Diabetes education and patient management

Diabetes Education

Mr. Bhavesh Sharma, a 68-year-old male, has been diagnosed with type 2 diabetes, hypertension, and dyslipidemia. During his follow-up visit, Mr. Sharma reported that he has been consistently taking his prescribed medications for the past two months and believes they are effective. His wife has been supportive in preparing healthy Indian meals, including naan, saag paneer, and desserts like gulab jamun. However, his primary form of exercise is riding the lawn mower, which is not exercise at all, really. Still, he is considering joining a pickleball group at a nearby recreational center, which would definitely count as exercise. With this in mind, it also appears that his overall understanding of diabetes management is limited, as indicated by his score of 5 out of 24 on the Patient Diabetes Knowledge Questionnaire (PDKQ).

Mr. Sharma’s vital signs and diagnostic results show some health concerns. His blood pressure is high, with readings ranging from 155/86 to 182/96 mmHg. His non-fasting glucose levels also are between 152 and 173 mg/dL. Laboratory tests from six weeks prior show an elevated hemoglobin A1C level of 7.9%, reduced kidney function with an eGFR of 43 mL/min/1.73m², and creatinine level of 1.9 mg/dL. His cholesterol levels are slightly elevated, with total cholesterol at 206 mg/dL and HDL at 115 mg/dL, although his LDL is low at 30 mg/dL. This data indicates a need for better disease management and for some lifestyle modifications.

Health literacy is defined as the ability to have basic health information to make appropriate health decisions (Liu et al., 2020). It should be considered a big factor influencing Mr. Sharma\\\\\\\'s health. His low score on the PDKQ represents a gap in his understanding of diabetes management, particularly in areas related to diet, exercise, and the role of medications. This lack of knowledge can act as a counter to his ability to adhere to treatment plans. Knowledge is what helps one to comprehend dietary recommendations, and embrace preventive health (Cerf, 2021). It is the foundation for the fight to control disease.

The use of the PDKQ was helpful in identifying Mr. Sharma’s health literacy needs. However, an alternative screening tool such as the Diabetes Self-Management Questionnaire (DSMQ) could provide a more comprehensive assessment of his self-care activities related to diabetes management. The DSMQ evaluates aspects such as glucose management, dietary control, physical activity, and health care use, and gives good insight into areas where intervention can help (Schmitt et al., 2022). Using the DSMQ would give a fuller picture of Mr. Sharma’s self-management skills.

To address Mr. Sharma’s health literacy and promote disease management, two measurable goals are proposed: first, improving his understanding of diabetes management and, second, improving his physical activity levels. To achieve these goals, two nursing interventions are recommended. First, he should receive personalized education that focuses specifically on diabetes management, and diet, exercise, and medication adherence in particular. Involving his wife in these educational efforts can reinforce dietary changes at home.