title: Are patients' initial experiences at the diagnosis of type 2 diabetes associated with attitudes and self-management over time?
abstract: Objective The purpose of this study was to investigate patients' experiences when diagnosed with type 2 diabetes and diabetes-related distress and self-management years later. Method One hundred seventy-nine adults with type 2 diabetes, 1 to 5 years after diagnosis, completed a questionnaire assessing what they were told and what was recommended at diagnosis as well as current diet, physical activity, and diabetes distress.
  
  
  
  Most patients (60%) expressed confidence in their health care provider (HCP) at diagnosis, but 30% reported that a clear action plan was not communicated. Current diabetes distress was significantly lower among those who reported being reassured at diagnosis that diabetes could be managed successfully and had developed a clearer action plan with their HCP. Patients' current dietary behaviors were significantly better among those receiving a clearer action plan at diagnosis.
  
  
  
  Patients' retrospective reports of reassuring HCP messages when diagnosed, along with the presentation of a clear action plan, are associated with less diabetes distress and better self-management at 1 to 5 years after diagnosis. Practical implications Findings suggest a long-lasting impact on patients' attitudes and behaviors when the diagnosis of type 2 diabetes is delivered clearly, a sense of hope is provided, and a specific care plan is put forward.
authors: The Department of Psychiatry, University of California, San Diego (Dr Polonsky)|Behavioral Diabetes Institute, San Diego (Dr Polonsky, Dr Guzman)
authors: William H
authors: WH
authors: Polonsky
authors: Department of Family and Community Medicine, University of California, San Francisco (Dr Fisher)
authors: Lawrence
authors: L
authors: Fisher
authors: Behavioral Diabetes Institute, San Diego (Dr Polonsky, Dr Guzman)
authors: Susan
authors: S
authors: Guzman
authors: Department of Family and Preventive Medicine, University of California, San Diego (Dr Sieber)|Inner Solutions for Success, LLC, San Diego (Dr Sieber)
authors: William J
authors: WJ
authors: Sieber
authors: Scripps Whittier Diabetes Institute, La Jolla (Dr Philis-Tsimikas)
authors: Athena
authors: A
authors: Philis-Tsimikas
authors: Division of Endocrinology and Metabolism, University of California, San Diego, and Veterans Affairs Medical Center, San Diego (Dr Edelman)
authors: Steven V
authors: SV
authors: Edelman
mesh_terms: D000328:Adult; D000368:Aged; D001294:Attitude to Health; D003924:Diabetes Mellitus, Type 2 / Q000175:diagnosis* / Q000523:psychology*; D004522:Educational Status; D005006:Ethnicity; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic; D011369:Professional-Patient Relations; D012648:Self Care; D011795:Surveys and Questionnaires; D035502:Trust