Person-centered education

Abstract

Diabetes education has evolved from models primarily focused on knowledge transmission toward approaches that recognize the individual as the central actor in health-related decision-making. In this context, the apparent controversy between structured diabetes education and person-centered education represents, rather than a dichotomy, an opportunity to explore how both approaches can be integrated to achieve better clinical and human outcomes.

The conceptual evolution of therapeutic education has progressed from competency-based structured programs to the current paradigm of person-centered care, which advocates tailoring education to each individual's values, priorities, goals, and life context. This transformation implies moving beyond questions focused exclusively on the disease ("What did you eat?", "How many carbohydrates did you consume?", "Why didn't you exercise?") toward questions that explore the lived experience of diabetes ("What concerns you most?", "What goals would you like to achieve?", "What prevents you from reaching them?", "What role does diabetes play in your life?").

Current evidence demonstrates that structured education programs remain essential to ensure quality, equity, and the acquisition of self-management competencies. However, their effectiveness is enhanced when they incorporate person-centered strategies, empathetic communication, shared decision-making, and ongoing behavioral support. A recent meta-analysis of person-centered interventions reported a 0.56% reduction in HbA1c, while a network meta-analysis of Diabetes Self-Management Education and Support (DSMES) programs demonstrated HbA1c reductions approaching 0.6%, together with improvements in additional cardiometabolic outcomes.

Furthermore, person-centered education has become both a challenge and a necessity in the era of diabetes technology. Continuous glucose monitoring, automated insulin delivery systems, and artificial intelligence require educational strategies capable of transforming data into meaningful, individualized decisions.

True innovation does not lie in replacing structured education but in strengthening it through a person-centered approach. Structure defines what should be taught; person-centered care determines how learning can become meaningful, foster autonomy, and translate into sustainable behavioral change. Rather than opposing models, structured education and person-centered care represent complementary dimensions of truly transformative diabetes education.