Diabetes Management and Insulin Administration
Summary of Teaching Plan
In recent years, an increase in demand for expansion of education programs for diabetes patients as also for Federal Government or third party payers to support these programs has been observed. A survey by Veterans Administration Hospital conducted a survey to evaluate the capability of patient for diabetes management reported lack of formal training in over 35% of patients interviewed (Miller, Goldstein & Nicolaisen, 1978, p. 275). Therefore, some recommendations for training patients to administer insulin therapy, which reflect best practices, are as follows:
• The therapy should be initiated after a thorough patient assessment, including numeracy skills and health literacy. Therapy initiation should be followed by follow-up phone calls.
• Treatment adherence should be measured during follow-up visits to recognize adherence issues, changing barriers or other problems due to poor recall of instructions etc. Injection practice should also be observed and re-trained, if required.
• They should be well-instructed about the site rotation and its importance; also sites inspection is crucial for any signs of lipohypertrophy or lipoatrophy during all follow-up visits.
• Appropriate language should be used while teaching injection technique avoiding terms like "spearing" or "throwing a dart." Moreover, psychological discomfort can be reduced by minimizing delay in injecting.
• Dose should be prepared by insulin inspection, manufacturer's directions for rolling to suspend insulin and evading air bubbles.
• Insulin-mixing should follow the prescription laid down by American Diabetes Association.
• Different creative strategies in insulin storage like applying colored dots or rubber bands, or colored vial sleeves to insulin vials, may be helpful in avoiding patient's confusion about different insulin types.
• Risk stratification table can be used to identify patient's target blood glucose level.
• Vials unused needs to be refrigerated. Recapping is critical while reusing the needles, while needles should be removed in extreme climates (Siminerio et al., 2011, pp. 5-6).
Epidemiological rationale
Timely intervention and delay or evasion of development of type 2 diabetes proves enormously beneficent for patients, in terms of improving their quality of life and increasing life expectancy; and possibly for health-care payers and society in economic terms. The International Diabetes Federation (IDF) Taskforce organized a consensus workshop in 2006 on Epidemiology and Prevention of diabetes. The resulting consensus paper launched in Barcelona in April 2007 at the 2nd International Congress on Prediabetes and the Metabolic Syndrome, published in Diabetic Medicine in the May 2007 issue, reflected significant changes in the health of a...
The approach for its prevention must be systematic and continued for a long time (IDF, 2015).
Therefore, not just the education but a conducive environment and condition must be created for maintaining and attaining an active and
healthy lifestyle and
eating habits. The
governments of all countries need to develop and implement a National Diabetes Prevention Plan according to IDF population strategy. This plan would include many groups including communities (namely ethnic and religious groups);
schools;
workplace (
health promotion in the
working environment); and the industry (investment policy,
marketing,
product development) (IDF, 2015).
Evaluation of
teaching experience
A survey was conducted on Australian adults with Type 1 diabetes (T1D), aged 18-35 years. Diabetes consumer-organizations recruited participants (n= 150) through advertisements and asked them to rate features of clinician-led diabetes education and identify their self-education sources for the evaluation. At initial diagnosis, 77.3% from a diabetes educator, while 74.7% of all participants/family members attained diabetes education through a specialist physician or endocrinologists. However, 58.0% received education from a dietician, and 26.7% from a GP, whereas 2% due to age were unaware of provision of any diabetes education (Wiley et al., 2014).
The results reported that 56% of respondents were satisfied with the extent of continuing diabetes education received from their health-care group. 76.6% were found confident about calculating bolus insulin requirements for meals, while 64.0% for calculating basal insulin requirements. 66.0% agreed about receiving adequate explanation to manage their diabetes when sick, 66.7% agreed about same when exercising, and 76.7% agreed about proper explanation of alcohol's effect on their diabetes. 96.6% of the respondents accessed additional resources of diabetes education and 73.3% stated that they obtained more diabetes information than the overall amount provided by their health-care team (Wiley et al., 2014).
Community response to teaching
The American Association of Diabetes Educators (AADE) declares that diabetes education is effective in delivering results. However, less than 60% of people affected with diabetes have acquired any formal diabetes education, but increasing that percentage has become a priority for Healthy People 2020, as research indicates that people who received diabetes education are more inclined and motivated to:
• Take medicine/treatment…
