Self-management Of Type 2 Diabetes In Gulf Cooperation Council Countries: A Systematic Review
Self-management of type 2 diabetes in gulf cooperation council countries: A systematic review Thamer Al Slamah , Barbara I. Nicholl , Fatima Y. Alslail , Craig A. Melville Affiliation: General Practice and Primary Care, Institute of Health and Wellbeing College of Medicine, Veterinary and Life Science, University of Glasgow, Glasgow, United Kingdom Affiliation: General Practice and Primary Care, Institute of Health and Wellbeing College of Medicine, Veterinary and Life Science, University of Glasgow, Glasgow, United Kingdom Affiliation: Director of the National Diabetes Control and Prevention Program, Ministry of Health, Riyadh, Kingdom of Saudi Arabia Affiliation: Mental Health and Wellbeing, Institute of Health and Wellbeing, College of Medicine, Veterinary and Life Science, University of Glasgow, Glasgow, United Kingdom This study aimed to systematically review intervention studies on self-management of type 2 diabetes in Gulf Cooperation Council (GCC) countries to determine the most effective self-management strategies for individuals with type 2 diabetes in this region. A search strategy was developed using multiple databases: Medline and Embase (via Ovid), CINAHL (via EBSCO), and PubMed. Study and intervention characteristics, intervention structure, content, cultural adaptation, and outcomes were extracted from the included studies. To be included in the review the studies should have met the following criteria: have examined the effectiveness of at least one intervention involving a type 2 DSME programme, have involved participants over 18 years old diagnosed with type 2 diabetes, have taken place to in a GCC country, have a study design that was observational, quasi-experimental or controlled, have reported at least one individual and have a quantitative outco Continue reading >>
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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 >>
Managing Type 2 Diabetes With Emphasis On Patient Education
Managing type 2 diabetes with emphasis on patient education Revised NICE guidance argues that providing education to patients is a key aspect of diabetes management. Nerys Hairon finds out more about the recommendations Hairon, N. (2008) Managing type 2 diabetes with emphasis on patient education. Nursing Times; 104: 22, 17-18. Download a print-friendly PDF file of this article here NICE published updated guidance on managing type 2 diabetes last week (NICE, 2008). Developed by the National Collaborating Centre for Chronic Conditions, it replaces four existing NICE guidelines on managing blood glucose, blood pressure and blood lipids, renal disease and retinopathy in type 2 diabetes. It also updates recommendations in three technology appraisals and will act as a single reference point on all aspects of care. The guidance emphasises patient education, as lifestyle changes, complexities of management and therapy side-effects make this a priority. It recommends that those with the condition receive ongoing education from diagnosis, as well as tailored dietary advice. Key priorities for implementation are identified as: structured patient education; dietary advice; recommendations on setting a target HbA1c level; advice on self-monitoring of plasma glucose; and starting insulin therapy. NICE recommends that practitioners should offer structured education to every person and/or their carer at the time of diagnosis, with annual reinforcement and review. They should inform patients and carers that such education is an integral part of diabetes care. This advice updates NICEs technology appraisal on patient-education models for diabetes (NICE, 2003), which recommended that structured education be available to all people with diabetes at the time of initial diagnosis and then Continue reading >>
Review Article Diabetes Self-management Education For Adults With Type 2 Diabetes Mellitus: A Systematic Review Of The Effect On Glycemic Control
Highlights • DSME appears most effective when group and individualized intervention are combined (74). • DSME appears most effective delivered by a team rather than single provider (65). • People in poor glycemic control benefit from participation in quality DSME (65). • More than 10 hours of DSME increases the likelihood of resulting in significant A1C improvement (84). • Time period over which DSME is delivered does not affect its impact on A1C (62). Abstract Assess effect of diabetes self-management education and support methods, providers, duration, and contact time on glycemic control in adults with type 2 diabetes. We searched MEDLINE, CINAHL, EMBASE, ERIC, and PsycINFO to December 2013 for interventions which included elements to improve participants’ knowledge, skills, and ability to perform self-management activities as well as informed decision-making around goal setting. This review included 118 unique interventions, with 61.9% reporting significant changes in A1C. Overall mean reduction in A1C was 0.74 and 0.17 for intervention and control groups; an average absolute reduction in A1C of 0.57. A combination of group and individual engagement results in the largest decreases in A1C (0.88). Contact hours ≥10 were associated with a greater proportion of interventions with significant reduction in A1C (70.3%). In patients with persistently elevated glycemic values (A1C > 9), a greater proportion of studies reported statistically significant reduction in A1C (83.9%). This systematic review found robust data demonstrating that engagement in diabetes self-management education results in a statistically significant decrease in A1C levels. The data suggest mode of delivery, hours of engagement, and baseline A1C can affect the likelihood of achieving stat Continue reading >>
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Role Of Patient, Physician And Systemic Factors In The Management Of Type 2 Diabetes Mellitus | Family Practice | Oxford Academic
Background. Few studies have explored the contextual dimensions and subsequent interactions that contribute to a lack of adherence in the application of guidelines for diabetes management. Objective. The purpose of this qualitative study was to explore family physicians' issues and perceptions regarding the barriers to and facilitators of the management of patients with type 2 diabetes mellitus (DM). Methods. Four focus groups composed of family physicians (n= 30) explored the participants' experiences in the management of patients with type 2 DM. A semi-structured interview guide began with questions on family physicians' experience of providing care and included specific probes to stimulate discussion about the various barriers to and facilitators of the management of type 2 DM in family practice. Results. Participants clearly identified type 2 DM as a chronic disease most often managed by family physicians. The findings revealed distinct barriers and facilitators in managing patients with type 2 DM which fell into three domains: patient factors; physician factors; and systemic factors. There was a dynamic interplay among the three factors. The important role of education was common to each. Conclusions. The interactions of patient, physician and systemic factors have implications for the implementation of a diabetes management model. The care of patients with type 2 DM exemplifies the ongoing challenges of caring for patients with a chronic disease in family practice. The findings, while specific to the management of type 2 DM, have potential transferability to other chronic illnesses managed by family physicians. Brown JB, Harris SB, Webster-Bogaert S, Wetmore S, Faulds C and Stewart M. The role of patient, physician and systemic factors in the management of type 2 Continue reading >>
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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 >>
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Importance Of Education In Managing Type 2 Diabetes During Ramadan
Importance of education in managing type 2 diabetes during Ramadan We are experimenting with display styles that make it easier to read articles in PMC. The ePub format uses eBook readers, which have several "ease of reading" features already built in. The ePub format is best viewed in the iBooks reader. You may notice problems with the display of certain parts of an article in other eReaders. Generating an ePub file may take a long time, please be patient. Importance of education in managing type 2 diabetes during Ramadan Doaa Farid, MA, Ellen Rosenberg, MD CM, and Gillian Bartlett, PhD Approximately 50 million Muslim adults with type 1 diabetes (T1D) and type 2 diabetes (T2D) go without food or drink from sunrise to sunset during the month of Ramadan, despite having a religious exemption. 1 For many Muslim people with diabetes, Ramadan is a religious conviction and the intermittent fasting is a key component of its observance. The EPIDIAR (Epidemiology of Diabetes and Ramadan) study investigated this phenomenon in 12 243 participants from 13 countries and observed that 43% of T1D patients and 79% of T2D patients fast during the month of Ramadan. 2 Fasting during Ramadan potentially affects dietary habits, daily physical activity, sleeping patterns, glycemic control, weight, lipid profile, and food intake. Figure 1 shows a typical Ramadan day. The benefits and risks of intermittent fasting in people with T2D are still being explored. The latest findings suggest that fasting T2D patients might be at risk of hypoglycemia with inappropriate continuation of pharmacotherapies; patients with T1D have a 4.7-fold (0.14 vs 0.03 episodes per month) and patients with T2D have a 7.5-fold (0.03 vs 0.004 episodes per month) increased risk of severe hypoglycemia. 1 Some other import Continue reading >>
Type 2 Diabetes
Live a long and healthy life with type 2 diabetes. This website can help you understand diabetes, health management, and diabetes treatment. Using this Website This website can help you learn about, and live a healthy life with type 2 diabetes. It is divided into 3 main sections: The modules can be read in any order. However, if you are newly diagnosed, it is best to start at the beginning in Understanding Diabetes, and work your way through the material. Below you will find a guide to each module. As you will see, depending upon your individual therapy, you can choose exercise guidelines and self-management sections that are specific for your diabetes treatment. Additionally, throughout the program, Self-assessment quizzes are available to help you monitor your progress, and how much you are learning. The Modules are: Additional modules: Continue reading >>
Diabetic Patient Education About Cardiovascular Disease Risk
In persons with diabetes mellitus, atherosclerosis is increased, develops prematurely, and is associated with an accelerated progression of atherosclerotic changes. More than 55% of deaths from diabetes are from cardiovascular disease. Central to the optimal management of diabetes and the prevention of chronic complications is effective patient education. The necessity of optimal glycemic control in the prevention of long-term diabetes-related complications, particularly microvascular disease, has been a primary focus of diabetes education during the past decade. It has become clear that to prevent cardiovascular disease in persons with diabetes, an increased emphasis on patient education aimed at reducing cardiovascular disease risk factors is essential. This review explores the scope, impact, and prevention of diabetes-related cardiovascular disease, focusing on integration of cardiovascular disease risk reduction during patient teaching and education programs. There are an estimated 17 million persons in the United States with diabetes, of which 5.9 million remain undiagnosed.[ 1 ] Diabetes affects 6.2% of the US population, and this number is increasing at an alarming rate, especially among minority populations.[ 1 ] Type 2 diabetes is the predominant form of diabetes in the United States, representing 90%95% of those affected.[ 2 ] Diabetes currently accounts for more than 150 million cases worldwide, and it is estimated that by 2025 this number will increase to 300 million.[ 3 ] The prevalence of diabetes increases with advancing age, affecting 20.1% of persons aged 65 years or older.[ 1 ] The age-related demographics of diabetes are changing. There are approximately 151,000 people younger than age 20 years with diabetes, and one in every 400 children and adolesc Continue reading >>
Education For Type 2 Diabetes Mellitus Self-care: From Compliance To Empowerment
Education for type 2 diabetes mellitus self-care: from compliance to empowerment * A educao para o autocuidado no diabetes mellitus tipo 2: da adeso ao "empoderamento" La educacin para el auto-cuidado en la diabetes "mellitus" tipo 2: de la adhesin al "empoderamento" Antonio Pithon CyrinoI; Lilia Blima SchraiberII; Ricardo Rodrigues TeixeiraIII IDepartment of Public Health, Botucatu School of Medicine, Unesp. Distrito de Rubio Jr. - Cx. Postal: 549, Botucatu, SP, Brazil. 18618-970. [email protected] IIDepartment of Preventive Medicine, School of Medicine, USP IIIDepartment of Preventive Medicine, School of Medicine, USP Through a critical review of the literature on education for diabetes self-care and self-management, it was sought to point out the inappropriateness of traditional approaches towards compliance with treatment and transmission of information, considering the complexity of self-care under chronic conditions. The influence of the social sciences on the field of studies on chronic degenerative diseases in general, and diabetes in particular, was explored. From this perspective, it can be recognized that the fields of anthropology and sociology have been incorporated into research focusing more on individuals as patients, and on the experience gained through this process. Recently, there has been a slight change within the field of health education research relating to diabetes, with the introduction of strategies that seek to value the experience and autonomy of patients as self-care agents. This paper discusses the strategy for empowerment in education for diabetes self-care and self-management, as a dialogue-focused practice that respects patients' moral and cognitive autonomy. Keywords: Type 2 diabetes mellitus. Selfcare. Health education/methods. Chron Continue reading >>
Patient Education: Diabetes Mellitus Type 2: Treatment (beyond The Basics)
TYPE 2 DIABETES OVERVIEW Type 2 diabetes mellitus occurs when the pancreas (an organ in the abdomen) produces insufficient amounts of the hormone insulin and/or the body becomes resistant to normal or even high levels of insulin. This causes high blood sugar (glucose) levels, which can lead to a number of complications if untreated. People with type 2 diabetes require regular monitoring and ongoing treatment to maintain normal or near-normal blood sugar levels. Treatment includes lifestyle adjustments, self-care measures, and medicines, which can minimize the risk of diabetes and cardiovascular (heart-related) complications. This topic review will discuss the treatment of type 2 diabetes. Topics that discuss other aspects of type 2 diabetes are also available: (See "Patient education: Diabetes mellitus type 2: Overview (Beyond the Basics)".) (See "Patient education: Diabetes mellitus type 2: Alcohol, exercise, and medical care (Beyond the Basics)".) TYPE 2 DIABETES TREATMENT GOALS Blood sugar control — The goal of treatment in type 2 diabetes is to keep blood sugar levels at normal or near-normal levels. Careful control of blood sugars can help prevent the long-term effects of poorly controlled blood sugar (diabetic complications of the eye, kidney, nervous system, and cardiovascular system). Home blood sugar testing — In people with type 2 diabetes, home blood sugar testing might be recommended, especially in those who take certain oral diabetes medicines or insulin. Home blood sugar testing is not usually necessary for people who are diet controlled. (See "Patient education: Self-monitoring of blood glucose in diabetes mellitus (Beyond the Basics)".) A normal fasting blood sugar is less than 100 mg/dL (5.6 mmol/L), although some people will have a different goal. Continue reading >>
Managing Stress And Diabetes
We hear about stress all the time. Often, you hear people say, Im under a lot of stress, or Im so stressed, or This is stressing me out. What exactly is stress? Stress is a physical and mental reaction to perceived danger. Conditions that seen uncontrollable or require emotional and behavioral change tend to be perceived as a threat. When the body and mind sense a threat, they get ready to either run or fight. Whether the threat is real or imagined, the body prepares for survival by turning up some bodily functions while turning others down. In either case, over time these changes are serious and over time are harmful. Diabetes management is a constant process; for many, it is an ongoing challenge that may be complicated by the impact of stress. Excessive stress is a major barrier to effective glucose control and a danger to ones general health. When a child has diabetes, the familys potential for stress is high. The child with diabetes, parents and siblings all feel their own share of stress. Excessive stress works against diabetes management by: Increasing blood glucose levels (quickly and substantially) Impairing sound thinking and decision-making Whether or not you have diabetes, over time, stress is harmful because it causes so much wear and tear on the body. For example, the heart works faster and harder in preparation for physical action. The increase in pulse and blood pressure causes a strain on the heart, veins and arteries. Prolonged stress also has a negative impact on other bodily systems: In addition, the ability to think clearly and to make good decisions is impaired when the mind is burdened with worry, anxiety or fear. This constant mental strain can also increase the risk for depression. Changes in appetite (eating more or less) Anxious thoughts (ofte Continue reading >>
What Is Diabetes Self-management Education?
Diabetes self-management education helps people to stay healthy and prevent costly complications, yet very few people with diabetes attend a course. Diabetes UK's Taking Control campaign aims to increase the provision and uptake of diabetes self-management education, so that everyone with diabetes has the skills and confidence to take control of their condition. This page gives healthcare professionals and local decision makers more information about patient education options. It includes resources to use with your patients and advice on improving uptake. People learn about their condition in different ways. A useful framework for understanding diabetes education, broadly based on a model used in Scotland, is in three levels: Level three: Structured education that meets nationally-agreed criteria (defined byNICE/SIGN), including an evidence-based curriculum, quality assurance of teaching standards and regular audit. Level two: Ongoing learning that may be quite informal, perhaps through a peer group. Level one: Information and one-to-one advice. Level three education: what is the evidence base? Diabetes education courses, often known as structured education, improve key outcomes, reduce the onset of complications and are cost effective or even cost saving. For a summary of the published evidence on structured education download Diabetes UK's reportDiabetes Education: the big missed opportunity in diabetes care (PDF, 285KB). Level three education: how to improve uptake and quality A short guide from Diabetes UK, including what your patients need to know about diabetes education and tips to improve attendance (see also key downloads).A short guide from Diabetes UK, including what your patients need to know about diabetes education and tips to improve attendance (see also Continue reading >>
Type 2 Diabetes- A Focus On New Guidelines
Type 2 diabetes- A focus on new guidelines By Michelle L. Hilaire PharmD CDE BCPS , Tonja M. Woods PharmD According to the American Diabetes Association (ADA), 18.8 million people in the United States have been diagnosed with diabetes, and another 7 million are thought to have the disease but have not yet been diagnosed.1 An additional 79 million Americans have prediabetes, which is a condition that indicates that the patient has a high risk for developing diabetes. The majority of patients with diabetes are 20 years old or older, of whom about 13 million are men and 12.6 million are women.1 In 2010, about 1.9 million people aged 20 years or older were newly diagnosed with diabetes. The indirect and direct costs of diabetes are increasing. In 2007, the total cost of diabetes was approximately $174 billion dollars. Medical expenses for patients with diabetes were 2 times higher than for those without diabetes. Indirect costs for diabetes total approximately $58 billion dollars, including workplace absenteeism and unemployment due to diabetes related disabilities.1 In 2007, diabetes was the seventh leading cause of death in the United States, although the incidence of diabetes-related death is likely underreported.1 Diabetes is also the leading cause of several health conditions, including kidney disease, heart disease, blindness and stroke. Uncontrolled diabetes can lead to complications such as periodontal disease, impaired immune system response, blindness, hypertension, sexual dysfunction and complications in pregnancy.1 There are 4 different types of diabetes, each with different insulin defects. Type 1 diabetes (resulting from B-cell destruction, and leading to absolute insulin deficiency), type 2 diabetes (resulting from progression of insulin secretory defects wi Continue reading >>
The Role Of Group Care In The Management Of Type 2 Diabetes
The Role of Group Care in the Management of Type 2 Diabetes European Endocrinology, 2010; 6:43-7; DOI: Group Care is a clinical pedagogic model aimed at offering continuing structured education and care to people with diabetes. The hypothesis is that patients are best helped to become self-sufficient and self-reliant, and consequently to improve clinically, by seeing them in groups rather than using the traditional one-to-one approach. The Group Care programme is articulated over seven sessions held over two years, with one session every three months, which can be repeated ad libitum. Each session lasts up to one hour and methodologies facilitate learning through cognitive and psychomotor abilities such as simulations, role-playing games, debates, workshops and working groups. A pragmatic randomised, controlled clinical trial proved that Group Care improves knowledge of diabetes, health behaviour and quality of life along with bodyweight, glycated haemoglobin (HbA1c) and high-density lipoprotein (HDL) cholesterol. In addition, Group Care encourages team work by motivating health operators and helps empower patients and build strategies enabling them to cope with diabetes. Type 2 diabetes, patient education, diabetes management, health behaviours, quality of life Disclosure: The authors have no conflicts of interest to declare. Received: 16 April 2009 Accepted: 27 July 2009 Citation: European Endocrinology, 2010;6(1):4347 Correspondence: Marina Trento, Laboratory of Clinical Pedagogy, Department of Medicine, University of Turin, Corso AM Dogliotti 14, 10126 Turin, Italy. E: [email protected] Increasing evidence supports the pivotal role of health education in preventing and treating diabetes more effectively.1,2 The World Health Organization (WHO) Regional Office f Continue reading >>
