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Self-Management of Type 2 Diabetes: A Synthesis of the Evidence

Principal Investigator: Nancy K. DalPezzo, RN, MSN
Organization: Cedar Crest College

Abstract

Problem

The National Institutes of Health estimates that 20.8 million Americans are afflicted with diabetes. Due to the prevalence of the disease, The Institute of Medicine has identified diabetes as one of its twenty priority areas for national action.

Evidence

Diabetes is a significant health problem in southeastern PA. In Lehigh County, PA, the death rate from diabetes is 69.9 per 100,000 people, as compared to the Healthy People 2010 goal of 45 per 100,000. 26% of patients admitted to the local Visiting Nurses Association suffer from complications of the disease. These complications are often the result of poor self-management of the condition.

Strategy

An extensive literature search was conducted to locate evidence regarding strategies and interventions to enhance diabetic self-management. Analysis was performed on evidence summaries, randomized control trials, evidence-based clinical practice guidelines, and primary research conducted between 2000 and 2006.

Practice Change

The evidence supports the use of the following seven strategies to improve diabetic self-management: a) Nursing assessments should include assessment of the patient’s health beliefs and attitudes toward the disease; b) Patients should be actively involved in setting goals for their care; c) Diabetic education programs should incorporate active teaching strategies; d) Use of technology should be incorporated into diabetic education programs; e) Diabetic education should be repeated and reinforced over time; f) Diabetic care and education must be culturally appropriate; g) Patients should be enrolled in case management and/or disease management programs when available.

Evaluation

The seven strategies have recently been incorporated into the VNA Diabetes Education Program. Results will be available in December 2007. Preliminary feedback from patients and staff has been positive.

Recommendations

Providers of diabetic care and education should review and revise their programs and protocols to incorporate the seven supported strategies.

Recognition

  • 3rd place poster winner, 2007 Summer Institute on Evidenced-Based Practice

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