Changing patient behavior

Objective: To discuss barriers and strategies relevant to initiating lifestyle modifications for the prevention and treatment of type 2 diabetes. Methods: Findings from previously published studies are reviewed. In light of reported successful changes in patient behavior and resultant improved outcomes pertinent to reduction or control of diabetes, methods to achieve optimal results are outlined. Results: Both the Diabetes Prevention Program and the Finnish Diabetes Prevention Study demonstrated that intensive lifestyle interventions, such as weight loss as a result of physical activity, can delay and prevent the development of type 2 diabetes. Key barriers to initiating behavioral modifications in patients include the following: (1) health-care provider experience, (2) patient experience and beliefs, (3) lack of health-care system support, and (4) minimal availability of community support. These barriers can be overcome through use of proven strategies - promoting patient awareness of health risks, selecting patients who are willing to participate in a behavioral modification program, defining realistic goals, establishing patient accountability, and maintaining regular follow-up for review of progress, providing assistance with problem solving, and reinforcement of efforts and successes. Conclusion: The feasibility of initiating successful lifestyle interventions has been shown in numerous studies. The effective implementation of these interventions in clinical practice will necessitate fundamental changes in the health-care system and society in general.