONS
  The time required by recommended self-care is substantial. Crossing the Quality Chasm suggests how clinicians and guideline developers can help patients make the best use of their self-care time: elicit the patient's perspective; develop evidence on the health consequences of self-care tasks; and respect patients' time.
authors.affiliation: Institute for Health, Health Care Policy, and Aging Research, Rutgers University, New Brunswick, NJ, USA.
authors.forename: Louise B
authors.initials: LB
authors.lastname: Russell
authors.forename: Dong-Churl
authors.initials: DC
authors.lastname: Suh
authors.forename: Monika A
authors.initials: MA
authors.lastname: Safford
mesh_terms: D003924:Diabetes Mellitus, Type 2 / Q000451:nursing / Q000628:therapy*; D006801:Humans; D010045:Outpatients / Q000193:education; D010353:Patient Education as Topic; D017410:Practice Guidelines as Topic; D012648:Self Care; D013997:Time Factors