Diabetes Mellitus: The Growing Need for DNEs - Research Paper

Introduction

Global health statistics indicate that the case for the diagnosis of diabetes mellitus is growing at an unprecedented rate. As a result, most healthcare organizations have been overwhelmed by the proliferation of type 2 diabetes mellitus, which has drawn attention to the need to balance the ratio between patients and diabetes nursing educators (DNEs). Diabetes mellitus is defined as a conglomeration of diseases that are characterized by elevated levels of blood sugar, which incapacitates the body from producing adequate insulin (Aalaa et al., 2014). Besides, hyperglycemia is the condition whereby unwarranted amounts of glucose are circulated within the body, and the situation may be exacerbated by factors such as lack of participation in physical activities, stress, medications, inflammation, and inadequate food consumption.

Is your time best spent reading someone else’s essay? Get a 100% original essay FROM A CERTIFIED WRITER!

Save 25%

Equally important is the fact that the chronic nature of diabetes warrants perpetual medical care. Moreover, effective treatment and management of diabetes are tied to a patient's timely access to self-management support mechanisms and subsequent education on how to prevent the advent of acute complications, which could be fatal (Bansal et al., 2014). Efficacy in the response of regulation of the circulation of glucose in the body necessitates a combination of elements, most notably, evaluation of pharmacology, monitoring of progress, and interventions targeting proper nutrition intake.

Conventionally, diabetes is portrayed as a medical condition that is managed through medication regimens, exercising, and dieting. Nevertheless, the forthright administration for diabetes has always proven to be a daunting task (Low Wang et al., 2016). Perhaps this phenomenon may be attributed to the fact that diabetes management has always been under constant evolution for the past two decades, thus augmenting the complexity of managing the ailment.

Nutritional intake is perhaps the most targeted component in regards to diabetes management. Contrariwise, the recommended diet for a patient diagnosed with diabetes has undergone a sense of transformation shifting from calorie-restrictions and clinician's prescription to a more customized meal plan for a particular patient. Some of the factors that are taken into consideration when developing an individualized nutritional plan included cultural background and the meal preferences of a patient. Further, engagement in physical activities is deemed vital for diabetes management, and in the contemporary setting, exercising is increasingly being associated with the patient's daily routine to optimize the positive effects of physical activities (Chaudhury et al., 2017).

Medication management has become an art of sorts as innovative medications, each with its distinctive benefits, characteristics, and side effects are being used alongside insulin. Initially, monitoring the progress of a diabetic patient involved conducting arbitrary plasma and capillary glucose tests, including occasional glycated hemoglobin (A1C) measurements. Currently, such a routine extends to self-monitoring of blood pressure and blood glucose and the planned clinical evaluation for A1C, kidney functions, and lipid levels (Chrvala, Sherr & Lipman, 2016). Moreover, the patient is expected to conduct routine metabolic measurements as well as determining the waist circumference, body mass index, examining the feet and eyes, and the scrutiny of the quality of life.

In as much as unregulated diabetes is continuously linked with the worsening of significant vascular complications, studies indicate that augmentation in glycemic control interventions creates benefits for patients diagnosed with type 2 diabetes. This implies that a percentage drop in A1C, as noted in the respective test, the risk of microvascular complications that affects the nerves, kidney, and eyes is diminished by as much as 40 percent. Consequently, the early and unrelenting glucose control holds the promise of a lasting impact. Equally important is the fact that DNEs acknowledge that diabetes management is not a straightforward undertaking.

Accordingly, such professions call for an interdisciplinary approach which focuses on creating a robust and collaborative network of healthcare team where members work closely with the patient to come up with the appropriate decisions. This implies that successful diabetes management is heavily reliant on the philosophies of patient-centered care to guarantee the quality and safety of the patient (Minet et al., 2010). Subsequently, the current body of literature suggests that DNEs have the responsibility of assisting patients with diabetes to obtain knowledge, competencies, and skills that would ensure efficacy in self-management of their conditions.

Role of DNE in Patient Education

Typically, a DNE serves as the lead in a multidisciplinary team that may be comprised of a dietician, social worker, endocrinologist, and a mental health worker to facilitate proper diabetes management. Moreover, the fundamental goal of optimum diabetes management is to attempt and restore the blood sugar levels to the recommended states while diminishing the risk of either hypoglycemia or hypoglycemia, including the reduction of macrovascular or microvascular complications (Eckel et al., 2011).

In essence, the role of the DNE is to offer patient education in regards to the ideal interventions for diabetes management that are in line with nursing practice proficiencies. These competencies may be summarised as ensuring the need to facilitate patient autonomy and empowerment, sensitizing the importance of the social and psychological aspects of diabetes, having an open dialogue and communication, addressing any concerns raised by the patient, and offering comprehensive information in regards to the patient's experience. Hence, the nurse ought to be ready to convey information and provide authentic feedback to the patient in her capacity as a health promoter and educator.

A Paradigm Shift

The management of diabetes necessitates the incorporation of a multidisciplinary approach. Moreover, studies indicate that knowledge as a standalone facto is not sufficient in promoting behavioral change in patients. Equally important is the fact that chronic ailments such as diabetes require the active involvement of the patient who is expected to take the lead role in the implementation of self-care. Additionally, the diagnosis of type 2 diabetes is particularly challenging since the symptoms begin to manifest it well after hyperglycemia exceeds the renal threshold, which is 180 mg/dL (Mohan, Shah & Saboo, 2013). Thus, in the absence of any symptomologies, encouragement for self-management may not suffice during the early stages of the diagnosis of type 2 diabetes.

Patient education is crucial for self-management, but the transference of information from the DNE to the patient only marks the commencement of a lifelong journey towards self-care. Equally important is the fact that motivating a patient to take control of their chronic ailment necessitates the incorporation of unique skills that tend to supersede the standard approaches of care. This phenomenon may be epitomized by the fact that empowering a patient diagnosed with diabetes integrates a paradigm shift whereby the conventional acute-care model is abandoned, and the self-management interventions are tailored towards supporting the education and the needs of the patient.

Consequently, such an intervention will require the application of an evidence-based response that informs on the essence of establishing patient-centered care. According to the Institute of Medicine, patient-centered care is defined as respecting the preferences and attitudes of a patient while incorporating concerted efforts to develop the appropriate decision making for disease management. The American Association of Diabetes Educators (AADE) defines the basic tenets of warranting efficacy in diabetes management, where the patient is regarded as being the epicenter of any intervention that is to be adopted. AADEs' code of ethics holds that the self-management of patients with diabetes ought to be individualized, and this approach has gained traction amongst most DNEs (American Diabetes Association, 2013).

This phenomenon is embodied by the fact that DNEs unanimously agreed that targeting blood sugar levels while integrating clinical practice guidelines and recommendations would be ideal rather than focusing on offering prescription and intensive use of algorithms. In as much as diabetes treatment ought to be customized to suit the needs of the patient, the success of self-management is heavily reliant on the commitment on the part of the patient. Thus, dealing with the daily complications associated with diabetes, the patient needs to be equipped with the core knowledge as well as possess the right abilities skillsets and incentives for self-management.

Importantly, even when diabetes treatment is tailored specifically to meet the needs of the individual, successful self-management depends on the commitment of that individual. To deal with the complexities of day-to-day diabetes, the individual with this disease must not only have core knowledge, but he or she must also possess the skills, abilities, and motivation for self-management.

Defining Diabetes Self-Management

Evidence-based studies indicate that patients who are lacking in formal diabetes self-management education (DSME) experience informational gaps, hence are not equipped with the recommended preventive services. Consequently, this implies that such patients are highly susceptible to the development of chronic complications as compared to the patients equipped with DSME. Ideally, DSME is considered as a collaborative, interactive and a continuous process that individuals who are at an elevated risk of contracting diabetes acquired competencies and knowledge which inform on the need to adapt behavior and in the process lead to the successful management of diabetes and the related conditions (Rawal et al., 2012). Equally important is the fact that DSME takes into consideration the patient's needs, objectives, and experiences in life, which offers a comprehensive insight into the etiology of the ailment.

Fundamentally, the goals of DSME comprise self-care behavioral patterns, active collaboration throughout the healthcare system, approaches to solving problems, and the need to improve the quality of life and health status. Accordingly, such educational strategies are customized ton assist patients diagnosed with diabetes to attain the highest level of health status, which in turn warrants the enhanced quality of life to diminish the requirement for added costs directed towards healthcare (Reinehr, 2013). Equally important is the fact that the most critical outcome of DSME is behavioral change. Accordingly, the expected outcome can be derived from a six-step process that comprises evaluation, setting goals, forecasting, organization, execution, application, and recording.

In essence, the first step during a health encounter between a clinician and a patient is assessment. The design and implementation of an efficient and customized DSME ought to be in-depth and must cover all the facets that are related to the management of self-care and diabetes. Equally important is the fact that an all-inclusive account that stretches beyond the mere activity of data collection tied to diabetes and the associated with objective symptoms and clinical data is crucial. Conventionally, such an approach touches on a patient's lifestyle and integrates...