Paper Example on Living Healthily with Diabetes: Self-Management Tips

Introduction

Many people around the world have diabetes. In America alone, The Centers for Disease Control and Prevention (2019, p.1) indicated that over 34 million Americans have diabetes and 90-94% of that number have type 2 diabetes. Unlike many health conditions across the world, diabetes requires self-management to allow people live healthy and quality lives. Self-management is significant in type 2 diabetes because it helps in controlling glycaemia, controlling blood pressure, and weight management. Furthermore, the self-management program (SMP) requires the involvement of the interdisciplinary team as well as other essential service providers such as nutritionists to improve the health status of the patient. On a broader perspective, patients in primary, secondary and tertiary settings out to exercise self-management practices to improve their quality of life and health status. In diabetes, several models of care can help in managing the condition. The Chronic Care Model (CCM), for instance, is a framework that helps people with chronic conditions such as diabetes with self-care practices and tracking systems that improve health behaviors and clinical outcomes. Besides that, a professional plan table is useful in the assessment of self-management for conditions such as type 2 diabetes. Most importantly, nurse-led care is an integral component of type 2 diabetes. The purpose of this research is to discuss self-management for a patient with type two diabetes in the clinical setting. Using the CCM and the professional plan, the paper evaluates the chronic disease prevention and management strategies across the patient’s lifespan. Additionally, the paper will effectively communicate health assessment data and decisions to the interdisciplinary health care team and other relevant service providers in type 2 diabetes management. More so, the paper will explore the nurse-led service models that support the patient’s self-management of type 2 diabetes in the primary, secondary, and tertiary levels.

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

Save 25%

Background of the Patient

Patient J is a 48-year woman who weighs 200 pounds and has had type 2 diabetes for the past three years. Before diagnosis, she had symptoms that indicated hyperglycemia one year. His blood glucose levels recorded values of values of 120–129 mg/dl. For the past three years, the patient has been taking atorvastatin (Lipitor), 10 mg daily to reduce her cholesterol levels. Also, she has been taking chromium picolinate and gymnema sylvestre to improve her glycemic control. Nevertheless, the patient has not been taking the medications daily because of what she described as being tired of them. At the time of diagnosis, the primary care physician advised the patient to lose at least 50 pounds. Despite the advice, patient J did not take any further action. The patient has been admitted in the hospital for the past one week and is up for discharge within the next few days. After discharge, the patient will need to utilize self-management care to improve their quality of life.

A self-management program (SMP) is necessary because it will help improve the quality of life of the patient, delay disease complication, and decrease the mortality rates. According to The Centers for Disease Control and Prevention (2019, p.1), some of the complications of type 2 diabetes include heart disease, kidney problems, nerve damage and digestion, vision loss, foot problems, hearing loss, and oral health.

Undoubtedly, the type 2 diabetes can be challenging to manage for patients (The Centers for Disease Control and Prevention, 2019, p.1). Due to that, the self-management program is necessary in managing the condition. Powers, Bardsley, Cypress, Duker, Funnell, Fischi, Maryniuk, Siminerio, and Vivian (2016, p.1372) affirmed that diabetes self-management improves health outcomes by helping a patient to sustain their coping skills and behaviors needed to self-manage daily. According to the authors, health care practitioners need to ensure that type-diabetes patients receive diabetes education and support to improve their health.

In this scenario, there is no doubt that patient J requires education and support of diabetes self-management to help manage her condition. Furthermore, Smoorenburg, Hertroijs, Dekkers, Elissen, and Melles (2019, p.3) indicated that health care providers should design the SMP to fit the patient’s needs, abilities, and preferences. In the case of patient J who evidently has uncontrolled type 2 diabetes, designing the SMP according to her needs will be useful to prevent complications. Moreover, Yao, Wang, Yin, Yin, Guo, and Sun (2019, p.2) determined that self-efficacy has an undeniable association to self-management. The authors established those results from a study they conducted in Chinese populations with type 2 diabetes (Yao et al., 2019, p.2). The CCM will help in determining the self-management practices of patient J.

Overview of Type 2 Diabetes

Type 2 diabetes is common in many patients who have diabetes. The Centers for Disease Control and Prevention (2019, p.1) stated that type 2 diabetes is common in adults over 45 years old even though most teens and children are developing it. The cause of type 2 diabetes is insulin resistance. Usually, when the pancreas produces too much insulin to keep the body cells active, it fails eventually in the production, which makes a person become pre-diabetic, and eventually develop type 2 diabetes. More so, the symptoms of type 2 diabetes go unnoticed as patients can live for years without knowing they have the condition. Nevertheless, some of the risk factors for type 2 diabetes include being pre-diabetic, overweight, family history, 45 years and older, and have gestational diabetes. Patients with the risk factors mentioned need to go for a blood sugar test to see whether they have type 2 diabetes.

Healthcare providers such as the primary care physician, foot doctor, nutritionist, eye-doctor, pharmacists, and diabetes educator need to work collaboratively to ensure that they help the patient manage his or her condition. Managing diabetes requires health eating, physical exercise, prescribed insulin, and ingestible medicine that would help the patient control their blood sugars (The Centers for Disease Control and Prevention, 2019 p.1). Also, patients with type- diabetes need to control their blood pressure and cholesterol levels to improve their quality of life and health status. A self-management plan will be useful because it will help patient J to manage her condition and improve her quality of life over time.

Chronic Care Model

The Chronic Care Model is a multifaceted evidence-based framework that enhances the delivery of care by identifying essential components that can be modified to improve the quality of life of a patient and create a patient-centered approach (Kadu & Stolee, 2015 p.1). for people with chronic conditions such as diabetes, the CCM would be useful in providing high-quality support for the patient. Chronic diseases remain a burden for people worldwide. Chronic disease management requires the utilization of a chronic care model that requires changes in patient’s behavior, culture and communication. Yeoh et al. (2018, p.279) asserted that the CCM, proposed by Wagner et al. in the 1990s, served as a patient centered, evidence-based, and a proactive framework that helped patients with chronic diseases to improve their health. This section discusses the components, strengths, and limitations of the CCM.

Components

Stuckey, Adelman, and Gabbay (2011, p.39) indicated that according to preliminary evidence, the incorporation of all the elements of the CMM is necessary to ensure that the patient achieves success in their self-management. The authors describe the elements of the CMM as follows:

• Health System or a Health Organization (HSHO) – relates to systems that focus on promoting improvement strategies such as leadership and stresses on optimal care.
• Clinical Information Systems (CIS) – relates to systems that leverage information technology to provide timely reminders to patients and providers on information related to type 2 diabetes.
• Decision Support (DS) – relates to systems that embed evidence-based guidelines into clinical practice and share the information with the patients to encourage participation and enhance collaboration.
• Delivery system design (DSD) – relates to the systems of delivery of care such as patient centered approaches and team-based approached that attend to the needs of the patient during the clinical visit and follow-up.
• Self-management Support (SMS) – relates to systems that provide knowledge and effective strategies that that help patients manage their condition.
• Community-including Organizations and Resources for Patients (CORP) – refers to systems where patients are encouraged to participate in community programs that would them improve their quality of life.

The implementation of CCM in clinical settings is feasible because it results in improved disease outcomes. In their research Bongaerts, Mussig, Wens, Lang, Shwartz, Roden, and Rathman (2017, p.12) investigated the effectiveness of chronic disease management models for type 2 diabetes on the improvement of patient outcomes in Europe. The researchers examined literature of the CCM model and found that there is limited study on all its six components simultaneously. Furthermore, Bongaerts et al., (2017, p.12) indicated that the components of the CCM offer self-management support that enhances a patient’s coping, confidence, and skills that would enable them manage their illness across their lifetime.

Strengths

Yeoh et al. (2018, p.280) indicated that in most of the studies they have examined, the use of the CCM created improved outcomes and patients complied with treatment. Also, in other studies, the use of the CCM reported a reduction in medical burden such as healthcare utilization. Furthermore, Sendall, McCosker, Crosssley, and Bonner (2016, p.3) indicated that the CCM is flexible as a healthcare practitioner can apply any of the components and determine whether it will be applied to a cohort of people with multiple chronic conditions. In a study of patients with type 2 diabetes in China, Kong et al. (2018, p.1) found that the implementation of the CCM model resulted in significant improvements in areas such as drinking habit, physical activity, eating habits, and parallel improvements of clinical outcomes such as reduction in cholesterol after a 9-month period. Some of the strengths that the authors mentioned include the following:

• Recognizes team function and practice systems
• Develops and implements evidence-based guidelines
• Provides guidelines through education
• Enhances interaction between generalists and specialists
• Enhances information systems to develop disease registries, tracking systems, and reminders of feedback on performance.

Limitations

One of its weakness is that CCM does not show how implementation handles morbidities. Boehmer, Dabrh, Gionfriddo, Erwin, and Montori (2018, p.2) asserted that even though the CCM describes the types of elements that should be implemented to support patients with chronic illnesses, it does not describe how the implementations handle multi-morbidity. As the authors indicated, CCM should be applied to handle multiple individual conditions and not just one.

Another limitation is in its components. Boehmer et al. (2018, p.1) affirmed that since its inception, the components of CCM were assembled based on favorable experiences rather than respond to the tenets of a conceptual framework. The authors added that the fact that each component is independent in the CCM is what makes limits its application. In their study of type 2 diabetes...