Strategies To More Effectively Manage Diabetes


by Wendy Mitchell - Date: 2007-07-21 - Word Count: 396 Share This!

Managing diabetes can be a challenge, but some recently proposed strategies may one day make it much easier.

Among the nearly 21 million Americans who have diabetes- and the estimated 39 million who will have it by 2050-many may find it hard to fit the demands of therapy into their daily lives. According to the Agency for Healthcare Research and Quality, yearly costs for treating diabetes complications were almost $3.8 billion and two-thirds of this amount were for preventable conditions.

A recent symposium sponsored, by the American Journal of Nursing (AJN), identified some barriers to- and strategies for-more effective self-management.

"Health care professionals expect a lot from people with diabetes," said Katie Weinger, EdD, RN, director of the Center of Innovation in Diabetes Education and of the Office of Research Fellow Affairs at Joslin Diabetes Center. "Newer treatments to prevent complications can make self-care even more complex, causing frustration in even the most conscientious patients and leading clinicians to think patients are not properly managing their care."

Patients may have trouble navigating the health care system and don't always receive adequate self-management education after a diagnosis of diabetes. They may have limited time with a nurse or nutritionist. Patient education may not be a priority for the health care system or patients may not understand the complexity of diabetes self-management. And, technology is not yet sufficiently advanced to enable some patients to keep their blood sugars within a recommended range, no matter how hard the patients may try.

"For those with diabetes and conditions like depression or heart disease, self-care can be even more challenging," said Jane Jeffrie Seley, MPH, MSN, NP, CDE, co-editor of the AJN report and diabetes nurse practitioner at New York Presbyterian-Weill Cornell Medical Center, NYC. "Someone who is depressed may be less likely to perform self-care. Poor vision makes it hard to measure the correct amount of insulin. Those with multiple disorders may have to contend with additional dietary restrictions and medications."

The symposium offered some of the following strategies to help patients improve self-management:

• Patients should receive information and support to help them navigate the health care system.

• Patients should receive a referral for diabetes self-management education as a standard component of care.

• Time spent in the waiting room can be devoted to education, using audiovisual techniques.

• Grassroots advocacy can promote provider reimbursement for diabetes education.

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For more information about these suggestions, you can visit www.nursingcenter.com/AJNdiabetes. Educating patients who have been diagnosed with diabetes can help improve lifesaving, self-management skills.

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