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Message: <blockquote data-quote="AndBreathe" data-source="post: 990339" data-attributes="member: 88961">I've thought about this a bit, and clearly one model doesn't fit all, so whilst the current "standard" really is failing so many T2s, no other single way will be wholly successful either.  Clearly some people want to be at the centre of their management and others prefer a led approach where they are given much more specific instruction, rather than choices.I believe many of us had poor experiences at the point of diagnosis – whether by the up-front lecture of gloom and doom, or at the other end of the spectrum, a feeling of abandonment and left to fend for oneself.I think there is some value to the diagnostic delivery being fairly brief, but then setting the scene for the next steps, and allowing the person a short while to do some thinking.  That initial delivery must include a brief question from the HCP to find out if the person knows anything about diabetes (which can immediately help signpost how the person might receive their own news), and a message of “don’t panic”.  Somehow in that initial diagnostic meeting the person also needs to leave with a bit of “homework” – although that really would take the form of some considerations they should be mulling over in the intervening period.  Things like how involved the patient wants to be, how much effort they are willing to make, what the patient’s expectations are (if it’s a silver bullet, that needs to be addressed….).  Obviously, that’s at the highest level, but from there a somewhat tailored approach could be formulated, from a menu of options/approaches, perhaps under general headings life:  Diet, Exercise, Weight Management, Medication, Testing, Related Medical Conditions, Reviews. Let’s face it; some patients simply aren’t open to change, and have no interest whatsoever in modifying their lifestyle, whereas others want to go the whole 9 yards.  This forum tends to have more of the latter than the former sticking around, so we are not a typical group, I’d suggest.A while ago I did some more developed thinking on this as I would love to have influenced the way diabetes is handled in my practise, but sadly there is no appetite for change in my practise the present.  I have massive experience in Change, but sadly, I see so many approaches which are simply doomed to failure, do to poorly thought out (if thought out at all) starting points.If I can be of assistance, please let me know.</blockquote>

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