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Diabetes Self-management Journal

On Keeping A Diabetes Journal

On Keeping A Diabetes Journal

Im looking through the green, spiral-bound notebook in which I journal and keep track of most things diabetes. For the first few months after my late-March 2007 diagnosis of Type 1 diabetes, I kept diligent track of the time of day and my blood glucose readingshighlighted in bluein the left-hand margins. I also wrote a paragraph or two about what Id eaten (if I had eaten), its carb content, as well as what activities I was up to, how I felt, and any thoughts, questions, or fears about my diabetes. Back in college, I found out that writing was my way of understanding the world, a process that I often began in one frame of mind and ended anywhere from 30 minutes to several hours later with a completely different way of seeing. I went outside and leaves on the trees were clearer, sharper; colors were more vibrant; odors in the neighborhood were richer, more robust; and the sounds of the world more distinct. Of course, the world hadnt changed. I had altered my perception of it during the time I spent writing. I had become more in tune with my world. And thats what Ive discovered through writing about my diabetes. Put your pen on the page, or open up a Word document, and take some notes. Maybe youve even thought about blogging. However you do it, just do it. It doesnt have to be formal. You dont need to be a published author or a journalist or a great essayist. To paraphrase the poet Richard Hugo about writing, Look over your shoulder. No ones there. No one has to read what youre saying about diabetes. You can be honest with yourself. You can lash out at the world, at your doctor, at the insurance industry, or maybe even at your family. You can celebrate the support you have, the small victories in self-management, or even reveal your innermost diabetes desires. It doesnt m Continue reading >>

Telehealth As An Alternative To Traditional, In-person Diabetes Self-management Support

Telehealth As An Alternative To Traditional, In-person Diabetes Self-management Support

Telehealth as an Alternative to Traditional, In-Person Diabetes Self-Management Support Journal of Clinical Outcomes Management. 2014 November;21(11) Greenwood DA, Hankins AI, Parise CA, et al. A comparison of in-person, telephone, and secure messaging for type 2 diabetes self-management support. Diabetes Educ 2014;40:51625. 1. Centers for Disease Control and Prevention. National diabetes fact sheet: national estimates and general information on diabetes and prediabetes in the United States. Atlanta, GA: US Department of Health and Human Services; 2011. 2. Norris SL, Lau J, Smith SJ, et al. Self-management education for adults with type 2 diabetes: a meta-analysis of the effect on glycemic control. Diabetes Care 2002;25:115971. 3. Stratton IM, Adler AI, Neil HAW, et al. Association of glycaemia with macrovascular and microvascular complications of type 2 diabetes (UKPDS 35): prospective observational study. BMJ 2000;321:40512. 4. Shani M, Sasson N, Lustman A, et al. Structured nursing follow-up: does it help in diabetes care? Isr J Health Policy Res 2014;3:27. Objective. To investigate the feasibility and effectiveness of administering diabetes self-management support (DSMS) via telephone or secure messaging. Design. Prospective, longitudinal quasi-experimental study. Setting and participants . Participants ( n = 150) who had previously completed diabetes self-management education (DSME) received follow-up DSMS in 1 of 3 self-selected ways: a one-time in-person visit, 3 brief visits by telephone, or via secure messaging via the electronic health record. The (usual care) in-person group ( n = 47) received 1 follow-up appointment at the patients request with a certified diabetes educator (CDE) within 3 to 6 months of DSME completion. The telephone group ( n = 44) was giv Continue reading >>

Community-based Diabetes Self-management Education: Definition And Case Study

Community-based Diabetes Self-management Education: Definition And Case Study

Abstract This article presents a pre-test/3-month post-test case study of a community-based, peer-led diabetes self-management program for 109 Spanish-speaking people. Participants demonstrated significant (P <0.05) improvements in health behaviors (exercise, relaxation, communication with physicians, eating protein for breakfast, number of portions of vegetables eaten, having a glucometer, and frequency of monitoring), health status (self-reported health, role function, fatigue, discomfort, and health distress), and trends toward less health care utilization. This suggests that such education may be an effective means of improving the quality of life for some people with diabetes. Diabetes patient education has long been considered a crucial part of comprehensive diabetes care. There is a large body of literature suggesting that, at least for the short term, patient education improves such physiological measures as glycosylated hemoglobin (HbA1c) and blood pressure.16 Of equal importance, this literature also suggests that patient education improves the quality of life for people with diabetes.7,8 Interestingly, however, the improvements demonstrated in physiological measures may be relatively unassociated with improvements in quality of life.8 Unfortunately, once people with diabetes have received basic disease-specific education, they are then usually left on their own to manage the disease for the rest of their lives. This is especially true for people who do not have continuity of health care and who do not speak English. A primary reason for this failure is that most diabetes education is offered by specially trained diabetes educators who are located in or paid by health care organizations. While the quality of this education is good, its reach is limited because Continue reading >>

Factors Influencing Diabetes Self-management Among Omani Patients With Type-2 Diabetes: Patients Perspectives | Alrahbi | Journal Of Nursing Education And Practice

Factors Influencing Diabetes Self-management Among Omani Patients With Type-2 Diabetes: Patients Perspectives | Alrahbi | Journal Of Nursing Education And Practice

Journal of Nursing Education and Practice International Peer-reviewed and Open Access Journal for the Nursing Specialists Factors influencing diabetes self-management among Omani patients with type-2 diabetes: Patients perspectives Background and aim: Management of diabetes requires using different approaches that include self-management in which the patients are the main key players. Diabetes self-management contributes to preventing diabetes-related complications and improving the QOL of patients with diabetes. The aim of this study was to explore the factors influencing diabetes self-management from the perspectives of the patients with type-2 diabetes in Oman. Methods: A qualitative descriptive design using semi-structured individual interviews was used to conduct this study. A purposive sample of 21 Omani patients with type-2 diabetes were interviewed. Interviews were transcribed verbatim and translated into English. Content analysis and constant comparison were used to analyze the data. Results: Eight factors influencing DSM were identified: awareness of diabetes complications and the importance of DSM, ability to adapt, support, fear of consequences, frustration and helplessness, complying with sociocultural norm/ritual, lack of care, and planning. Conclusions: To improve the quality of diabetes care and decrease the devastating diabetes-related complications, managing diabetes has to take the form of a collaborative approach that put into consideration the factors influencing diabetes self-management that were identified by this study. Continue reading >>

Enhancing The Cost Effectiveness Of Diabetes Self-management Education Provision In A European Context: Gerardine Doyle

Enhancing The Cost Effectiveness Of Diabetes Self-management Education Provision In A European Context: Gerardine Doyle

The cost-effectiveness of type 2 diabetes self-management programmes (DSME) has been difficult to substantiate. The lack of patient-level cost information at provider level, as well as differing national level costing practices, has hindered accurate comparisons at EU level. As a result it has been challenging to conduct comparative evaluations in terms of programme costs and effectiveness. Therefore, we assessed the cost-effectiveness of individual and group based DSME programmes in Europe, Israel and Taiwan. Time-Driven Activity-Based Costing (TD-ABC), a bottom up costing methodology, was adopted to determine the cost of care activities and resource consumption within each process step related to DSME. The core activities conducted by a diversity of health professionals and administrative staff, in the provision of diabetes education for the duration of each specific programme, was recorded and analysed. The cost data was then combined with pre-post outcome data gathered from programme attendees to demonstrate the per-person programme cost relative to the outcome achieved. There are various methods of delivering patient education across and within the participating countries including individual, group based and peer led education provision. Variation exists in terms of personnel delivering the programme. Furthermore, the curriculum varied between and within countries, considerable differences in administration hours existed, and the number of patients taking part in each course differed. DSME were found to be cost-effective when the cost of care of the complications associated with type 2 diabetes were considered. There are variations in costs in relation to the delivery of DSME both within and between countries. TD-ABC has the potential to identify unnecessary proc Continue reading >>

Literacy And Diabetes Self-management

Literacy And Diabetes Self-management

Successful diabetes care requires two-way communication between health care providers and patients, 1 involvement of patients in treatment decisions, 2 and active participation of patients in self-care and goal setting. 3 Yet people with inadequate literacy may lack the skills to accomplish such tasks and find it difficult or impossible to access and understand health care information and instructions or to implement recommended behaviors. Because of the complexity of diabetes regimens 4 and the layered barriers of language, culture, and a health care system that is difficult to navigate, 5 the burden of self-care can be overwhelming to someone with inadequate literacy. I reviewed the literature between 1990 and mid-2006 to identify the state of the science for overcoming inadequate literacy in diabetes self-management. Using the keywords literacy, illiteracy, readability, communication barriers, health education, educational status, and health outcomes, I searched PubMed, Education Resources Information Center, and PsycINFO for articles published in English. All articles concerned patients, health education, behavior change, and outcomes. I excluded studies in which literacy assessment or knowledge was the primary outcome. My focus was on studies that identified literacy as a factor in self-management outcomes and examined effective strategies to overcome barriers posed by inadequate literacy. Although I concentrated on nursing contributions to the science of diabetes management, I didn't require that all articles be written by nurse authors. I included studies of chronic diseases other than diabetes if the articles described relevant strategies. Literacy refers to the ability to read and write as well as knowledge about a particular topic (for example, computer liter Continue reading >>

P37barriers To And Facilitators Of Effective Diabetes Self-management Among People Newly Diagnosed With Type 2 Diabetes Mellitus (t2dm): A Qualitative Study From Malaysia | Journal Of Epidemiology & Community Health

P37barriers To And Facilitators Of Effective Diabetes Self-management Among People Newly Diagnosed With Type 2 Diabetes Mellitus (t2dm): A Qualitative Study From Malaysia | Journal Of Epidemiology & Community Health

P37 Barriers to and facilitators of effective diabetes self-management among people newly diagnosed with type 2 diabetes mellitus (t2dm): a qualitative study from malaysia P37 Barriers to and facilitators of effective diabetes self-management among people newly diagnosed with type 2 diabetes mellitus (t2dm): a qualitative study from malaysia 1Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, Kings College London, London, UK 2Non_Communicable Disease Unit, Primary Care Clinic Tampoi, Johor Bahru, Malaysia Background To determine the views and experiences of people with Type 2 diabetes (T2DM) in relation to their diabetes self-management and to understand what additional support is required to support lifestyle changes. Methods A qualitative study using semi-structured face-to-face and audio/telephone interviews. All interviews were audio-recorded, transcribed verbatim and analysed using a thematic approach. Seventeen people with newly diagnosed T2DM (less than 3 years of diagnosis) were recruited from a primary care clinic in the southern region of Malaysia (Johor Bahru). Results Qualitative analysis revealed three major barriers to diabetes self-management: (i) psychological issues, e.g. depression and anxiety, such as feeling sad about the diagnosis and worried about the future; (ii) social factors e.g. shame and stigma of T2DM, feeling ashamed have diabetes at a young age and being different from peers ; (iii) perceived barriers e.g. environment and culture, such as ineffective support from healthcare providers, beliefs and use of herbal medicine, and the importance of eating rice and feast culture. Facilitators of diabetes self-management included greater perceived self-efficacy such as being disciplined about eating well, g Continue reading >>

Diabetes Self-management: Facilitating Lifestyle Change

Diabetes Self-management: Facilitating Lifestyle Change

Diabetes Self-Management: Facilitating Lifestyle Change MARLON RUSSELL KOENIGSBERG, PhD, and JENNIFER CORLISS, MD, University at Buffalo Family Medicine Residency Program, Williamsville, New York Am Fam Physician.2017Sep15;96(6):362-370. Patient information: Handouts on this topic are available at and . Healthy eating and increased physical activity can prevent or delay the onset of diabetes mellitus and facilitate diabetes management. Current guidelines recommend long-term weight loss of 5% to 7% of body weight and 150 minutes of at least moderate-intensity physical activity per week for most patients with prediabetes and diabetes. Techniques to assess and facilitate adherence to these lifestyle changes can be practical in primary care. During office visits, physicians should assess and gradually encourage patients' readiness to work toward change. Addressing patients' conviction and confidence can be effective in moving them toward action. Long-term goals are best separated into highly specific short-term outcome goals and achievable behavior targets. Lifestyle goals and targets should be tailored to patients' preferences and progress while building confidence in small steps. Screening for diabetes-related attitudes, expectations, and quality of life, and addressing psychosocial factors, both favorable and unfavorable, can facilitate the likelihood of success. Follow-up contact with patients helps maintain and expand progress by reviewing self-monitored goals, targets, and achievements; finding opportunities to encourage and empower; reviewing slips, triggers, and obstacles; and negotiating further customization of the plan. Approximately 9% to 10% of the U.S. population has type 2 diabetes mellitus, including estimated undiagnosed cases. 1 From 1980 to 2014, the pre Continue reading >>

Self-efficacy, Self-management, And Glycemic Control In Adults With Type 2 Diabetes Mellitus

Self-efficacy, Self-management, And Glycemic Control In Adults With Type 2 Diabetes Mellitus

Self-efficacy, self-management, and glycemic control in adults with type 2 diabetes mellitus Enter your login details below. If you do not already have an account you will need to register here . Due to migration of article submission systems, please check the status of your submitted manuscript in the relevant system below: Check the status of your submitted manuscript in EVISE Check the status of your submitted manuscript in EES: Once production of your article has started, you can track the status of your article via Track Your Accepted Article. CiteScore: 2.82 CiteScore measures the average citations received per document published in this title. CiteScore values are based on citation counts in a given year (e.g. 2015) to documents published in three previous calendar years (e.g. 2012 14), divided by the number of documents in these three previous years (e.g. 2012 14). The Impact Factor measures the average number of citations received in a particular year by papers published in the journal during the two preceding years. 2017 Journal Citation Reports (Clarivate Analytics, 2018) 5-Year Impact Factor: 2.814 Five-Year Impact Factor: To calculate the five year Impact Factor, citations are counted in 2016 to the previous five years and divided by the source items published in the previous five years. 2017 Journal Citation Reports (Clarivate Analytics, 2018) Source Normalized Impact per Paper (SNIP): 1.066 Source Normalized Impact per Paper (SNIP): SNIP measures contextual citation impact by weighting citations based on the total number of citations in a subject field. SCImago Journal Rank (SJR): 1.317 SCImago Journal Rank (SJR): SJR is a prestige metric based on the idea that not all citations are the same. SJR uses a similar algorithm as the Google page rank; it provi Continue reading >>

Diabetes Self-management Education And Support Delivered By Mobile Health (m-health) Interventions For Adults With Type 2 Diabetes Mellitus

Diabetes Self-management Education And Support Delivered By Mobile Health (m-health) Interventions For Adults With Type 2 Diabetes Mellitus

Diabetes self-management education and support delivered by mobile health (m-health) interventions for adults with type 2 diabetes mellitus University Medical Center Utrecht, Julius Center, Utrecht, Netherlands Anne Meike Boels, Julius Center, University Medical Center Utrecht, Universiteitsweg 100, Utrecht, 3584 CG, Netherlands. [email protected] . [email protected] . Institute of General Practice, Medical Faculty of the Heinrich-Heine-University Dsseldorf, Cochrane Metabolic and Endocrine Disorders Group, Dsseldorf, Germany Cited by (CrossRef): 0 articles Check for updates This is a protocol for a Cochrane Review (Intervention). The objectives are as follows: To assess the effects of diabetes self-management education and support delivered by mobile health interventions in adults with type 2 diabetes mellitus. Download PDF(368.6 KB) Download PDF(368.6 KB) One of the most important goals in the treatment of type 2 diabetes mellitus (T2DM) is to prevent complications at both the macrovascular and microvascular level. To do so, diabetes treatment aims to control glycaemia, blood pressure, and cholesterol levels, and if necessary to reduce body weight and achieve smoking cessation. More than 20% of all individuals with T2DM in primary care need insulin treatment ( Sharma 2016 ), and this group needs to be especially capable of adequate self-management, which means they should make healthy food choices, exercise frequently, monitor their blood glucose regularly, administer insulin properly, and adjust both dietary intake and insulin dose in relation to physical activity. However, optimal self-management of T2DM requires sufficient knowledge on relevant topics and often behavioural change. Diabetes self-management education (DSME) can provide people with thi Continue reading >>

Challenges And Opportunities For Implementing Diabetes Self-management Guidelines

Challenges And Opportunities For Implementing Diabetes Self-management Guidelines

Abstract Purpose: The purpose of this article was to examine primary care providers' perceived challenges when implementing evidence-based diabetes self-management guidelines and opportunities for promoting the use of such guidelines in practice. Methods: We engaged 3 group discussions with 43 key stakeholders representing family physicians, medical directors, and quality assurance leaders in a large, university-affiliated, integrated health care organization in Central Texas. Transcripts from group discussions were summarized using thematic content analysis. Results: Key themes that emerged as challenges of implementing evidence-based diabetes self-management guidelines included lack of easily retrievable electronic patient health information, inadequate coordination with other health care providers when implementing guidelines, conflict between information in the guidelines and physicians' knowledge, and physician compensation by patient load rather than by quality of care. Two main opportunities identified were the use of health coaches or nurses trained in diabetes self-management and active collaboration between practicing providers and key stakeholders in the development and dissemination of guidelines. Conclusion: Our study shows a need for involving front-line family physicians and other primary care providers as well as patients in the design and development of best practice guidelines to enhance implementation of diabetes self-management guidelines in primary care settings. Methods We engaged 3 different groups—front-line primary care providers, medical directors, and administrative leaders in family medicine—working for a large, university-affiliated, integrated health care system in central Texas in 3 different discussions. The participants were recruite Continue reading >>

Diabetes Self-management (dsm) In Omani With Type-2 Diabetes - Sciencedirect

Diabetes Self-management (dsm) In Omani With Type-2 Diabetes - Sciencedirect

Diabetes self-management (DSM) in Omani with type-2 diabetes Author links open overlay panel HilalAlrahbi Open Access funded by Chinese Nursing Association The aim of this study was to assess the status of diabetes self-management (DSM) among Omanis with type-2 diabetes and its relationship with glycemic control and demographic variables. A correlational descriptive design using questionnaire was conducted with a convenience sample of 266 Omani patients with type-2 diabetes to collect the data. The findings indicated that DSM among the study subject is sub-optimal. Only 1% of them were regular on SMBG; 9.5% of them exercise regularly; and 18% of them maintain healthy diet practices. No significant relationship between DSM and glycemic control (p >0.05) was found. DSM was found to be associated with age, gender, level of education, and duration of diabetes. Examining the differences between two regions in Oman (Muscat & Aldhakiliyah) indicated that participants from Muscat differ only in practicing SMBG. Results indicated that many Omani patients with type-2 diabetes do not perform DSM consistently. The findings of this study set the stage to develop teaching strategies that will improve DSM and subsequently improve diabetes management in patient with type-2 diabetes in Oman. Continue reading >>

Diabetes Self-management Education And Support In Type 2 Diabetes: A Joint Position Statement Of The American Diabetes Association, The American Association Of Diabetes Educators, And The Academy Of Nutrition And Dietetics

Diabetes Self-management Education And Support In Type 2 Diabetes: A Joint Position Statement Of The American Diabetes Association, The American Association Of Diabetes Educators, And The Academy Of Nutrition And Dietetics

Diabetes is a chronic disease that requires a person with diabetes to make a multitude of daily self-management decisions and to perform complex care activities. Diabetes self-management education and support (DSME/S) provides the foundation to help people with diabetes to navigate these decisions and activities and has been shown to improve health outcomes (1–7). Diabetes self-management education (DSME) is the process of facilitating the knowledge, skill, and ability necessary for diabetes self-care. Diabetes self-management support (DSMS) refers to the support that is required for implementing and sustaining coping skills and behaviors needed to self-manage on an ongoing basis. (See further definitions in Table 1.) Although different members of the health care team and community can contribute to this process, it is important for health care providers and their practice settings to have the resources and a systematic referral process to ensure that patients with type 2 diabetes receive both DSME and DSMS in a consistent manner. The initial DSME is typically provided by a health professional, whereas ongoing support can be provided by personnel within a practice and a variety of community-based resources. DSME/S programs are designed to address the patient’s health beliefs, cultural needs, current knowledge, physical limitations, emotional concerns, family support, financial status, medical history, health literacy, numeracy, and other factors that influence each person’s ability to meet the challenges of self-management. It is the position of the American Diabetes Association (ADA) that all individuals with diabetes receive DSME/S at diagnosis and as needed thereafter (8). This position statement focuses on the particular needs of individuals with type 2 diabet Continue reading >>

Jmir-digital Health Interventions For Adults With Type 2 Diabetes: Qualitative Study Of Patient Perspectives On Diabetes Self-management Education And Support | Pal | Journal Of Medical Internet Research

Jmir-digital Health Interventions For Adults With Type 2 Diabetes: Qualitative Study Of Patient Perspectives On Diabetes Self-management Education And Support | Pal | Journal Of Medical Internet Research

The Karma system is currently undergoing maintenance (Monday, January 29, 2018). The maintenance period has been extended to 8PM EST. Karma Credits will not be available for redeeming during maintenance. Preprints (earlier versions) of this paper are available at , first published Jul 13, 2017. This paper is in the following e-collection/theme issue: Digital Health Interventions for Adults With Type 2 Diabetes: Qualitative Study of Patient Perspectives on Diabetes Self-Management Education and Support 1Department of Primary Care and Population Health, University College London, London, United Kingdom 2Department of Psychology, University of Bath, Bath, United Kingdom 3Centre for Behaviour Change, University College London, London, United Kingdom 4Faculty of Health Sciences, University of Southampton, Southampton, United Kingdom 5Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom 6Department of Psychology, University of Southampton, Southampton, United Kingdom 7Department of Diabetic Medicine, Whittington Hospital, London, United Kingdom Department of Primary Care and Population Health Background: The prevalence of type 2 diabetes is increasing globally, and health services in many countries are struggling with the morbidity, mortality, and costs associated with the complications of this long-term condition. Diabetes self-management education (DSME) and behavioral support can reduce the risks of developing diabetes-related complications and improve glycemic control. However, their uptake is low. Digital health interventions (DHI) can provide sustained support and may overcome challenges associated with attending diabetes self-management sessions. They have the potential for delivery at multiple locations at convenient times Continue reading >>

Role Of Self-care In Management Of Diabetes Mellitus

Role Of Self-care In Management Of Diabetes Mellitus

Abstract 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. World Health Organization estimates that more than 346 million people worldwide have DM. This number is likely to more than double by 2030 without any intervention. 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. Introduction Diabetes mellitus (DM) is a chronic progressive metab Continue reading >>

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