Graduation, whether from grammar school, high school, or college, is never the end; it’s a new beginning. Diabetes Self-Management Support (DSMS) can be that new beginning for patients with diabetes, after “graduating” from our self-management education sessions. Just as a new high school graduate looks ahead to college with excitement and a little apprehension, our patients look ahead to their future with diabetes with lots of different emotions.

Installment 4: How do we create concordance? The determinants of patient non‐compliance have been examined for years in an effort to better understand how to improve patient adherence. Patient and provider concordance is a factor that affects compliance. While compliance relates to how a patient is expected to follow advice from a healthcare professional, concordance represents a partnership between the patient and the health care professional.

Installment 5: Health Engagement. Health engagement fulfills a very therapeutic and purposeful role in our lives. It begins when we realize that in order to be well, we need to be interested in our own well-being. It continues when we put that into practice in the course of our daily lives – living in the present and making the best health decisions we can based upon current circumstances.

Installment 3: How do you empower patients? We all strive to empower our patients in order to achieve better self-management. However, the interesting thing about empowerment is that there is actually no clear method to define, deliver or measure it. Upon closer observation, this should come as no surprise. Considering the many variables in play, from each provider’s individual style, to each patient’s internal and external needs, it is impossible to develop a formula that will deliver patient empowerment.

Patients generally consult healthcare providers because they want to address immediate discomfort. The good news is that in doing so, they are actually playing a role in self-activation. The not so good news is that despite this first step, they still have a long way to go in becoming fully activated and engaged

Learner-centered Education. What does a patient-centered approach mean to you? With this online series, I would like to generate a real exchange focused on Personal Health Engagement™ (PHE), in which I plan to share with you what I have learned from healthcare providers around the world and also to hear from you about the everyday realities of working with patients. The

Ever since I was a sophomore in college, I knew that I wanted to be a dietitian. What I never really considered at the time was that the majority of my career would be spent as an educator. In college I studied chemistry, biology and nutrition, but only took one education course.

I am just getting over some type of bug. I spent all day Sunday in bed, feeling bad that I was wasting the day yet not able to get up and do anything. I lost my appetite for a few days but as soon as I began to feel better, I thought, "What can I eat or drink that will make me feel better quickly? Tea with lemon and honey?

What does it take to deliver a true "patient-centered" diabetes encounter? What are the skills needed to be a good vs. great vs. exceptional diabetes educator? Can empathy, which is needed to be a caring and attentive clinician, be learned? Can you be a knowledgeable and competent diabetes educator with a minimal level of empathy? Are they mutually exclusive?

When I was 7 or 8 years old, I would occasionally spend the night at my grandparents' two-flat a few miles from my home. The highlight of the stay was walking down their busy street on the way to the local ice cream stand. As my grandma and I made our way down the block, she taught me that it was very important to look everyone in the eye, say "good morning" or "good afternoon," and give them a BIG smile.