Type 2 diabetes, also called non-insulin dependent diabetes, is the most common form of diabetes. While people with Type 2 diabetes produce insulin (unlike those with Type 1), their pancreas does not produce enough of it or the body cannot use it adequately.

Patients with Type 2 diabetes have to follow strict self-management behaviors at home if they wish to control their blood glucose levels. Self-management means that the patient is independent and participates safely in a wide variety of activities while living with diabetes.

The behaviors typically include continuously checking blood sugar level, following a diabetes diet, always exercising, and taking diabetes medications as instructed by their doctor. These kind of behaviors are associated with better metabolic control and lower overall morbidity and mortality.

It has always been thought that personal and home-related factors such as the patients’ race, family support available to them, their demographics, relationships with their doctors, stress levels, and the social context in which they live, are the only factors that are related to diabetic patients’ behaviors at home. However, a recent study (in which I am the primary author) has shown that the characteristics of the clinic where the patient receives his/her care are also associated with patient behaviors.

For example, in clinics where doctors have appropriate decision support systems, patients are more likely to adhere to all four self-management behaviors mentioned above. Decision support systems include the availability of timely scientific information for doctors in the clinics, the involvement of diabetic specialists in patient care, and the presence of continuous education for doctors on how to provide better care for their patients.

Moreover, patients receiving care in clinics that address theirs and their families’ concerns and that focus on effective behavior change interventions and peer support, were more likely to adhere to their diabetes medications.

External environmental influences affecting diabetic patients at their homes, such as family support or the easy availability of fast-foods have a strong effect on how effectively these patients can manage their condition. But other factors related to where the patients are getting their care might also play an important role. Patients should ask about these factors before choosing a clinic to receive their care.