Such interactions across cultures often times can be difficult even in the best of situations. In many cultures, what is considered acceptable interactions in one culture often times translates as inappropriate and rude interaction in another culture. A review of the literature demonstrates there is no culturally acceptable standardized practice protocol for Advanced Practice Registered Nurse to disseminate such information to their patients. An expanded role in nursing is emerging globally in response to the need to increase human resources to achieve Universal Health Coverage UHC.
The PCP also informs the patient that he is at risk for diabetic retinopathy, an extension and worsening of heart disease and kidney disease, and foot ulcers and only immediate changes in his lifestyle and health habits can prevent these complications.
An Overview Of Diabetes Diabetes is an enormous and rapidly growing public health problem. In addition, millions of Americans have pre-diabetes and many people who have diabetes have not been diagnosed.
Diabetes Classification and Pathophysiology There are many types of diabetes and they can be usefully classified into four groups. The condition of pre-diabetes will also be discussed.
Type 1 diabetes is an autoimmune disease caused by genetic susceptibility and environmental triggers. Type 2 diabetes is characterized by insulin resistance and a relative lack of insulin production.
Type 2 diabetes is also caused by an interplay of genetics and environment but in this form of the disease the environmental factors that increase the risk of developing type 2 diabetes have been clearly identified and many of them are modifiable, e.
The onset is usually in late adulthood. Gestational diabetes occurs during pregnancy, and the incidence of this form of the disease has been estimated to be 9. Diabetes due to other causes: It should also be noted that the traditional separation of diabetes into type 1 and 2 has been questioned as researchers have found that there can be a clinical overlap between the two Schwartz et al.
Pre-diabetes is not a disease. It is a condition characterized by a cluster of risk factors and identified by impaired fasting glucose and impaired glucose tolerance.
Taken together these risk factors and the abnormal laboratory results identify individuals who are likely to develop type 2 diabetes.
All adults should be tested for diabetes beginning at age If the tests are normal they should be repeated at three year intervals, at a minimum. Diabetic Complications Chronic hyperglycemia initiates several pathologic processes that increase the production of reactive oxygen species and cause inflammation and cellular damage.
Certain tissues such as the capillary cells of the retina, cells in the renal glomeruli, and neurons and Schwann cells in peripheral nerves cannot efficiently regulate the transport of glucose, making them vulnerable to persistently high levels of serum glucose and large amounts of free radicals.
Diabetes, both type 1 and type 2, is a major cause of amputations, blindness and vision loss, and kidney disease and diabetic retinopathy, diabetic nephropathy, and diabetic neuropathies are common chronic complications of both type 1 and type 2 diabetes.
In addition, diabetes is considered to be a risk factor for the development of atherosclerosis, heart disease, hypertension, and stroke. However, maintaining glycemic control and initiating and sustaining these lifestyle changes is very difficult for most people.
But if patients at risk for diabetes and those who have the disease are able to modify their behaviors the rewards are huge: However, attaining these goals depends on self-care, and in the context of diabetes this is a complex and life-long commitment that requires patient education, education that is often lacking Kueh et al.
Self-care is critical for diabetic patients and at-risk patients and it depends on education.
Support is also a vital aspect of diabetic self-care and both of these concepts are discussed in the next section of the module.
High-quality diabetes self-management education DSME has been shown to improve patient self- management, satisfaction, and glucose control. The ongoing process of facilitating the knowledge, skill, and ability necessary for pre-diabetes and diabetes self-care.
This process incorporates the needs, goals, and life experiences of the person with diabetes or pre-diabetes and is guided by evidence-based standards.
The overall objectives of DSME are to support informed decision-making, self-care behaviors, problem-solving, and active collaboration with the health care team and to improve clinical outcomes, health status, and quality of life Haas et al. Activities that assist the person with pre-diabetes or diabetes in implementing and sustaining the behaviors needed to manage his or her condition on an ongoing basis beyond or outside of formal self-management training.
The type of support provided can be behavioral, educational, psychosocial, or clinical Haas et al. Each patient should be evaluated for possible access issues and barriers to effective self-care such as cultural, geographical, economical, language, and monetary barriers ADA, ; Haas et al.
Coordination is essential for good diabetic care Powers et al.Diabetic foot ulcers deserve special mention because: 1) They are very common, and 2) There are many practical day-to-day things a patient can do to prevent diabetic for ulcers (Ahmin & Doupis, ).
NCBDE was established in as an independent organization to promote the interests of diabetes educators and the public at large by granting certification to qualified health professionals involved in teaching persons with diabetes, through establishment of eligibility requirements and development of a written examination.
Since it was first awarded in , the CDE® credential has become. Getting started on a new way of eating can be both energy and time consuming. It takes a while to work out what you can and can't eat, to plan your meals that fit the guidelines. And most importantly, to actually stick with your new way of eating.
Here are some tips to get you started.
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B ackground. Surveys conducted from to , when treatment prospects for cancer were bleak, revealed that most physicians considered it inhumane and damaging to the patient to disclose the bad news about the diagnosis [1, 2].Ironically, while treatment advances have changed the course of cancer so that it is much easier now to offer patients hope at the time of diagnosis, they have also.
Communication in our daily environment allows for people to interact in real time and instantaneously. Such interactions across cultures often times can be difficult even in the best of situations.