Most patients with type 2 diabetes receive their medical care from primary care providers. Shared medical appointments (SMAs) are one option to meet the various medical and education needs of patients in one appointment, while also providing peer support and motivation. Research suggests that SMAs can be effective in improving knowledge, quality of life, and problem-solving skills in patients with diabetes. However, more research is needed to determine the optimal group size, format, and curriculum.

Diabetes educators have valued and unique skills in the art and science of diabetes management that are beneficial in the delivery of shared medical appointments (SMAs). These contributions augment and expand the medical model of intervention in chronic disease because psychosocial concerns and behavior change are integral to successful outcomes. This article reflects on lessons learned from a multidisciplinary team of diabetes health care professionals with a strong diabetes education background who have been delivering comprehensive diabetes care for more than 6 years in an SMA model.

In an attempt to make education a nonstop process, the University of Turin in Italy developed an education and clinical care model called Group Care for patients with type 2 diabetes. Through this model, a series of seven sessions facilitated by a nurse, a dietitian, and a pedagogist are matched with clinical practice in the diabetes clinic. A primary goal of the sessions is to transform people with diabetes into self-educators. A randomized, controlled trial documented improvements in metabolic outcomes, quality of life, and health behaviors for participants in Group Care compared to a control group. A second multicenter trial demonstrated that Group Care can be effectively reproduced in other medical clinics. This article describes the Turin experience, from development of the program through its evaluation.

What patients with diabetes want and need for the successful management of their disease is exactly what shared medical appointments (SMAs) can provide. Topping the list are increased access to care, quality time with the physician, an active role in medical and lifestyle decision-making, their unique needs individually addressed in a timely manner, and encouragement and support from other people with diabetes. For health care professionals, SMAs are a cost-effective way to provide both diabetes medical management and self-care education in the same visit in a manner consistent with highly interactive patient-centered care. This article offers an overview of Medicare and private insurance reimbursement for SMAs.

Background. Type 2 diabetes is a growing concern among medically underserved Chinese Americans. However, very few interventions have been developed or adapted for Chinese Americans with diabetes.

Objective. To use a participatory research approach to evaluate the effectiveness of a culturally tailored, linguistically appropriate model for diabetes care employing health coaches to improve A1C levels among Chinese-American patients in a federally qualified health center setting.

Methods. We compared change in A1C between intervention participants (n = 46), who received a health coaching intervention, and control participants (n = 46), who received usual care over a period of ~ 6 months.

Results. Intervention participants showed a decrease in mean A1C at follow-up (–0.40%) compared to control subjects (+0.04%), although this difference was not statistically significant. At the 6-month follow-up, a significantly higher percentage of intervention participants (45.7%) had well-controlled A1C levels compared to control subjects (23.9%) (P = 0.048).

Conclusions. It is feasible to implement a culturally tailored, linguistically appropriate teamlet model of care for Chinese Americans with type 2 diabetes. Such a model may be helpful in reducing A1C levels. Given trends in A1C improvement during a 6-month pilot, future randomized trials with a larger sample capable of providing adequate statistical power to detect improvements are warranted.