Diabetes Self-management Education

Diabetes Self-management Education Theory and Practice

Introduction

Diabetes is an international health problem that is responsible for the high mortality cases in many countries. As a result, self-management education programs are developed to help diabetes patients manage their condition. In reference to the Diabetes Australia Position Statement, the following report explains a diabetes self-management education session for people living with diabetes. The health problem addressed in the report is one of the ADEA seven self-care behaviors; blood glucose monitoring. The issue is addressed within the context of the health model determinants. The audience targeted is people of between 45 to 65 years living with diabetes. The report includes a learning or education strategy on monitoring blood glucose to improve diabetes management, a list of goals, objectives, and a lesson plan. Lastly, an evaluation plan has been designed to measure the success of the program on influencing self-monitoring on the target group.

Monitoring Blood Glucose and Using Results to Improve Diabetes Management

One of the ADEA seven self-care behaviors is monitoring blood glucose for people with diabetes to improve diabetes management. Diabetes Australia Position Statement explains the need for monitoring one’s glucose level to personally manage their condition (Adu, Malabu, Malau-Aduli, & Malau-Aduli, 2019). This is a behavior that has proven a bit difficult for diabetic people to follow because of its confusing and constantly developing nature. In other words, people need to be well informed and educated on their best type of blood glucose monitoring. Within the context of determinants of health model, several issues arise on the lifestyle and nutrition determinants. These are modifiable determinant factors that are self-manageable. The issues under these health model determinants comprise unhealthy eating habits and lack of knowledge which constitute negative impacts on one’s health status. The underlying causes of these issues under lifestyle and nutrition include unhealthy diets, early addictions, stress levels, and poor living conditions. Diet is a key factor affecting the well-being of a person. In the current world, many human diseases are relating to the kind of foods people consume. Fighting age-related illnesses are also identifiable to nutrition in diets. As a result, the education session aims to improve personal skills in monitoring while addressing the underlying health issues. Self-monitoring is a critical aspect of self-care on diabetes patients (Bonger, Shiferaw, & Tariku, 2018). The program will further aim to equip patients with competent skills in testing and interpreting their glucose tests (Austin, 2013). It is then after these results that the need for the nutrition and lifestyle lessons come in. Individual testing of blood glucose levels enables patients to assess their health progress and adopt necessary changes to meet their health goals (Yarmohammadi, Momenyan, Ghaffari, Ali, & Azizpour, 2019). In the long run, patients will be able to manage their diabetes and get used to a new lifestyle without difficulty. Therefore, the main purpose of the education session is to promote intervention on nutrition and lifestyle health model factors of diabetes patients while prioritizing self-monitoring techniques to improve diabetes management.

Target Group

The above education session topic solely targets people who are living with diabetes. The target group is of both adult men and women aged between 45 to 65 years. The patients must have suffered from type-2 diabetes for the past at least 2 years and can understand the language of English. The patients have to show responsibility in self-management of their condition and the willingness to learn. Most people living with diabetes believe that it is a death sentence and medical care can only be directed by their clinician. However, the education program will aim to get rid of such beliefs and misconceptions by equipping them with self-care skills. They will be taught the skills of personal health management and monitoring blood sugar levels. The topic is relevant because most old diabetic patients assume that diabetes is uncontrollable and worry much about future complications (ReadingTurch, Heitkemper, Lor, Burgermaster, & Mamykina, 2019). This increases their stress levels and triggers the development of depressive symptoms (Yusoff, Ishak, Rahman, & Kadir, 2017). As a result, teaching them operational and interpretive skills of blood sugar testing will work to monitor their health performance and develop a positive attitude. Due to their old age, the group will want to learn through demonstrations where other factors such as visual acuity and preference are taken into consideration. For instance, when choosing a blood glucose testing meter, the patient should be allowed to choose the preferred one in terms of size and quality. Scientific research reveals that middle-aged diabetic patients are at a greater risk of developing onset long-standing diabetes. Early preventive and control measures are therefore advised to avoid complications. The group has been targeted to ensure that the patients can easily monitor and maintain the recommended blood sugar levels. For patients with special needs such as the visually impaired, special education sessions will be organized (Mogre, Johnson, Tzelepis, & Paul, 2019). These will not be left behind because it is also possible for them to monitor their health from home. There will be diabetic educators who teach them how to use speaking glucose meters. Those who have visual difficulties can as well be provided with big meters that give big readings.

Goal, Objective and Lesson Plan

The health promotion education program will be conducted with the overarching goal of promoting efficient self-evaluation of a patient’s lifestyle and nutrition habits through self-monitoring of blood glucose levels. One of the objectives is to empower patients in playing the most important role of diabetes self-health care management ( Mohebi, Parham, Sharifirad, Gharlipour, Mohammadbeigi, & Rajati, 2018). Most patients believe that their health progress is solely the role of their clinicians. Consequently, they lack proper nutrition education and skills on how to monitor their health status. The patient’s choice of foods is highly determined by their level of knowledge and skills in diabetes healthy nutrition. For instance, most patients believe that they can forego the restricted diet plan for strict medical adherence. Lack of awareness and skills influences the patient’s behaviors and attitudes which in return harms their health (Ouyang, 2017). Using a well-structured education program that accounts for the patients’ cultural and preference needs will therefore ultimately progress the need for adopting healthy nutrition standards and lifestyles. As a result, the program will focus on training patients on how to select and effectively use glucose meters in blood glucose monitoring (Adolfsson, Parkin, Thomas, & Krinelke, 2018 ). Educators will assist patients in choosing the most appropriate meters considering several factors such as size, features, cost, and accuracy (Lautsch, Mondesir, & Ekhlaspour, 2017). Ensuring accurate measurements depends on the human input in performing the test. The education session will thereby include the stepwise information on the proper usage of the item beginning from the storage to proper cleaning. Another objective is to differentiate all program activities to suit the needs and preferences of all the patients. Patients with special needs will be educated especially. While the visually impaired will be trained using ‘speaking’ blood glucose meters, those with eye difficulties will use meters that give highly visible readings. The meters will have memory features where the patient can relate his glucose levels with his diets and lifestyle habits. In an online environment, the relevant patients will be guided on how to download the meters and correctly interpret the graphic results (Goyal, Morita, Lewis, Yu, Seto, & Cafazzo, 2016). The patients will liaise with their educators to electronically send their results to the latter for further reviews. The health behavior theory has greatly influenced session development in that diabetes management is centered on one’s habits and lifestyle (Peek, Ferguson, Roberson, & Chin, 2014). Similarly, the education activity puts great emphasis on individual responsibility on managing their condition. Finally, several resources will be needed for the most successful outcomes in the diabetes education program. First, there have to be gender-sensitive educators depending on the number of patients on board. Special educators will also be hired to educate patients with special needs such as the visually impaired. Although the acquisition of meters is on a personal insurance basis, educators will have to input their time and finances in bringing them to their clients (Kruger, Edelman, Hinnen, & Parkin, 2018). Other blood glucose meters will be needed for training purposes to ensure a precise understanding of the clients.

Lesson Plan

Evaluation Plan

A proper evaluation plan is essential in measuring success and ensuring that objectives have been met. To determine the effectiveness of the education program, the primary outcome to be looked at will be the rate of diabetes mortality. This is the long run and long-term goal of conducting a health education program for people living with diabetes. Proper home-based care and personal monitoring will transform into fewer deaths and higher life expectancy. The secondary outcomes will include the number of clinical visits, quality of life, and behavioral measures. If the number of clinical visits emerges high, then the patients are not adequately competent in managing diabetes self-health care. Contrary to that, the objectives of the education system will have been met as patients can monitor their health progress. Behavioral measures will include the taking of healthy diets, engaging in physical activities, and a reduction in obesity cases (Muchiri, Gericke, & Rheeder, 2019). These will be measured through one on one conversation or by filling in questionnaires. Besides, progress will be measured through the direct reports or electronic transactions of blood glucose meter results from the patients to educators.

Conclusion

Blood sugar monitoring is a critical aspect of diabetes self-care management. Self-monitoring helps patients learn about the effects of their behaviors and practices on their health. They can directly track their progress and adhere to the recommended practices to maintain the right glucose levels (Mogre, Abanga, Tzelepis, Johnson, & Paul, 2017). Sharing the results with one’s clinician or educator creates a chance for further discussion on the ultimate diabetes management. It is these results that form the basis for health decisions relating to diets, physical activities, and medications. The monitoring process is different for every patient depending on one’s diabetes goals and overall health. Due to the lack of awareness, knowledge, and sufficient skills in managing diabetes, health education programs serve a great role in guiding patients.

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 References

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Adolfsson, P., Parkin, C., Thomas, A., & Krinelke, L. (2018 ). Selecting the Appropriate Continuous Glucose Monitoring System – a Practical Approach. European Endocrinology, 24–29.

Adu, M., Malabu, U., Malau-Aduli, A., & Malau-Aduli, B. (2019). Enablers and barriers to effective diabetes self-management: A multi-national investigation. PLoS One, 14(6).

Austin, M. (2013). The Two Skill Sets of Self-Monitoring of Blood Glucose Education: The Operational and the Interpretive. Diabetes Spectrum, 83-90.

Bonger, Z., Shiferaw, S., & Tariku, E. (2018). Adherence to diabetic self-care practices and its associated factors among patients with type 2 diabetes in Addis Ababa, Ethiopia. Patient Prefer Adherence, 963–970.

Goyal, S., Morita, P., Lewis, G., Yu, C., Seto, E., & Cafazzo, J. (2016). The Systematic Design of a Behavioural Mobile Health Application for the Self-Management of Type 2 Diabetes. Canadian Journal of Diabetes, 95-104.

Kruger, D., Edelman, S., Hinnen, D., & Parkin, C. (2018). Reference Guide for Integrating Continuous Glucose Monitoring Into Clinical Practice. The Diabetes Educator, 3S-20S.

Lautsch, N., Mondesir, D., & Ekhlaspour, L. (2017). Comparative Accuracy of 17 Point-of-Care Glucose Meters. Journal of Diabetes Science and Technology, 558-566.

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Mogre, V., Johnson, N., Tzelepis, F., & Paul, C. (2019). Barriers to diabetic self‐care: A qualitative study of patients’ and healthcare providers’ perspectives. The International Voice of Nursing Research, Theory and Practice, 2296-2308.

Muchiri, J., Gericke, G., & Rheeder, P. (2019). Adapting a diabetes nutrition education program for adults with type 2 diabetes from a primary to a tertiary healthcare setting. South African Journal of Clinical Nutrition, 24-33.

Ouyang, C.-M. (2017). Dietary education for patients with type 2 diabetes: failure or success? Diabetes Management, Volume 7.

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ReadingTurch, M., Heitkemper, E., Lor, M., Burgermaster, M., & Mamykina, L. (2019). Designing for engagement with self-monitoring: A user-centered approach with low-income, Latino adults with Type 2 Diabetes. International Journal of Medical Informatics, Volume 130.

Yarmohammadi, S., Momenyan, S., Ghaffari, M., Ali, R., & Azizpour, M. (2019). Impact of functional, communicative, and critical health literacy on glycemic control among patients with type 2 diabetes, and the mediating role of self-care. Psychology Research and Behavior Management, 427–435.

Yusoff, S., Ishak, N., Rahman, R., & Kadir, A. (2017). Diabetes self-care and its associated factors among elderly diabetes in primary care. Journal of Taibah University Medical Sciences, 504-511.

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