Organisation of Diabetes Care: Diabetes Specialist Nursing, Diabetes Education and General Practice

2010 ◽  
pp. 224-228
Keyword(s):  
General Practice ◽  
Diabetes Care ◽  
Diabetes Education ◽  
Diabetes Specialist

scholarly journals Development of a group-based diabetes education model for migrants with type 2 diabetes, living in Sweden

2020 ◽  
Vol 21 ◽  
Author(s):  
Emina Hadziabdic ◽  
Sara Pettersson ◽  
Helén Marklund ◽  
Katarina Hjelm
Keyword(s):  
Type 2 Diabetes ◽  
Diabetes Care ◽  
Teaching Method ◽  
Diabetes Education ◽  
Self Care ◽  
Developed Countries ◽  
Cultural Aspects ◽  
Health And Illness ◽  
Education Model

Abstract Aim: To develop a diabetes education model based on individual beliefs, knowledge and risk awareness, aimed at migrants with type 2 diabetes, living in Sweden. Background: Type 2 diabetes is rapidly increasing globally, particularly affecting migrants living in developed countries. There is ongoing debate about what kind of teaching method gives the best result, but few studies have evaluated different methods for teaching migrants. Previous studies lack a theoretical base and do not proceed from the individuals’ own beliefs about health and illness, underpinned by their knowledge, guiding their health-related behaviour. Methods: A diabetes education model was developed to increase knowledge about diabetes and to influence self-care among migrants with type 2 diabetes. The model was based on literature review, on results from a previous study investigating knowledge about diabetes, on experience from studies of beliefs about health and illness, and on collaboration between researchers in diabetes care and migration and health and staff working in a multi-professional diabetes team. Findings: This is a culturally appropriate diabetes education model proceeding from individual beliefs about health and illness and knowledge, conducted in focus-group discussions in five sessions, led by a diabetes specialist nurse in collaboration with a multi-professional team, and completed within three months. The focus groups should include 4–5 persons and last for about 90 min, in the presence of an interpreter. A thematic interview guide should be used, with broad open-ended questions and descriptions of critical situations/health problems. Discussions of individual beliefs based on knowledge are encouraged. When needed, healthcare staff present at the session answer questions, add information and ensure that basic principles for diabetes care are covered. The diabetes education model is tailored to both individual and cultural aspects and can improve knowledge about type 2 diabetes, among migrants and thus increase self-care behaviour and improve health.

Trial of a New Diabetes Education Model: Closing the Gap in Health Disparity for People with Diabetes

2021 ◽  
pp. 193229682110014
Author(s):  
Thomas W. Martens ◽  
Janet S. Lima ◽  
Elizabeth A. Johnson ◽  
Jessica A. Conry ◽  
Jennifer J. Hoppe ◽  
...  
Keyword(s):  
Diabetes Care ◽  
Patient Population ◽  
Diabetes Education ◽  
Quality Measures ◽  
Healthcare Barriers ◽  
Clinic Setting ◽  
Closing The Gap ◽  
Education Model ◽  
Flexible Model ◽  
Improve Diabetes Care

Background: Quality measures relating to diabetes care in America have not improved between 2005 and 2016, and have plateaued even in areas that outperform national statistics. New approaches to diabetes care and education are needed and are especially important in reaching populations with significant barriers to optimized care. Methods: A pilot quality improvement study was created to optimize diabetes education in a clinic setting with a patient population with significant healthcare barriers. Certified Diabetes Care and Education Specialists (CDCES) were deployed in a team-based model with flexible scheduling and same-day education visits, outside of the traditional framework of diabetes education, specifically targeting practices with underperforming diabetes quality measures, in a clinic setting significantly impacted by social determinants of health. Results: A team-based and flexible diabetes education model decreased hemoglobin A1C for individuals participating in the project (and having a second A1C measured) by an average of −2.3%, improved Minnesota Diabetes Quality Measures (D5) for clinicians participating in the project by 5.8%, optimized use of CDCES, and reduced a high visit fail rate for diabetes education. Conclusions: Diabetes education provided in a team-based and flexible model may better meet patient needs and improve diabetes care metrics, in settings with a patient population with significant barriers.

Diabetes Care in Romania: Increasing Interest in Diabetes Education

1989 ◽  
Vol 6 (8) ◽  
pp. 739-740 ◽  
Author(s):  
C. Dumitrescu ◽  
D. Cheţa
Keyword(s):  
Diabetes Care ◽  
Diabetes Education

Diabetes Care During COVID-19 Pandemic in Singapore Using a Telehealth Strategy

2021 ◽  
Author(s):  
Xia Lian ◽  
Rinkoo Dalan ◽  
Cherng Jye Seow ◽  
Huiling Liew ◽  
Michelle Jong ◽  
...  
Keyword(s):  
Diabetes Care ◽  
Ad Hoc ◽  
Care Delivery ◽  
Diabetes Education ◽  
Circuit Breaker ◽  
Glucose Monitoring ◽  
Retrospective Assessment ◽  
Phone Calls ◽  
Intensively Managed ◽  
Health Applications

AbstractSingapore currently has one of highest number of confirmed COVID-19 cases in Southeast Asia. To curb the further spread of COVID-19, Singapore government announced a temporary nationwide lockdown (circuit breaker). In view of restrictions of patients’ mobility and the enforcement of safe distancing measures, usual in-person visits were discouraged. Here we describe how diabetes care delivery was ad hoc redesigned applying a telehealth strategy. We describe a retrospective assessment of subjects with diabetes, with and without COVID-19 infection, during the circuit breaker period of 7th April to 1st June 2020 managed through Tan Tock Seng Hospital’s telehealth platform. The virtual health applications consisted of telephone consultations, video telehealth visits via smartphones, and remote patient monitoring. The TTSH team intensively managed 298 diabetes patients using a telehealth strategy. The group comprised of (1) 84 inpatient COVID-19 patients with diabetes who received virtual diabetes education and blood glucose management during their hospitalisation and follow-up via phone calls after discharge and (2) 214 (n=192 non-COVID; n=22 COVID-positive) outpatient subjects with suboptimal glycaemic control who received intensive diabetes care through telehealth approaches. Remote continuous glucose monitoring was applied in 80 patients to facilitate treatment adjustment and hypoglycaemia prevention. The COVID-19 pandemic situation mooted an immediate disruptive transformation of healthcare processes. Virtual health applications were found to be safe, effective and efficient to replace current in-person visits.

scholarly journals Glycaemic benefit of structured diabetes education in Nepal, a resource limited environment

2020 ◽  
Vol 20 (2) ◽  
pp. 107-112
Author(s):  
Jaya Pradhan ◽  
Satyan M Rajbhandari
Keyword(s):  
Type 2 Diabetes ◽  
Energy Intake ◽  
Plasma Glucose ◽  
Diabetes Care ◽  
Diabetes Education ◽  
Control Group ◽  
Postprandial Plasma Glucose ◽  
Education Group ◽  
Resource Limited

Introduction: Structured diabetes education is a key element in the management of type 2 diabetes, but this is challenging to deliver in settings where resources are limited.Methods: We conducted a randomised evaluation of a single 90-minute session of structured diabetes education added to the local standard of diabetes care compared with a control group (standard diabetes care only) in 150 patients with recently diagnosed type 2 diabetes in Nepal. The level of knowledge about diabetes was low.Results: Follow-up 6 months after the intervention showed that the reduction in mean (SD) fasting plasma glucose was significantly larger in the education group (from 8.6 (2.9) mmol/L to 6.7 (1.2) mmol/L) compared with the control group (from 8.1 (1.8) mmol/L to 7.0 (1.8) mmol/L) (p=0.029 for comparison between groups). A significant reduction in postprandial plasma glucose also occurred in the education group (from 11.7 (3.7) mmol/L to 8.3 (1.2) mmol/L) compared with the control group (from 11.5 (4.0) mmol/L to 9.7 (2.3) mmol/L) (p=0.005 between groups). A trend to reduced HbA1c was seen for the education versus the control group at 6 months (p=0.06). There were no significant changes in lipids or blood pressure. Overall energy intake and the proportion of energy intake from fat was lower at 6 months compared with baseline for the education group but not for the control group, although there were no significant changes in anthropometric parameters.Conclusion: Our results suggest that a single session of structured diabetes education may provide glycaemic benefits in newly-diagnosed type 2 diabetes patients, and that this may be a pragmatic means of improving diabetes self-care in resource-limited countries such as Nepal.

scholarly journals Heterogeneity in Average Cost per Patient with type 2 Diabetes at Primary Health Facilities in Mexico: Comparing Comprehensive Diabetes Management Medical Offices with General Practice

2020 ◽  
Author(s):  
M. Arantxa Colchero ◽  
Rousellinne Gómez ◽  
Ruy López-Ridaura ◽  
Daniel López-Hernández ◽  
Iyari Sánchez-Díaz ◽  
...  
Keyword(s):  
General Practice ◽  
Diabetes Care ◽  
Diabetes Management ◽  
Unit Cost ◽  
Health Facilities ◽  
Patient Knowledge ◽  
Factors Associated ◽  
Unit Costs ◽  
Primary Health ◽  
Primary Health Facilities

Abstract Background. Despite the high health and financial burden imposed by diabetes in Mexico, few studies have estimated the cost per patient treated. The objective of this study was to estimate the average annual cost per patient (unit cost) with diabetes among 60 primary health facilities in Mexico comparing comprehensive diabetes management medical offices (MIDE) and those from general practice (Non-MIDE). Methods. We described the variation in unit costs across these two types of medical offices and explored factors associated. Unit costs were the sum of staff, medications, laboratory tests, and equipment. We show descriptive statistics to analyze the heterogeneity of unit costs, and the distribution of total costs by input and the distribution of staff costs by personnel all by medical office. We estimated a multivariate linear regression model to explore factors associated with the unit costs. Results. Unit costs vary from $267.2 USD in Non-MIDE offices to $410.6 for MIDE. Unit costs were negatively associated with scale, Non-MIDE offices, medical competence, patient knowledge of diabetes and positively associated with comorbidities. Conclusions. Results from this study might help design more efficient programs for diabetes care in primary health facilities to reduce the burden of diabetes in the system. Investing in staff training and educational interventions to increase patient knowledge of diabetes could be promising interventions to reduce diabetes care costs in primary care settings.

scholarly journals Socioeconomic disparities in access to intensive insulin regimens for adults with type 1 diabetes: a qualitative study of patient and healthcare professional perspectives

2019 ◽  
Vol 18 (1) ◽  
Author(s):  
Anne Scott ◽  
Alicia O’Cathain ◽  
Elizabeth Goyder
Keyword(s):  
Type 1 Diabetes ◽  
Health Outcomes ◽  
Diabetes Education ◽  
Socioeconomic Disparities ◽  
Socioeconomic Groups ◽  
Diabetes Specialist ◽  
Lower Socioeconomic ◽  
Specialist Services ◽  
Specialist Nurses

Abstract Background Type 1 diabetes is a complex chronic condition which requires lifelong treatment with insulin. Health outcomes are dependent on ability to self-manage the condition. Socioeconomic inequalities have been demonstrated in access to treatment and health outcomes for adults with type 1 diabetes; however, there is a paucity of research exploring how these disparities occur. This study explores the influence of socioeconomic factors in gaining access to intensive insulin regimens for adults with type 1 diabetes. Methods We undertook a qualitative descriptive study informed by a phenomenological perspective. In-depth face-to-face interviews were conducted with 28 patients and 6 healthcare professionals involved in their care. The interviews were analysed using a thematic approach. The Candidacy theory for access to healthcare for vulnerable groups framed the analysis. Results Access to intensive insulin regimens was through hospital-based specialist services in this sample. Patients from lower socioeconomic groups had difficulty accessing hospital-based services if they were in low paid work and because they lacked the ability to navigate the healthcare system. Once these patients were in the specialist system, access to intensive insulin regimens was limited by non-alignment with healthcare professional goals, poor health literacy, psychosocial problems and poor quality communication. These factors could also affect access to structured diabetes education which itself improved access to intensive insulin regimens. Contact with diabetes specialist nurses and attendance at structured diabetes education courses could ameliorate these barriers. Conclusions Access to intensive insulin regimens was hindered for people in lower socioeconomic groups by a complex mix of factors relating to the permeability of specialist services, ability to navigate the healthcare system and patient interactions with healthcare providers. Improving access to diabetes specialist nurses and structured diabetes education for vulnerable patients could lessen socioeconomic disparities in both access to services and health outcomes.

Engagement of primary care practice in Australia: learnings from a diabetes care project

2019 ◽  
Vol 25 (1) ◽  
pp. 82
Author(s):  
Rajna Ogrin ◽  
Tracy Aylen ◽  
Toni Rice ◽  
Ralph Audehm ◽  
Arti Appannah
Keyword(s):  
General Practice ◽  
Chronic Disease ◽  
Diabetes Care ◽  
Descriptive Analysis ◽  
Healthcare Providers ◽  
Pilot Project ◽  
Care Practice ◽  
Structured Interviews ◽  
Contributing Factors ◽  
Practice Nurses

Effective community-based chronic disease management requires general practice engagement and ongoing improvement in care models. This article outlines a case study on contributing factors to insufficient participant recruitment through general practice for an evidence-based diabetes care pilot project. Key stakeholder semi-structured interviews and focus groups were undertaken at cessation of the pilot project. Participants (15 GPs, five practice nurses, eight diabetes educators) were healthcare providers engaged in patient recruitment. Through descriptive analysis, common themes were identified. Four major themes were identified: (1) low perceived need for intervention; (2) communication of intervention problematic; (3) translation of research into practice not occurring; and (4) the service providing the intervention was not widely viewed as a partner in chronic disease care. Engaging GPs in new initiatives is challenging, and measures facilitating uptake of new innovations are required. Any new intervention needs to: be developed with GPs to meet their needs; have considerable lead-in time to develop rapport with GPs and raise awareness; and ideally, have dedicated support staff within practices to reduce the demand on already-overburdened practice staff. Feasible and effective mechanisms need to be developed to facilitate uptake of new innovations in the general practice setting.

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