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As three undergraduates with first-hand knowledge of diabetes management and care challenges, this article resonated with
us. In reading your article, we were intrigued to learn about the many different strategies implemented by primary care
practices to improve diabetes care delivery. They looked at the development of care teams, how they were beneficial, and how
they may have been unproductive. A more sustainable outcome came from active care teams and stronger relationships with
patients were perceived as essential in establishing the trust necessary to promote adherence to behavioral change
recommendations. Overall, the study sample included large practices with multiple locations. A key finding centered on the
employee onboarding process and how it could increase long-term diabetes quality of care. We were left with questions about
which strategies for onboarding resulted in the best care for diabetes management. Also, the authors identified change
management strategies commonly identified by over half of the practices, but no single practice identified all nine strategies.
We were left wondering why the authors believed these findings emerged. It was noted in the discussion that all interviewed
practices already had a solid diabetes management treatment in place. In the future, we are curious to know if the authors plan
to extend their study to include a sample of practices with different performance levels for diabetes treatment and
management. Our final question for the authors is how can practices continually monitor patient reports more efficiently.