In this year’s American Diabetes Association (ADA) 75th Annual Scientific Meeting, Professor Steven V. Edelman from the University of California was interviewed by Medscape.com and gave his views on diabetes management. We now have many tools to treat type 1 diabetes and type 2 diabetes, and especially type 2 diabetes with nine oral medications, new insulins, and GLP-1 receptor agonists. But why hasn’t the number of patients achieving glycemic control improved? I think we have too many tools, but we probably don’t need too many. What we need to do is get these new medications into the hands of patients, but more importantly, educate and encourage patients on how to use these medications so that they can help them survive longer and healthier, which will also benefit family members of people with diabetes. For me, the fact is that the issue of “adherence” (and why so few patients stay on their medications) comes down to education and encouragement. For this, there is no rocket science. We need to talk with patients, gain their trust, and slowly make small changes. Without this, the issue of patient adherence and the issue of improving HbA1c levels in our country will not improve significantly. In conclusion, we can provide all the new drugs that patients in the world want, but we must educate and encourage our patients to become self-starters and work with their physicians to get the best possible management. Medscape user comment @karla zamiska: I think doctors need better education too, it’s more about: what do patients fear about diabetes management? What do patients need to know but don’t know yet? And how to make diabetes management easier for patients. For example, patients on insulin require multiple injections, and everyone is afraid of needles. How many doctors or diabetes trainers understand how to help patients have pain-free or less painful injections? This is something that can be had. There are gaps between nerves and we can lightly touch the skin with the needle and position it by simply moving the needle tip around the area of injection. These could be taught but are not. @BarbaraMeadows: Cost is an issue that cannot be ignored. Diabetes meds are expensive, insulin has been around for decades but is still as expensive as oral meds. Costs to patients are skyrocketing. It is important to educate and discuss with patients that it is very difficult for them to comply when the cost is very high for them, so it is important to make sure that the issue of cost is not one of the reasons for poor compliance.