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Improving the quality of diabetes education in Vietnam - a community-based approach

Recent economic development in Vietnam, which has a population of nearly 90 million people, has been accompanied by rising prevalence of type 2 diabetes. However, diabetes management in general is far from optimum, due largely to the lack of specific education available to people with the condition. There is only a small number of specialized educators, and diabetes education is generally provided by doctors who do not have the time or background to carry out this work adequately.

The need for tact, openness and honesty when talking about complications

Discussing the sensitive issue of long-term complications is difficult for people with diabetes and the healthcare providers who work with them. Consequently, this area of diabetes management is often not handled well. In some situations, healthcare providers are reluctant to impose 'unpleasant' information on people who might be struggling to cope with diabetes; in others, the potential risk of developing complications might be used as a threat in an attempt to scare people into following medical advice.

A case for including peers as providers of diabetes self-management education

Diabetes distinguishes itself from many other chronic conditions because of the complexity of its day-to-day management – both medical management and self-management, which must be carried out by people with diabetes on a sometimes hourly basis. People require self-management education in order to master these complexities. Kate Lorig discusses the complexity of diabetes self-management education, how it is currently delivered, and suggests an effective additional means of offering this education.

Teaching and learning in diabetes: techniques and methods

The goals of diabetes education are to optimize blood glucose control, prevent chronic and potentially life-threatening complications, and optimize quality of life, while keeping costs within acceptable limits. Research has shown that with appropriate education lower-extremity amputation rates, medication costs, emergency room visits and hospitalizations are reduced. Nowadays, diabetes self- management education is an integral and critical part of any treatment plan.

Empowerment, education and discipline: implementing a diabetes self-management plan

Nowadays, few people would question the role of a person with diabetes as the central figure in his or her diabetes care team. But ‘patient’ empowerment extends well beyond the concept of self-determination. Diabetes does not occur in a vacuum, but interacts with a variety of emotional states and exists within many cultural and social boundaries. People with diabetes hold the power to manage their condition – not their healthcare providers or their family members.

The benefits of diabetes education: better health outcomes through successful self-management

Diabetes is mostly managed by people with the condition. In order to do so effectively, people with diabetes need to acquire and develop a broad base of knowledge and skills, and incorporate lifestyle choices into daily living which facilitate and enhance self-care. Diabetes education is an active process that supports people in building self-management skills, and provides for shared decision making about how best to fit diabetes treatment into daily life.

The Jaipur Foot: an effective low-cost prosthesis for people with diabetes

In people with diabetes, optimal management of their condition, regular examinations, the use of adequate footwear, and education are the best strategies to prevent diabetes-related foot problems, such as ulceration. If foot problems cannot be prevented, these should be treated as early as possible. However, in many cases, some degree of amputation of lower limbs cannot be avoided. In people who undergo a major amputation, artificial limbs are required to enable them to continue normal daily life.

Prevention and management of diabetes: the role of the physiotherapist

As the diabetes epidemic grows in size and complexity, there is an increasing realization that physicians alone are unable to provide the care required by people with diabetes. To help them live life to the fullest, people with the condition need the services of a range of healthcare personnel, including diabetes nurses, dietitians, podiatrists, psychologists and eye specialists. The role of most of these is well defined; the multi-disciplinary team approach benefits increasing numbers of people with diabetes worldwide.

From adolescence to adulthood: the transition from child to adult care

Adolescence, the period of transition from childhood to adulthood, is a key phase of human development. It is characterized by rapid changes – physical, sexual, psychological, emotional, cognitive, and social. The psychological imbalance that prevails during adolescence is particularly significant in people with diabetes as it often leads to a decline in self-care. This brings about a deterioration in blood glucose control, and creates difficulties that hamper the development of harmonious relationships between the young person with diabetes and his or her healthcare providers.

Guideline for the management of post-meal blood glucose

Diabetes is a leading cause of death in most developed countries, and has become a serious epidemic in many developing and newly industrialized nations. Currently, an estimated 246 million people worldwide have diabetes. Poorly controlled diabetes is associated with disabling and potentially life-threatening complications such as eye disease, kidney disease, nerve damage and cardiovascular disease. Until recently, lowering fasting and pre-meal glucose levels was a key focus of diabetes management.

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