Diabetes is a self managed disease that requires many strategies to keep it under control and a system of care to monitor the prevention and provide early treatment and prevent complications. Efforts should be directed to strategies that can be used to teach people with diabetes. Education is a key component if diabetes is to be well controlled.
Diabetes is a challenge disease to manage successfully and many patients do not achieve good glycemic control and continue to suffer health problems or even complication because of this. However, it has been proved that most patients with good diabetes self-care behaviour can attain an excellent glycemic control. In most cases, patient self-care management is directed towards; diet, exercise and medication which infact, have a greater effects on the expected outcome.
Poor Dieting or Not Dieting At All
Nutrition, meal planning and weight control are the foundation of diabetes management. The most important objectives in the dietary and nutritional management of diabetes are control of total caloric intake to attain or maintain reasonalbe body weight, control of blood glucose levels and normalization of lipids and blood pressure to prevent heart disease. The food we eat are directly responsible for the level of sugar in our blood. Refined carbohydrates like cakes, soft drinks are metabolized quickly and can cause high level of blood sugar. The best food for diabetic patient should include complex carbohydrates which raise sugar more slowly and can keep it at an appropriate level for longer period of time. In addition, consistency in the approximate time intervals between meals, with additional of snack when necessary, helps to prevent hypoglycemia and maintain overall blood glucose under control. For obese patients with diabetes, weight loss is the key to treatment.
Lack of Exercise
Exercise is another important factor in diabetes management because of its effect on lowering blood glucose and reducing cardiovascular risks factor. Exercise lowers blood glucose level by increasing the uptake of glucose by body muscles and by improving insulin utilization. It also improves circulation and muscle tone. However, patients who have blood glucose levels exceeding 250mg/dL or 14mmol/L and who have ketones in their urine should not begin exercise until the urine test results are negative for ketones and blood sugar level is closer to normal. Otherwise, exercising with elevated blood sugar level increases the secretion of glucogen, growth hormones which leads to liver releasing more glucose and the results is an increase in the blood glucose level. Ideally the person should exercise at the same time preferably when the blood sugar are at their peak and the same amount each day. Regular daily exercise, rather than sporadic exercise should be encouraged.
Lack of Proper Knowledge About Medications
Diabetes medications alter blood sugar levels. They must be taken in specific amounts at regular intervals. Maintaining a schedule is vital to ensuring stable blood sugar levels. Knowing how other medications affect the blood sugar is important, others like corticosteroids are known to increase blood sugar levels in some patients, even those who have not been diagnosed with diabetes. Proper storage of insulin is important to maintain its effectiveness.
Stress and Illness
Stress and illness can affects the blood sugar. During stress the cortisol hormones is produced to combat stress and is responsible for raise in the blood sugar level.
On the other hand, when it comes to health care providers, effective behavior intervention can only be attained if we understands why, how and when the patient fail to engage in optimal diabetes self-management behavior. There would be possible reasons such as: lack of knowledge and skills about the disease, financial concerns, lack of patient motivation. The patient may also have some beliefs and attitudes that affects the overall self care management.
There are other enironmental concerns that would affects the patient’s ability to appropriate self care. This could be conflict among the family members that may undermine the given diabetes management. There is the possibility that the patient may be having specific psychological or psychiatric disorders such as depression, anxiety or eating disorders that impair effective diabetes management. These are some of the issues that should be screened for their potential role in diabetes management problems.