Diabetes may lead to complications such as amputations, blindness, cardiovascular disease, and renal disease. If unchecked, it may lead to premature deaths. Risk factors such as diet and physical activities are modifiable, meaning that a change of lifestyle can reverse the propensity and the effects of diabetes. Therefore, there is an opportunity for management and prevention of the onset of diabetes. Disproportionately, diabetes affects mostly middle and low-income earners in various countries around the globe (Chomutare et al., 2011). In essence, the growth in cases of diabetes is directly attributable to the shifts in lifestyles fuelled by rapid urbanization and social mobility. The paper delves into the interventions’ that are available for patients with diabetes and the application evidence-based practice in its management.
Concept of Care for Diabetes
Care for diabetes should be patient-centered to be effective. In practice, the care for a diabetic patient should be based on the needs of the patient as determined by the healthcare provider. Patients have different needs based n their background, the family needs, lifestyle, cultural affiliation, and the genetic composition. Towards this end, the caregiver should carry out comprehensive assessment and diagnosis to determine the right care (Hartling et al., 2013). It is noteworthy that patients with diabetes have a higher risk of cardiovascular disease. It, therefore, implies that a patient-centered approach should address specific issues such as lipid and blood pressure control, smoking prevention and cessation, physical activity, weight management, and adhering to healthy lifestyle choices.
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Various patients with diabetes are adults, especially the ones with type 1 diabetes. Incidents of type-2 diabetes are common in young adults and children (Dyson et al., 2018). As mentioned, patients tend to have varying needs. Advocacy for a patient with either type-1 0r type-2 diabetes is necessary for improved outcomes. Active support to advance policies that will change the level of care, therefore, is essential for such patients. The care providers must invest tremendous efforts in curbing certain habits and practices such as physical inactivity, obesity, and smoking. Determining and then handling the mentioned issues at the root is of considerable significance to the patient and the care providers.
Diabetes Care Model
The care for diabetes requires the design and implementation of various care models for improved probability of positive outcomes. Combining different approaches is effective when handling diabetic cases. A fragmented delivery system is a significant barrier to care since it lacks information on clinical care (Dyson et al., 2018). Such a system is poorly designed and tends to duplicate services hat hinders the delivery of care to patients with chronic conditions. Comprehensive care for patients with diabetes requires the application of the Chronic Care Model (CCM).
The CCM has vital elements that help in the delivery of care and monitoring of patients with diabetes. The first element is the design of the delivery system that is effective when proactive. The proactive approach requires the care providers to plan visits through the team-based approach in which the team members are aware of their designated day of visit to the patients. Additionally, the patient and their families should also beware of the visits. The patient should have the option of self-management where the care providers also provide the necessary (Hartling et al., 2013). Self-management entails training the patient on the best methods that they can use to control their blood sugar levels. It encompasses proper dietary provisions and the possibility of learning how to administer insulin.
The CCM also advocates for the use of decision support that mainly involves making decisions based on various parameters such as history and the information available on the patient and then providing appropriate care. For instance, if the blood sugar level of the patient goes down, it is essential to administer glucose to return it to acceptable and functional levels. The clinical information system is also critical in handling patients with diabetes since they help the care providers in ensuring patient-specific and population-based support to the care team (Dyson et al., 2018). Mobilizing community resources in support of policies and care strategies form part of the care plan for people with diabetes as well. The CCM advocates for proper coordination of the healthcare systems to create a quality-oriented culture.
Objectives of Evidence-Based Care for Patients with Diabetes
The first objective is to optimize the behavior both the patient and the care providers for a better outcome. The priority of the care team should be to intensify both pharmacological and lifestyle therapy for patients, especially the ones that have not attained the desired levels of blood pressure, glucose, and lipid control. The most advisable strategies, in this regard, include goal setting for the patient, identifying and, subsequently, addressing numeracy, language, and cultural barriers. The focus is on cultural barriers that may hinder the provision of care, integrating clinical information tools to care, and incorporating the care management team that includes nurses and pharmacists. The mentioned strategies help in the optimization of both team and provider behaviour, thereby catalyzing reductions in blood pressure, A1C, and LDL cholesterol.
The second objective is to provide support for patient behavior change. It is worth noting that the effective and successful management of diabetes requires a systematic approach that supports behaviour change on the patient. It includes various activities such as the change embracement of healthy lifestyle choices. Healthy lifestyle choices include healthy eating, weight management, engagement in physical activities, and effective coping. Disease self-management is also an essential aspect of diabetes control and management. Self-management entails managing and taking medications (Dyson et al., 2018). At times, especially when it is clinically relevant, self-monitoring of blood pressure and glucose levels is essential. Finally, prevention of any complications related to diabetes is of great significance. In this regard, monitoring of foot health, participation in eye screening, renal, and foot complications is necessary. High-quality self-management education on diabetes has the propensity of improving patient satisfaction, self-management, and glucose control.
The next objective is to change the care system. The top priority for institutions is to provide quality care to the patients and their families. The aim is to improve basic care based on evidence-based guidelines and expand the roles of teams in the implementation of more intensive strategies for the management of the disease. Further, it aims to redesign the care process, implement electronic care records, and educate of patients are some the productive guidelines aimed at improving the system of care for diabetes patients (Hartling et al., 2013). Removing financial barriers by providing extensive coverage for the patients is a great strategy to improve access to care for patients with diabetes. Furthermore, the system of care should focus on identifying, engaging, and developing public policy and community resources that help in support of healthy lifestyles.
In the management of diabetes, the main components are excise and diet. As a chronic condition, patients must manage the condition using the stipulated methods that may include but not limited to dietary interventions, excise, and clinical interventions such as the intake of insulin to keep the blood glucose n check. The goal of management is to keep the bold glucose in check by keeping as near healthy as possible. The goal is to balance the intake of medication, food, and exercise to ensure equilibrium in the levels of glucose (Dyson et al., 2018). Maintaining the blood cholesterol and lipid at normal levels is a healthy diabetes management strategy. The blood pressure should not go over 140/90. Additionally, prevention of diabetes-related complications is essential in keeping the patients and ensuring that they function as normal as possible. Planning what one eats is important, meaning that the patient should have an approved meal plan and take the medications as prescribed by the doctors.
Conclusion
Diabetes is one of the leading causes of premature death among the lower and middle-income earners. It affects people from various places around the globe. Care for people with diabetes should be based on the needs of the patient, which depend on the assessment by the caregivers. Advocacy for a patient with diabetes is necessary. Active support to advance policies that will change the level care, therefore, are essential for such patients. The care providers must invest tremendous efforts in curbing certain habits and practices such as physical inactivity, obesity, and smoking. The objective of management is to keep the blood glucose in check by keeping as near normal as possible. The goal is to balance the intake of medication, food, and exercise to ensure equilibrium in the levels of glucose. In line with the national standards for diabetes education and self-management, all people with diabetes have an obligation to participate in management and education programs to facilitate their skills, knowledge, and ability for better self-care. Education on self-management should be patient-centered, responsive and respectful to patient values, needs, and preferences and should, therefore guide clinical decisions. Implementation of the strategies helps in the adoption of sustaining behaviors and skills for various processes that include diagnosis and self-management of diabetes. The goal is to educate the patients and improve clinical outcomes for patients with diabetes.
References
Chomutare, T., Fernandez-Luque, L., Årsand, E., &Hartvigsen, G. (2011). Features of mobile diabetes applications: review of the literature and analysis of current applications compared against evidence-based guidelines. Journal of Medical Internet Research , 13 (3), e65.
Dyson, P. A., Twenefour, D., Breen, C., Duncan, A., Elvin, E., Goff, L., & Mellor, D. (2018).Diabetes UK evidence‐based nutrition guidelines for the prevention and management of diabetes. Diabetic Medicine , 35 (5), 541-547.
Hartling, L., Dryden, D. M., Guthrie, A., Muise, M., Vandermeer, B., & Donovan, L. (2013).Benefits and harms of treating gestational diabetes mellitus: a systematic review and meta-analysis for the US Preventive Services Task Force and the National Institutes of Health Office of Medical Applications of Research. Annals of Internal Medicine , 159 (2), 123-129.
