Health Delivery

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Small-scale strategies to improve diabetes awareness in those who need it most

After only a few hours at an outpatient diabetes clinic in Tanzania, it becomes apparent to any observer that most people with diabetes arrive unaccompanied. The lack of affordable transportation forces people to visit the clinics alone. Unfortunately, such behaviour not only fosters a lack of support from the family but also creates a gap between the family and the healthcare provider. When it comes to managing diabetes at a population level, a team approach is necessary that includes people with diabetes, their family and their healthcare providers.

Why I adopted a reduced carbohydrate approach

Having lived with diabetes for many years, Ron Raab noticed that when he reduced the amount of carbohydrate in his diet, his blood glucose levels improved. His experience of the shortcomings of high-carbohydrate dietary recommendations in regulating his blood glucose led him to adopt an alternative approach. In this article, the author outlines his choice of a much reduced carbohydrate dietary intake as a key element of his diabetes management.

The Steno Diabetes Center: from education to action

The Steno Diabetes Center was founded in 1932. It has since been a leading player in the struggle against diabetes through clinical care and development, and wide research activities. During the 1980s, the paternalistic model of care was shown to be inadequate to cover the demands of people with diabetes. The need for coaching, learning and education became clear. A team approach was gradually developed, involving nurses, dietitians and foot specialists, as well as physicians.

Lifestyle education for children - some useful strategies

In many cases, overweight and obesity in children constitute a grim warning for future health: if no action is taken, an overweight or obese child is likely to grow into an overweight or obese adult with a series of chronic health problems – among them, type 2 diabetes. Indeed, obesity-related health conditions, including the metabolic syndrome – a strong risk factor for cardiovascular diseases – are increasingly prevalent among children around the world.

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.

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