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Diabetes Self Management Education

December 1, 2021by Josh Pirestani

What Is Diabetes Self-Care Management

When patients can’t or will not see a health care provider, they’re left to their own devices. This often leads to Diabetes Self-Care Management, which many people take for granted.

Self-care is usually done to relax. Relaxation through indulging – taking a hot bath, pouring a glass of wine or cutting an extra-large slice of cake – is healthy for the most part. But people living with diabetes can’t get carried away, because indulgence might get in the way of their diabetes treatment plan and lead to some consequences. Diabetes Self-Care Management implies a long-term commitment to preventing health issues if you don’t have access to medical professionals.

This type of Diabetes Self-Care Management can be so overwhelming for diabetics undergoing treatment, and it’s unsurprising that a Journal of General Internal Medicine study has found that most sufferers have a tougher time being motivated to take care of themselves.

Understanding Diabetes and Blood Sugar

Diabetes Mellitus is a chronic condition that causes people to have high levels of blood sugar. It’s brought on by the body’s inability to produce or properly utilize insulin, a hormone that regulates sugar levels.

Common forms of diabetes:

Type 1: People who have Type 1 diabetes often rely on insulin injections to help control their sugar levels. The body usually produces enough insulin for this, but in some people – those diagnosed with Type 1 diabetes – the pancreas doesn’t produce any at all. 5% of the world’s diabetic population has T2.

Type 2: Type 2 diabetes has traditionally been the most common form of diabetes and historically occurred primarily in adults. Recently there has been an increase in occurrence with children. Someone with Type 2 diabetes has developed insulin resistance, or their body doesn’t produce enough insulin. Due to these symptoms not being recognized early on, people with diabetes often have high blood sugar levels for many years before the condition is properly diagnosed.

Prediabetes: Prediabetes is a type of diabetes. High blood sugar or polyuria can be signs of prediabetes. However, the symptoms of prediabetes can be easily confused with other health complications and therefore it is critical that adults get tested.

American Diabetes Association recommends that those with prediabetic symptoms should:

  • People who are overweight or obese are characterized by having a Body Mass Index (BMI) of over 25 or 30, respectively.

  • Have a high amount of body fat around the abdomen.

  • Lack of regular physical activity.

  • Be women who have had gestational diabetes.

  • Have someone in your family who has had diabetes, like Type 1 or Type 2.

The Importance of Diabetes Self-Care

Having diabetes can lead to long-term damage of essential organs including the eye, kidney, heart, nerves and blood vessels. Therefore, diabetes self-care is necessary to limit potential organ damage, and it can reduce the likelihood of hospitalizations and ER visits for patients.

A study published in the Journal of Diabetes & Metabolic Disorders concluded the following seven self-care practices helped patients with diabetes avoid hospital visits and serious health consequences:

  • Healthy eating

  • Being physically active

  • Monitoring blood sugar levels

  • Complying with medications

  • Using problem-solving skills

  • Developing healthy coping skills

  • Practicing risk-reduction behaviors

The aforementioned strategies have all been shown to positively influence your blood sugar and outcomes in general. However, there are a few other recommendations that can be useful too:

Attending annual eye exams: Seeing an eye doctor regularly is one of the most important things you can do for good eye care. Early detection of retinopathy–a condition that causes blurred vision or partial blindness-is critical to your long term health.

Caring for feet: Check underneath the toes and on the soles of the feet for open lesions or sores, and make sure to keep fingernails trimmed across. It’s also a good idea to wear closed-toed shoes, which can help prevent injuries.

Reporting symptoms, especially numbness or tinglingNumbness can be a sign of neuropathy, which is dangerous for older patients who lose feeling in their limbs and are not able to test whether bathwater is too hot or feel an open wound.

Practicing good oral hygiene: Maintaining dental health, like brushing and flossing right after eating, can minimize the effects of gingivitis and periodontitis. If these diseases develop, they have the potential to contribute to blood glucose irregularities. Visiting a dentist twice a year is recommended for prevention purposes.

Checking the skin: Check your skin from time to time as that can make it more vulnerable to being scraped or otherwise damaged. Be especially careful if you’re dehydrated. People also pay attention to whether their hair is growing evenly or whether they’re losing any of it, so keep an eye out for these things too! This could be due to hormonal changes, stress, or nerve damage. Drinking plenty of water every day helps maintain strong skin and healthy hair.

Maintaining sexual health: Additionally, anyone can have problems with frequent urination. Women should be checked for possible urinary tract infections, yeast infections, and abnormal discharge. Men with diabetes face a high risk of erectile dysfunction as well as other issues associated with diabetes. Patients should make sure they list any abnormal symptoms they may have when they visit their gynecologist or general practitioner. This is because it could be related to a serious, potentially life-threatening complication.

Relying on social circles: We encourage patients to speak about their routines with family members, care givers or friends.

Reducing stress: It’s normal to feel under more pressure when you’re feeling overwhelmed or distressed. It may then be harder to stick to your treatment plan, leaving you feeling that things are hopeless. Because stress reduction is different in every person, we emphasize the importance of discussing methods with a provider or caregiver and keeping track of your feelings and progress.

The Social Determinants of Diabetes Self-Care

The recommendations for Diabetes Self-Care Management are often difficult to adhere to which makes it hard for patients with diabetes. Although many people aren’t happy with the discrepancies in their medical treatment, it is not for lack of self-care or desire. The root cause may be that doctors are not providing enough support or education about health management.

According to the National Center for Education Statistics, there are many social determinants that can be hazardous to people’s treatment plans and lead to low adherence.

Education: People with low academic achievement often have low health literacy, meaning they find it more difficult to read & understand medical information

Housing status: Without shelter, patients can’t store their medication. This is a huge problem for those who live in urban areas or apartment complexes. A related issue is the lack of safe outdoor spaces for frequent exercise, as well as an accessible kitchen.

Food security: Living in an area without a grocery store nearby can make it difficult to find vitamins and minerals.

Income: Socioeconomic status affects a person’s access to healthcare coverage, transportation, ability to buy nutritional food or time off work for medical appointments. Many patients find it difficult to justify the time-off work when necessary.

Age: Elderly could have been afflicted with conditions which make it difficult to work out or maintain their general health, meaning they may struggle to care for themselves.

A Smyrna pharmacist’s dedication to diabetes awareness

Dr. TaQuina Warren – better known as “Dr. Tee” – treats her patients like family, oftentimes inducting them as her newfound relatives when they enter her Smyrna pharmacy.

For a patient, a pharmacist may be just a professional that can provide them with an essential medicine. However, Warren has become much more than that as she’s been an important link in the community.

“I realized that I wanted to connect with my patients on a totally different level,” Warren said. “A lot of times I tell them when they come in, ‘I’ll be your adopted niece so I’ll call them aunt so-and-so or uncle so-and-so.’”

Warren was recently featured in an episode of “Good Morning America” where her business, Focus Pharmacy, was revitalized with help from Wells Fargo volunteers.

Her personal experiences with diabetes have allowed her to forge empathetic relationships with her patients as well as provide more nuanced treatment information. Warren also talks about her deep passion for connecting with people and being able to help them by guiding them on their health & wellness journey.

Diabetes Self-Care Management Podcast

Jerry Meece, RPh

On today’s episode of the Pharmacy Podcast Network, we welcome Jerry Meece, RPh, who is a major leader in Diabetes Self-Care Management with nearly 25 years of experience. We discuss how diabetes education has evolved from a knowledge-based approach to a patient empowerment-based approach. Jerry also discussed the 10-minute consult that he created, and how it can be implemented in your DSMES practice. He provides advice about how pharmacists can become more involved in diabetes management at a higher level.

Reference: PSAD Special Issue PaperTrends in diabetes self-management education

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