scholarly journals Improving patient self-care using diabetes technologies

2019 ◽  
Vol 10 ◽  
pp. 204201881882421 ◽  
Author(s):  
Valeria Alcántara-Aragón
Keyword(s):  
Cost Effectiveness ◽  
Unmet Needs ◽  
Diabetes Management ◽  
Glycated Hemoglobin ◽  
Diabetes Education ◽  
Self Care ◽  
Use Of Technology ◽  
Diabetes Technology ◽  
Improve Patient ◽  
And Training

Diabetes technologies are an unstoppable phenomenon. They offer opportunities to improve patient self-care through empowerment. However, they can be a challenge for both patients and clinicians. Thus, the use of technology may empower or burden. To understand and benefit from the use of diabetes technologies, one must understand the currently unmet needs in diabetes management. These unmet needs call for perspectives beyond glycated hemoglobin and an evaluation of technology solutions. Optimal use of these technologies is necessary to obtain benefits and achieve cost-effectiveness; this process depends on diabetes education and training. This review evaluates clinician and patient perspectives regarding diabetes technologies, followed by an evaluation of technology solutions. Diabetes technology solutions are evaluated according to available results about their effectiveness and their potential to empower people living with diabetes.

scholarly journals Diabetes education and medication adjustment in Ramadan (DEAR) program prepares for self-management during fasting with tele-health support from pre-Ramadan to post-Ramadan

2018 ◽  
Vol 9 (8) ◽  
pp. 231-240 ◽  
Author(s):  
Sueziani B. Zainudin ◽  
Khalishah Nadhirah B. Abu Bakar ◽  
Salmiah B. Abdullah ◽  
Aslena B. Hussain
Keyword(s):  
Diabetes Management ◽  
Glycated Hemoglobin ◽  
Diabetes Education ◽  
Glucose Monitoring ◽  
Self Management ◽  
Ramadan Fasting ◽  
Health Support ◽  
Tele Monitoring ◽  
Medication Adjustment

Background: We evaluated the outcome for fasting Muslims with diabetes prepared with pre-Ramadan optimization through education and medication adjustment, tele-support and intervention up to post-Ramadan. Methods: Muslims with diabetes planning to fast were recruited into a focused diabetes program for Ramadan fasting. It consisted of (a) a pre-Ramadan assessment and test fasting to optimize glycemic control, (b) education on diabetes management during fasting, (c) tele-monitoring from pre-Ramadan and (d) a post-Ramadan review. Their metabolic profiles and diaries for meals, activities and glucose monitoring were evaluated. Results: Twenty-nine participants were enrolled, with mean age 58.4 ± 9.2 years, 75.9% female, 79.3% Malays and 93.1% type 2 diabetes. A total of 92% needed medication adjustment and 93% fasted for at least 14 days. Glycated hemoglobin (HbA1c) and weight decreased from 8.8 ± 1.8% (72.7 mmol/mol) pre-Ramadan to 8.5 ± 1.7% (69.4 mmol/mol) post-Ramadan and 76.6 ± 20.3 kg pre-Ramadan to 75.9 ± 21.3 kg post-Ramadan, respectively. There were decreased complications of hypoglycemia from 13.8% to 10.3% and several-fold improvement in hyperglycemia from 31.0% to 3.5% during Ramadan fasting when compared with pre-Ramadan. Conclusions: Muslims with diabetes were able to self-manage when fasting using tele-monitoring support and intervention, with decreased complications during Ramadan compared with pre-Ramadan.

scholarly journals Effect of Diabetes Education Through Pattern Management on Self-Care and Self-Efficacy in Patients with Type 2 Diabetes

2019 ◽  
Vol 16 (18) ◽  
pp. 3323 ◽  
Author(s):  
Lee ◽  
Shin ◽  
Kim ◽  
Lee
Keyword(s):  
Type 2 Diabetes ◽  
Self Efficacy ◽  
Diabetes Management ◽  
Diabetes Education ◽  
Self Care ◽  
Positive Influence ◽  
Control Group ◽  
Control Groups ◽  
Significant Difference

This study investigated the effect of applying a customized diabetes education program through pattern management (PM), using continuous glucose monitoring system (CGMS) results, on individual self-care behaviors and self-efficacy in patients with type 2 diabetes mellitus. Patients with type 2 diabetes who had never received diabetes education, enrolled from March to September 2017, were sequentially assigned to either PM education or control groups. In the PM education group, the CGMS test was first conducted one week before diabetes education and repeated three times by PM in order to obtain data on self-care behaviors and self-efficacy. These results were then compared before and after education at three and six months. The control group received the traditional diabetes education. Self-efficacy showed statistically significant interactions between the two groups over time, indicating a significant difference in the degree of self-efficacy between the PM education and control groups. Diabetes education by PM using CGMS result analysis improved life habits with a positive influence on self-care behaviors and self-efficacy for diabetes management. Further studies are needed to further develop and apply individual diabetes education programs in order to sustain the effects of self-care behaviors and self-efficacy in patients with diabetes who experience a decrease in self-efficacy after three months of education.

The Mediating Role of Self-Efficacy in the Association Between Diabetes Education and Support and Self-Care Management

2021 ◽  
pp. 109019812110088
Author(s):  
Lucía D. Juarez ◽  
Caroline A. Presley ◽  
Carrie R. Howell ◽  
April A. Agne ◽  
Andrea L. Cherrington
Keyword(s):  
Care Coordination ◽  
Self Efficacy ◽  
Diabetes Management ◽  
Diabetes Education ◽  
Self Care ◽  
Mediating Effect ◽  
Self Management ◽  
Foot Care ◽  
Self Monitoring ◽  
Management Behaviors

Diabetes self-management education and support enhance self-efficacy and promote self-management behaviors essential for diabetes management. We investigated the mediating effect of self-efficacy on the association between diabetes education or care coordination and self-care activities. We surveyed a population-based sample of adults with type 2 diabetes (19–64 years of age) covered by Alabama Medicaid. We examined whether receipt of diabetes education or care coordination were associated with improvements in diabetes self-care activities. We then examined if improvements were mediated by self-efficacy. Models were adjusted for age, gender, race, education, insulin use, diabetes duration, and depressive symptoms. Results A total of 1,318 participants were included in the study (mean age = 52.9 years, SD = 9.6; 72.5% female, 56.4% Black, 3.1% Hispanic). Diabetes education was associated with increases in self-care activity scores related to general diet, physical activity, glucose self-monitoring, and foot care; care coordination was associated with glucose self-monitoring. In addition, mediation analysis models confirmed that improvements in self-efficacy led to improved self-care activities scores, mediating the association of diabetes education and self-care activities. Conclusions Diabetes education and self-efficacy were associated with better self-care. Receiving diabetes education led to a higher likelihood of engaging in self-care activities, driven in part by increases in self-efficacy. Future interventions that aim to improve diabetes self-management behaviors can benefit from targeting self-efficacy constructs and from the integration of diabetes education in the care coordination structure.

scholarly journals Findings of a nationwide survey of the diabetes education and training needs of midwives in the UK

2018 ◽  
Vol 18 (4) ◽  
pp. 147-153 ◽  
Author(s):  
Umesh Dashora ◽  
Alban Davies Huw ◽  
Shelley Bennett ◽  
Anne Goodchild ◽  
Julia Hugason-Briem ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Diabetes Management ◽  
Diabetes Education ◽  
Unmet Need ◽  
Education And Training ◽  
Training Needs ◽  
Roles And Responsibilities ◽  
Training Programmes ◽  
The Uk ◽  
And Training

Introduction: The incidence and prevalence of diabetes is increasing in pregnant women. Midwives manage a substantial proportion of care of these women. Currently it is notknown whether midwives have sufficient competence in managing these patients well. The Diabetes Care Trust commissioned a survey to assess the diabetes education and training needs of midwives who look after pregnant women with diabetes.Material and methods: A freedom of information request was made to all the NHS Trusts in the UK to gather relevant information about the roles and responsibilities of midwives in thematernity units in the UK. This was followed by a Survey Monkey questionnaire to midwives in the UK who are members of the Royal College of Midwives to assess their education and training level, needs, desires and views preceded by a test survey on nine midwives.Results: The survey revealed considerable variation in the roles and responsibilities, current levels of training and education needs of midwives. Over 85% of midwives expressed a desire to access additional education on diabetes management in different areas. Training in insulin initiation and titration, management during labour and ability to contribute to the antenatal clinic was desired by over 85% of midwives surveyed. Conclusions: There is an unmet need for structured education and training programmes for midwives in the management of diabetes in pregnancy. We recommend further work in producing tailored and accredited training programmes at different levels to suit the differing needs of midwives and diabetes specialist midwives in the UK. 

scholarly journals Diabetes Education, Specialty Care, and Self-Care Advice among Obese African American Women with Type 2 Diabetes

2016 ◽  
Vol 26 (2) ◽  
pp. 229
Author(s):  
Stephania T. Miller ◽  
Jennifer Cunningham-Erves ◽  
Sylvie A. Akohoue
Keyword(s):  
Physical Activity ◽  
African American ◽  
African American Women ◽  
Diabetes Management ◽  
Diabetes Education ◽  
Self Care ◽  
Specialty Care ◽  
American Women ◽  
Provider Advice

<p><strong>Objective</strong>: Healthy People 2020 (HP2020) includes benchmarks for diabetes management. The objective of our study was to describe diabetes management among African American women, a patient group that carries a disproportionate diabetes burden.</p><p><strong>Design:</strong> Cross-sectional survey study.</p><p><strong>Participants:</strong> African American women with type 2 diabetes enrolled in dietary and weight management interventions.</p><p><strong>Main Outcome Measures:</strong> Self-report assessments of diabetes education, specialty care, self-care behaviors and advice. Associations between diabetes self-care behaviors and diabetes advice using Chi-square tests.</p><p><strong>Results:</strong> Among 96 participants (age = 53 ± 9.4; BMI = 37.9 ± 7.3 kg/m2), reported diabetes education and foot exams were lower than HP2020 benchmarks, 48.9% vs 62.5% and 35.1% vs 74.8%, respectively and higher for dilated eye exams (70.1% vs 58.7%). The most frequently reported dietary advice was to increase fruit/ vegetable intake (58%) and approximately 50% reported physical activity advice. Receiving no exercise advice was associated with greater odds of little or no physical activity (OR = 3.38) and planned exercises (OR = 2.65).</p><p><strong>Conclusion:</strong> Receipt of diabetes education and some specialty care were below national benchmarks while health care provider advice influenced patient self-care behaviors. Increasing diabetes education and specialty care should be included within existing efforts to address the excess diabetes burden experienced by African American women. Longitudinal studies exploring the relationship between health care provider advice and self-care behaviors are needed. <em>Ethn Dis.</em> 2016;26(2):229-234; doi:10.18865/ed.26.2.229</p>

67 The Evolution of A Frailty Service

2021 ◽  
Vol 50 (Supplement_1) ◽  
pp. i12-i42
Author(s):  
C Abbott ◽  
K Bishop ◽  
F Hill ◽  
C Finlow ◽  
R Maraj
Keyword(s):  
Cost Effectiveness ◽  
Patient Outcomes ◽  
Local Population ◽  
Management Team ◽  
Pdsa Cycle ◽  
North Wales ◽  
Number Of Patients ◽  
Constant State ◽  
Clinical Resource ◽  
Improve Patient

Abstract Introduction In September 2017 our frailty service was started within our medium sized DGH in North Wales. Working with our management team we secured a significant clinical resource including: We describe how resources, setting and staffing develop over a 2 year period in order to create a service which meets the needs of the local population. Method The service has been in a constant state of development since it has been in operation, utilising a PDSA model with regular meetings of clinical and managerial staff to analyse performance. Results With each new PDSA cycle the amount of patients reviewed has increased. With the move to AMU we increased the monthly number of patients reviewed from 29 to 172 patients reviewed, 97 of which were discharged directly from the unit. Conclusion Using QI methodology our Frailty Service has improved dramatically since its inception. We will continue to analyse how we work to improve patient outcomes and cost effectiveness.

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.

scholarly journals THE ROLE OF HEALTH LITERACY ON PROCESS AND OUTCOMES OF A DIABETES SELF-HELP INTERVENTION WITH KOREAN AMERICANS

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S406-S406
Author(s):  
Miyong T Kim
Keyword(s):  
Health Literacy ◽  
Glucose Control ◽  
Self Efficacy ◽  
Diabetes Management ◽  
Self Care ◽  
Korean Americans ◽  
Target Population ◽  
Management Intervention ◽  
Underlying Mechanisms

Abstract The purpose of this study was to explicate the underlying mechanisms of the role of health literacy (HL) in diabetes management process involving a group of Korean Americans with type 2 diabetes mellitus (DM). We used data from a randomized clinical trial of an HL-focused diabetes self-management intervention (n = 250). A series of path analyses identified the level of self-efficacy and self-care skills as a significant mediator between HL and glucose control (HbA1C) and quality of life for the target population. In addition, education and acculturation were revealed as the most significant correlates of HL for this new immigrant group. Despite inconsistent empirical findings regarding the statistically significant effect of HL on glucose control, this study confirmed the apriority hypothesis that HL indirectly influences health outcome through mediators such self-care skills as self-efficacy. This study highlighted the importance of HL in chronic disease management for people with limited HL.

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