By Megan M. Krischke, contributor
Nov. 20, 2009 - What if nurses could help curb an epidemic that experts predict might eventually affect up to a third of the country’s population?
November is American Diabetes Month®, designed to spotlight this serious and widespread disease that can lead to life-threatening complications such as heart disease, stroke, kidney disease, blindness and amputation. This year the American Diabetes Association (ADA) is using this annual observance to launch a national movement to Stop DiabetesSM, and experts point out the important role that nurses can play in this movement.
When it comes to the incidence of diabetes, the statistics are staggering: the ADA reports that more than 24 million Americans of all ages have diabetes, another 57 million are at risk for developing type 2 diabetes, and, if current trends continue, 1 in 3 children born today will have diabetes in their lifetime.
In addition, half of the patients admitted to the hospital are diabetic, according to Donna M. Rice, MBA, RN, CDE, president of the Diabetes Health and Wellness Institute, an affiliate of Baylor Healthcare Systems in Dallas, Texas.
“Nurses need to be really aware about diabetes because it complicates everything about a diabetic’s medical care, from meals to medications to surgeries,” explained Rice. “Because of the disease’s prevalence it touches many different people in many different settings. Whether a patient is hospitalized for appendicitis or stroke or even a car accident, diabetes makes the nursing care more complex so all nurses need to be very savvy about diabetes when they are delivering care.”
Because the symptoms of type 2 diabetes—increased thirst, blurred vision, sores that do not heal quickly, and tiring easily—are not readily recognized by patients, nurses need to be on the lookout for evidential signs and provide regular screenings for patients who are sedentary, overweight or who have a family history of diabetes.
Martha M. Funnell, MS, RN, CDE, is the chair of the National Diabetes Education Program.
“Diabetes is largely a patient-managed disease. Diabetics give 99 percent of their own care,” commented Martha M. Funnell, MS, RN, CDE, research investigator for the department of medical education at the Michigan Diabetes Research and Training Center. “Patient education is a very traditional role for nurses, but one that sometimes gets lost in the current health care system.”
“It is critical for nurses working with diabetics not only to educate, but to motivate,” Funnell continued. “We need to help people take on the responsibility of caring for their health. We can’t forget that even with all the new technologies and therapies available, at the end of the day it comes down to what is the patient going to do.
“One thing nurses need to be aware of is the stress diabetics feel. Eighty-five percent of diabetics experience distress at the time of diagnosis and are continuing to have quite a bit of distress 15 years later. Patients tell us they don’t get help for those issues. Diabetes is an overwhelming and burdensome disease and we need to offer ongoing support to help patients deal with their anger, frustration and fear because that ultimately influences their ability, or inability, to manage their disease.”
One approach currently being tested in the care of diabetic patients is the Chronic Care Model (CCM), developed by MacColl Institute for Healthcare Innovation with support from the Robert Wood Johnson Foundation. This model encourages health care to be proactive, rather than reactive, and is a team-based model in which nurses play a key role.
Rice encourages nurses to become better stewards of people with diabetes, “Nurses need to get continuing education, we need to be on top of cutting edge therapies, we need to know how to treat it and prevent it, we need to know how to recognize symptoms in babies, we need to be able to advise people on how to manage their diabetes when they have the flu or are preparing for surgery, and we need to be good communicators.”
Rice recommends that nurses join the American Association of Diabetes Educators to learn more about educating others with diabetes and to stay abreast of the latest in care and treatments. Other resources for information include the National Diabetes Education Program, the American Diabetes Association and dLifeTV, a weekly broadcast on CNBC.
“The most important things nurses can do are to really understand diabetes and to help patients to understand the seriousness of diabetes and the impact that they can make on their own health,” said Funnell. “Managing diabetes isn’t easy, but it is worth the effort because it will impact future health and quality of life. Complications aren’t necessarily inevitable.”
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