Ozdemir's problems are not entirely physical in nature. Her loneliness and isolation in a country in which she has limited command over English have caused her to pour her energies into cooking traditional, heavy meals for her family and using overeating as a coping mechanism. Seeing a counselor who speaks her language and can aid her in talking about her cultural adjustment issues seems essential. Without psychological support, it is unlikely that Mrs. Ozdemir will feel sufficiently motivated to change her lifestyle. Ideally, diabetes education at the secondary level should also be culturally sensitive, and provide dietary and exercise-related suggestions. Proposed menus can reflect Mrs. Ozdemir's culture, such as Mediterranean dishes that emphasize vegetables and beans, rather than sugary sauces and meats. Also, walking rather than taking public transportation is a potential source of exercise. Ozdemir should receive regular lipid screening, and, if warranted, eye exams and cholesterol screening.

Tertiary

Tertiary or hospital-level care may be necessary if the patient's blood sugar becomes uncontrollable. However,...

"Every time a nurse checks a patient's blood glucose level or administers insulin is an opportunity for teaching…Discharge planning is a team effort and should begin the moment hyperglycemia occurs and the patient receives an insulin injection. Nurses should review the discharge plan with the patient and work with the physician or other providers to modify it if it's overly complicated or unrealistic" (Peeples & Seley 2007). Reviewing home meter reading, glucose monitoring, and appropriate methods of self-care should be a regular part of diabetic treatment in a hospital. A nurse specialized in diabetes monitoring is the ideal teacher, although other trained healthcare providers can be used.
References

Peeples, Malinda & Seley, Jane Jeffries. "Diabetes care: The need for change."

American Journal of Nursing. June 2007. 107.6 (June 1007):13-19. 7 Apr. 2011.

"Primary care." A Dictionary of Nursing. 2008. Encyclopedia.com. 7 Apr. 2011

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