Diabetes Educator Role Boundaries In Australia: A Documentary Analysis

Diabetes educator role boundaries in Australia: a documentary analysis

Abstract
Background
Diabetes educators provide self-management education for people living with diabetes to promote optimal health and wellbeing. Their national association is the Australian Diabetes Educators Association (ADEA), established in 1981. In Australia the diabetes educator workforce is a diverse, interdisciplinary entity, with nurses, podiatrists, dietitians and several other health professional groups recognised by ADEA as providers of diabetes education. Historically nurses have filled the diabetes educator role and anecdotally, nurses are perceived to have wider scope of practice when undertaking the diabetes educator role than the other professions eligible to practise diabetes education. The nature of the interprofessional role boundaries and differing scopes of practice of diabetes educators of various primary disciplines are poorly understood. Informed by a documentary analysis, this historical review explores the interprofessional evolution of the diabetes educator workforce in Australia and describes the major drivers shaping the role boundaries of diabetes educators from 1981 until 2017.
This documentary analysis was undertaken in the form of a literature review. STARLITE framework guided the searches for grey and peer reviewed literature. A timeline featuring the key events and changes in the diabetes educator workforce was developed. The timeline was analysed and emerging themes were identified as the major drivers of change within this faction of the health workforce.
This historical review illustrates that there have been drivers at the macro, meso Continue reading

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Taking blood pressure drugs at night wards off diabetes, study finds

(Mike Derer / Associated Press)
Sometimes, disease-prevention really is this simple: Adults with high blood pressure who take all of their hypertension medications before they go to bed, rather than in the morning, are less likely to develop Type 2 diabetes, new research has found.
The new findings are in line with other insights gleaned by the same investigators: that hypertension patients who are most at risk of developing diabetes -- and cardiovascular disease -- are those whose blood pressure fails to show a substantial dip during sleep.
It stood to reason, then, that a medication regimen that more tightly controls a hypertensive's blood pressure while he or she sleeps might help to at least forestall the development of Type 2 diabetes.
In a large clinical trial conducted in Spain and published Wednesday in the journal Diabetologia, that hypothesis turned out to be true. And effecting such tight nighttime blood-pressure control turned out to be as simple as having subjects take their hypertension drugs -- whether ACE inhibitors, angiotensin-receptor blockers or beta blockers -- before they turned in for the night.
A drop in blood pressure is normal while sleeping. But not all people see such a dip while they sleep, and some see more shallow dips.
A second trial, also published in Diabetologia on Wednesday and conducted by the same group of Spanish researchers, found that subjects whose blood pressure did not dip, and those whose readings dipped more briefly or shallowly, were more likely to develop Type 2 diabetes than those whose sleep-time blood pressure saw a deep an Continue reading

Is “Keto” the Key to Reversing Diabetes?

SEATTLE -- A wave of recent studies show that in many cases, type 2 diabetes is partly or wholly reversible with high fat, very low carb ketogenic diets.
Speakers at the Personalized Lifestyle Medicine Institute 5th annual Thought Leaders Consortium urged the clinical community to radically re-think the received wisdom about this common disorder, and start applying diet and lifestyle programs that actually address the root causes of the condition.
Fresh data from an ongoing study of 232 overweight or obese women and men with type 2 diabetes (average age 54 years, average BMI of 41), provide evidence that after 10 weeks on a carefully-formulated low-carb ketogenic diet, 36% were able to stop insulin therapy completely, while an additional 51% were able to significantly lower their doses.
Mean hemoglobin A1c (HbA1c) measures dropped from 7.5% to 6.5%, with 56% of the participants reaching A1c levels below the diagnostic threshold for diabetes. This was accompanied by clinically significant weight loss in 71% of cases (McKenzie A, et al. JMIR Diabetes. 2017 2 (1): e5).
Though many clinicians and researchers have long predicted the possibility, this is the first large-scale study to show that major biomarkers of type 2 diabetes can be consistently shifted in the right direction via dietary interventions.
“We are very pleased with what we are seeing,” said Stephen Phinney, MD, PhD, Chief Medical Officer and co-founder of Virta Health, a San Francisco based clinic specializing in lifestyle-based treatment of diabetes and related metabolic diseases. “And all of this is based Continue reading

Polydipsia: Causes, symptoms, and treatment

Polydipsia is the medical term for extreme thirst, which does not improve no matter how much a person drinks.
It is not a disease by itself but can be an important symptom of certain health problems, such as diabetes. People who have this symptom should always see a doctor.
This article aims to help readers understand polydipsia and how to manage it.
What is polydipsia?
Everyone knows the feeling of thirst. For example, a person may drink large amounts of fluid to relieve thirst brought on after eating salty food, strenuous exercise, or a day in the hot sun.
This type of thirst usually doesn't last long and is easily quenched with fluids.
Polydipsia, on the other hand, can last days, weeks, or even longer depending on the cause. An individual with polydipsia tends to be thirsty most if not all the time, despite regularly drinking large amounts of fluid.
Comments such as "I can't get enough to drink" or "my mouth is so dry" are possible indicators that the person has polydipsia.
Polyuria (large amounts of urine) almost always accompanies polydipsia. One of the kidneys' primary jobs is to help the body find the right balance of water and other fluids.
Polyuria is defined as passing 3 or more liters of urine in 24 hours in adults.
The kidneys also pass more than fluid. For example, sodium and potassium often leave the body along with urine. This can lead to changes in these salts in the body, which can introduce other problems.
While other symptoms found with polydipsia depend on its cause, a common symptom is a dry mouth.
How much water should I drink every day?
How much wate Continue reading

When You Have Diabetes and Urinary Problems

Diabetes and urination problems often go hand in hand — which can be stressful. Dealing with these issues can affect your daily living and quality of life. According to the National Institutes of Health, more than half of people with diabetes have bladder dysfunction.
Difficulties with urination can happen as you get older, but when you have diabetes, bladder problems, and urinary tract infections can start earlier in life and occur more often.
This is because diabetes can cause damage to the nerves that are responsible for urinary system health and function.
In general, women are more likely to experience leakage or urinary incontinence than men because of different anatomical structures and bodily changes from pregnancy and delivery. Men may experience dribbling, weak stream, intermittent flow and urethral obstruction.
Causes of Urinary Problems in Diabetes
Bladder problems can be caused by diabetes nerve damage, nerve damage from other causes, injuries, infections and other diseases. High blood sugar levels can cause frequent urination.
The risk is increased with poor diabetes management, high cholesterol, high blood pressure, excess weight, advanced age, smoking and a sedentary lifestyle. Insulin use increases the risk for urinary incontinence.
Common Urinary Problems with Diabetes
Overactive bladder: Bladder spasms or contractions cause an urgent strong need to urinate more than eight times a day or more than two times at night.
Urine leakage or urinary incontinence can be a problem. Treatment options for overactive bladder include medication, bladder training method Continue reading