Type 2 diabetes: A patient-centric approach to care

An informative Q&A with Dr. Sam Engel, associate vice president, cardiometabolic and women’s health at Merck Research Laboratories

Dr. Sam Engel talks about the importance of taking an individualized approach to type 2 diabetes care.

How would you define patient-centered care and how does it differ for those with type 2 diabetes?

We use the term patient-centered care to describe an approach grounded in an individual’s goals and priorities, plus how their disease (e.g., type 2 diabetes) fits into their particular life. These insights guide a tailored strategy to help patients manage their disease for the long term – for those with a chronic, progressive disease such as type 2 diabetes, this is a critical step.

I remember vividly a patient who came to me and said, “I have diabetes, but I get so much joy out of life from food. Can you work with me so I can continue to get joy from food, but still manage my type 2 diabetes?” I learned a lot from that conversation. This patient taught me that once you know what’s off the table (literally!) in terms of care, then you can figure out what is possible.

But, these are not the only things we need to think about when it comes to patient-centered care. We also need to consider other factors that may impact a patient’s ability to manage their disease, which may include:

Health literacy
Can they access, understand and apply health information?


Family and social support systems
Do they have a support network?


Financial concerns
Can they afford care?



How would you encourage health care providers to offer more personalized care?

Time is of the essence for everyone. I think providers need to plan for sufficient time to listen and empower patients as true partners in the process.

Also consider short, medium-and long-term strategies to help patients move forward, recognizing which goals are accessible now and which behaviors might take a long time to modify.

What steps can people with type 2 diabetes take to become more involved in their care?

I encourage patients to proactively communicate with their health care team. Patients can start by explaining their:


I understand that type 2 diabetes can feel like a full-time job, but together with a healthcare professional, patients can act daily on their management plan.

How can family members play a role in helping people with type 2 diabetes?

As a chronic disease, type 2 diabetes requires many self-management decisions throughout each and every day, as well as performing complex care activities. Family members may be able to provide important emotional and practical support on issues related to diet and lifestyle, among other things, for those managing the disease. But remember, as your supporters, family members must remember to be sensitive to your choices and know when to be involved and when not to be involved.

At the end of the day, type 2 diabetes requires a very individualized treatment strategy. So, each person with diabetes needs to be vocal and tell providers and family members, “This is where I would appreciate your help.”