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New White Paper on Obstacles to Diabetes Care

Originated by: Laura Wilson

Submitted: 03 Feb 2012

Last updated on: 3 Feb 2012

Related Health Topics:


Through new research sponsored by the Diabetes Working Group, this white paper examines provider barriers to offering the current standards of diabetes care and offers recommendations to mitigate these barriers. To better understand these issues, the DWG undertook the following initiatives:

  • A comprehensive literature review of peer-reviewed articles on current standards of diabetes care, outcomes evidence, and current health economics data of diabetes care and treatment;
  • A provider survey fielded to a large sample of diabetes care providers in the United States, with an objective of identifying barriers for diabetes providers to providing optimal diabetes care; and
  • A theoretical Standards of Care Delivery Model designed to estimate the necessary resources to consistently deliver the current standards of care to diabetes patients in the United States. The model illustrates the gap between the current provision of care and what is needed to improve patient outcomes to meet current guidelines.


Barriers to care

The survey demonstrates that providers in the diabetes community recognize the importance of standards-based diabetes care, yet also notes that most patients with diabetes are not receiving such care. In fact, many obstacles arise in achieving optimal diabetes care, and providers face many of these barriers on a daily basis. The results of this extensive provider survey illustrate five provider-specific barriers that are most critical to their ability to provide patients with diabetes the care and treatment required to meet current standards:

  • patient adherence
  • time with patients
  • compensation for care
  • team coordination
  • care management



Three key provider barriers to optimal diabetes care emerged from the original research conducted by the DWG through the provider survey and economic model: time with patients,inadequate reimbursement, and patient adherence. The white paper provides recommendations on overcoming these key provider barriers to optimal diabetes care. Recommendations are arrayed across three areas of provider engagement: care management, payment reform, and workforce supply.


Diabetes Working Group White Paper: http://www.endo-society.org/upload/20120123-DWG-White-Paper.pdf

The DWG is committed to improving care and outcomes for people with diabetes in the U.S.The following experts contributed to this paper as part of the DWG: Dr. Stuart Brink representing the American Academy of Pediatrics; Dr. Dan Einhorn, Dr. Etie Moghissi, and Dr.Farhad Zangeneh representing the American Association of Clinical Endocrinologists; Dr. Karen Fitzner, representing the American Association of Diabetes Educators; Dr. Richard Bergenstal representing the American Diabetes Association; Kelly Close representing diaTribe; Dr. Robert Vigersky representing the Endocrine Society; Dr. Aaron Kowalski representing the Juvenile Diabetes Research Foundation; Dr. Lynne Levitsky representing the Pediatric Endocrine Society; Dr. Bruce Bode, Dr. Irl Hirsch, and Dr. William Tamborlane. In addition, Avalere Health assisted the DWG with coordination, research, and writing efforts.

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