Primary care management of type II diabetes in Mrs. Gulcin Ozdemir

¶ … Patient

Mrs. Gulcin Ozdemir

Primary care

Primary care for a patient with type II diabetes requires the treatment of the immediate physical symptoms of the illness, limiting the risks for the exacerbation of the illness in the future, and addressing the psychological and lifestyle issues contributing to the disorder. "In the UK the delivery of primary care is via GP services," (Primary care, a Dictionary of Nursing, 2011). General Practitioners must prescribe a self-care regime that a patient can use to manage diabetes on a daily basis. "If a patient sees a provider for a 10- or 15-minute office visit four times a year, that's equivalent to an hour of interaction annually. But the patient lives with diabetes 8,760 hours a year. Providers diagnose, prescribe and adjust medications, and monitor for complications, but it's the patient who manages the disease every day" (Peeples & Seley 2007). It is extremely troubling that Mrs. Ozdemir believes that the 'tablets' she has been prescribed will cure her.

The GP must make Mrs. Ozdemir cognizant of the nature of diabetes: it can be controlled with modifications in her diet and medication, but the medication controls her blood sugar, it does not cure her. Weight loss, exercise, and careful dietary management and blood sugar control is required to treat diabetes. Unless Mrs. Ozdemir understands the nature of how the disease progresses, she will be unable engage in appropriate self-monitoring. She also faces additional challenges, given the linguistic and cultural barriers she faces. "Fewer than one-third of people with diabetes reported that they were able to manage their disease themselves" (Peeples & Seley 2007).

Tertiary

Tertiary or hospital-level care may be necessary if the patient's blood sugar becomes uncontrollable. However, given that diabetes patients are eventually released into the outside world, this environment still offers opportunities for counseling and treatment. "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.