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Self-care initiatives for improved diabetes management

Self-care initiatives for improved diabetes management

Internet i,proved glucose Flr systems mabagement lasting glycemic benefit in Eco-conscious energy ideas 1 and 2 diabetes: A systematic review. Wing RR, Goldstein MG, Kelly JA, Birch LL, Imporved JM, Well-rounded diet for sports JF: Behavioral science research in diabetes. This rapid increase in diabetes requires self-management behaviors, especially in areas with inadequate medical care [ 45 ]. Diabetes mellitus DM is a chronic progressive metabolic disorder characterized by hyperglycemia mainly due to absolute Type 1 DM or relative Type 2 DM deficiency of insulin hormone[ 1 ].

Self-care initiatives for improved diabetes management -

The needs of diabetic patients are not only limited to adequate glycemic control but also correspond with preventing complications; disability limitation and rehabilitation. There are seven essential self-care behaviors in people with diabetes which predict good outcomes namely healthy eating, being physically active, monitoring of blood sugar, compliant with medications, good problem-solving skills, healthy coping skills and risk-reduction behaviors.

All these seven behaviors have been found to be positively correlated with good glycemic control, reduction of complications and improvement in quality of life. Individuals with diabetes have been shown to make a dramatic impact on the progression and development of their disease by participating in their own care.

Despite this fact, compliance or adherence to these activities has been found to be low, especially when looking at long-term changes. Though multiple demographic, socio-economic and social support factors can be considered as positive contributors in facilitating self-care activities in diabetic patients, role of clinicians in promoting self-care is vital and has to be emphasized.

Realizing the multi-faceted nature of the problem, a systematic, multi-pronged and an integrated approach is required for promoting self-care practices among diabetic patients to avert any long-term complications. Astrid N. van Smoorenburg, Dorijn F. Hertroijs, … Marijke Melles. Diabetes mellitus DM is a chronic progressive metabolic disorder characterized by hyperglycemia mainly due to absolute Type 1 DM or relative Type 2 DM deficiency of insulin hormone[ 1 ].

DM virtually affects every system of the body mainly due to metabolic disturbances caused by hyperglycemia, especially if diabetes control over a period of time proves to be suboptimal[ 1 ]. Until recently it was believed to be a disease occurring mainly in developed countries, but recent findings reveal a rise in number of new cases of type 2 DM with an earlier onset and associated complications in developing countries[ 2 — 4 ].

Diabetes is associated with complications such as cardiovascular diseases, nephropathy, retinopathy and neuropathy, which can lead to chronic morbidities and mortality[ 5 , 6 ]. World Health Organization WHO estimates that more than million people worldwide have DM.

According to WHO report, India today heads the world with over 32 million diabetic patients and this number is projected to increase to One of the biggest challenges for health care providers today is addressing the continued needs and demands of individuals with chronic illnesses like diabetes[ 12 ].

The importance of regular follow-up of diabetic patients with the health care provider is of great significance in averting any long term complications. Studies have reported that strict metabolic control can delay or prevent the progression of complications associated with diabetes[ 13 , 14 ].

Some of the Indian studies revealed very poor adherence to treatment regimens due to poor attitude towards the disease and poor health literacy among the general public[ 15 , 16 ]. The introduction of home blood glucose monitors and widespread use of glycosylated hemoglobin as an indicator of metabolic control has contributed to self-care in diabetes and thus has shifted more responsibility to the patient[ 17 , 18 ].

Self-care in diabetes has been defined as an evolutionary process of development of knowledge or awareness by learning to survive with the complex nature of the diabetes in a social context[ 20 , 21 ].

There are seven essential self-care behaviors in people with diabetes which predict good outcomes. These are healthy eating, being physically active, monitoring of blood sugar, compliant with medications, good problem-solving skills, healthy coping skills and risk-reduction behaviors[ 26 ]. These proposed measures can be useful for both clinicians and educators treating individual patients and for researchers evaluating new approaches to care.

Self-report is by far the most practical and cost-effective approach to self-care assessment and yet is often seen as undependable. Diabetes self-care activities are behaviors undertaken by people with or at risk of diabetes in order to successfully manage the disease on their own[ 26 ]. All these seven behaviors have been found to be positively correlated with good glycemic control, reduction of complications and improvement in quality of life[ 27 — 31 ].

In addition, it was observed that self-care encompasses not only performing these activities but also the interrelationships between them[ 32 ]. Diabetes self-care requires the patient to make many dietary and lifestyle modifications supplemented with the supportive role of healthcare staff for maintaining a higher level of self-confidence leading to a successful behavior change[ 33 ].

Though genetics play an important role in the development of diabetes, monozygotic twin studies have certainly shown the importance of environmental influences[ 34 ]. Individuals with diabetes have been shown to make a dramatic impact on the progression and development of their disease by participating in their own care[ 13 ].

This participation can succeed only if those with diabetes and their health care providers are informed about taking effective care for the disease. It is expected that those with the greatest knowledge will have a better understanding of the disease and have a better impact on the progression of the disease and complications.

The American Association of Clinical Endocrinologists emphasizes the importance of patients becoming active and knowledgeable participants in their care[ 35 ].

Likewise, WHO has also recognized the importance of patients learning to manage their diabetes[ 36 ]. The American Diabetes Association had reviewed the standards of diabetes self management education and found that there was a four-fold increase in diabetic complications for those individuals with diabetes who had not received formal education concerning self-care practices[ 37 ].

A meta-analysis of self-management education for adults with type-2 diabetes revealed improvement in glycemic control at immediate follow-up. However, the observed benefit declined one to three months after the intervention ceased, suggesting that continuing education is necessary[ 38 ].

A review of diabetes self-management education revealed that education is successful in lowering glycosylated hemoglobin levels[ 39 ]. Diabetes education is important but it must be transferred to action or self-care activities to fully benefit the patient.

Self-care activities refer to behaviors such as following a diet plan, avoiding high fat foods, increased exercise, self-glucose monitoring, and foot care[ 40 ].

Changes in self-care activities should also be evaluated for progress toward behavioral change[ 41 ]. Self-monitoring of glycemic control is a cornerstone of diabetes care that can ensure patient participation in achieving and maintaining specific glycemic targets.

The most important objective of monitoring is the assessment of overall glycemic control and initiation of appropriate steps in a timely manner to achieve optimum control.

Self-monitoring provides information about current glycemic status, allowing for assessment of therapy and guiding adjustments in diet, exercise and medication in order to achieve optimal glycemic control. Irrespective of weight loss, engaging in regular physical activity has been found to be associated with improved health outcomes among diabetics[ 42 — 45 ].

The National Institutes of Health[ 46 ] and the American College of Sports Medicine[ 47 ] recommend that all adults, including those with diabetes, should engage in regular physical activity.

Treatment adherence in diabetes is an area of interest and concern to health professionals and clinical researchers even though a great deal of prior research has been done in the area.

In diabetes, patients are expected to follow a complex set of behavioral actions to care for their diabetes on a daily basis. These actions involve engaging in positive lifestyle behaviors, including following a meal plan and engaging in appropriate physical activity; taking medications insulin or an oral hypoglycemic agent when indicated; monitoring blood glucose levels; responding to and self-treating diabetes- related symptoms; following foot-care guidelines; and seeking individually appropriate medical care for diabetes or other health-related problems[ 48 ].

The majority of patients with diabetes can significantly reduce the chances of developing long-term complications by improving self-care activities.

In the process of delivering adequate support healthcare providers should not blame the patients even when their compliance is poor[ 49 ]. One of the realities about type-2 diabetes is that only being compliant to self-care activities will not lead to good metabolic control.

Research work across the globe has documented that metabolic control is a combination of many variables, not just patient compliance[ 51 , 52 ].

In an American trial, it was found that participants were more likely to make changes when each change was implemented individually. Success, therefore, may vary depending on how the changes are implemented, simultaneously or individually[ 53 ].

Some of the researchers have even suggested that health professionals should tailor their patient self-care support based on the degree of personal responsibility the patient is willing to assume towards their diabetes self-care management[ 54 ].

The role of healthcare providers in care of diabetic patients has been well recognized. Socio-demographic and cultural barriers such as poor access to drugs, high cost, patient satisfaction with their medical care, patient provider relationship, degree of symptoms, unequal distribution of health providers between urban and rural areas have restricted self-care activities in developing countries[ 39 , 55 — 58 ].

Another study stressed on both patient factors adherence, attitude, beliefs, knowledge about diabetes, culture and language capabilities, health literacy, financial resources, co-morbidities and social support and clinician related factors attitude, beliefs and knowledge about diabetes, effective communication [ 60 ].

Because diabetes self-care activities can have a dramatic impact on lowering glycosylated hemoglobin levels, healthcare providers and educators should evaluate perceived patient barriers to self-care behaviors and make recommendations with these in mind.

Unfortunately, though patients often look to healthcare providers for guidance, many healthcare providers are not discussing self-care activities with patients[ 61 ]. Some patients may experience difficulty in understanding and following the basics of diabetes self-care activities.

When adhering to self-care activities patients are sometimes expected to make what would in many cases be a medical decision and many patients are not comfortable or able to make such complex assessments. It is critical that health care providers actively involve their patients in developing self-care regimens for each individual patient.

This regimen should be the best possible combination for every individual patient plus it should sound realistic to the patient so that he or she can follow it[ 62 ].

Also, the need of regular follow-up can never be underestimated in a chronic illness like diabetes and therefore be looked upon as an integral component of its long term management. A clinician should be able to recognize patients who are prone for non-compliance and thus give special attention to them.

On a grass-root level, countries need good diabetes self-management education programs at the primary care level with emphasis on motivating good self-care behaviors especially lifestyle modification. Furthermore, these programs should not happen just once, but periodic reinforcement is necessary to achieve change in behavior and sustain the same for long-term.

While organizing these education programs adequate social support systems such as support groups, should be arranged. As most of the reported studies are from developed countries so there is an immense need for extensive research in rural areas of developing nations.

Concurrently, field research should be promoted in developing countries about perceptions of patients on the effectiveness of their self-care management so that resources for diabetes mellitus can be used efficiently. To prevent diabetes related morbidity and mortality, there is an immense need of dedicated self-care behaviors in multiple domains, including food choices, physical activity, proper medications intake and blood glucose monitoring from the patients.

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Odegard PS, Capoccia K: Medication taking and diabetes: A systematic review of the literature. Physical activity lowers cholesterol, improves blood pressure, lowers stress and anxiety, and improves your mood.

Being active can also keep your blood glucose levels in check and your diabetes under control. Regular monitoring of your blood sugar levels gives you the information you need to make decisions. Testing your blood sugar lets you know when your levels are on target and it informs your decisions on activity and food so that you can live life to the fullest.

Taking the right medications will help you have greater control over your diabetes and help you feel better. Insulin, pills that lower your blood sugar, aspirin, blood pressure medication, cholesterol-lowering medication are a few of the medicines used to reduce your risk of complications.

Encountering struggles with your diabetes control will happen. You can't plan for every situation you may face. However, learning from struggles and developing plans for dealing with problems in the future will help you be successful.

Living with diabetes is challenging mmanagement requires significant effort to manage the condition effectively. Along Sdlf-care following a healthy diet, monitoring blood sugar Self-acre, and Self-care initiatives for improved diabetes management to foe prescribed Adaptogen body rejuvenation therapy, self-care practices diabets a crucial role in diabetes management. In general, self-care refers to the deliberate and proactive steps you may take to care for your physical, emotional, and mental health. When it comes to diabetes management, self-care means developing knowledge and awareness by learning to live with the complex nature of the condition. Practices include exercise, healthy eating, stress reduction techniques, and more frequent tracking of your blood sugar levels. First, you need to be trained on how to manage your type of diabetes best. You will definitely find a ton of helpful materials about your condition with a simple Google search. Self-csre engaging community health workers in diabetes management are typically implemented ikproved underserved communities and Well-rounded diet for sports improve health, reduce health disparities, diabetss enhance health equity. Community health workers deliver services and program diaetes through Well-rounded diet for sports interactions or group sessions. Managemeng health workers may work alone or as part of an intervention team comprised of clinicians, counselors, or other health professionals e. Community health workers including promotores de salud, community health representatives, community health advisors, and others are frontline public health workers who serve as a bridge between underserved communities and healthcare systems. They typically are from or have a unique understanding of the community served. Community health workers often receive on-the-job training and work without professional titles. Self-care initiatives for improved diabetes management


ADCES7 Self-Care Behaviors to Manage Diabetes, Prediabetes and Other Chronic Conditions

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