The Specialist Forum Volume 13 No 11 November 2013 | Page 32
DIABETES
The value of self-monitoring
I
n 2003, the International Diabetes Federation (IDF) estimated that
there would be 285 million people with diabetes by 2010. This was
a gross underestimate. The fifth edition of the IDF Atlas shows that
there were 366 million people with diabetes worldwide in 2011 (183
million of these were undiagnosed), said Prof Ian Campbell of the
Bute School of Medicine at St Andrews University in Scotland. He
was speaking to a special meeting to create greater awareness about
diabetes among healthcare professionals.
The conservative South African estimate is that 6.5% of adults aged
20-79 years have diabetes, but age-adjusted prevalence of up to 13%
have been described in urban populations as far back as 1994. The
effects of urbanisation and an unhealthy lifestyle are important contributors to the rising prevalence of obesity and diabetes. The 2003
Demographic and Health Survey showed that 30% of South Africans
are overweight or obese.
Goal of diabetes management and self-care
The primary goal of diabetes management is to improve and maintain
the quality of life for the person with diabetes. Successful management of diabetes can be achieved through the individualised adjustment of diet, exercise and medication. Successful self-care can be
attained through patient participation in individualised education programmes, using a multidisciplinary team approach wherein the person
with diabetes holds the central position.
The goal of self-care can be accomplished by improving the necessary patient knowledge and skills, and by facilitating changes in attitudes, values and beliefs. Just as people with diabetes change with
time and experience, so does diabetes care change and improve.
Diabetes education
Regular assessment and adjustment of the education plan will be
needed to encourage patients to achieve and maintain optimum quality of life. Diabetes education is vital to the management of diabetes. It
is integral to effective self-care, and has been shown to be effective in
decreasing the complications in both the short and long term. Diabetes
education is preventative in nature and associated with significant cost
benefit when delivered in an effective manner, noted Prof Campbell.
Caregivers of people with diabetes seek out professional assistance
to help their family member with good diabetes management, such as
the correct monitoring of blood glucose levels and consuming a healthy
diet, and therefore play a key role in supporting their loved ones in
managing their condition.
The future
It is estimated that by 2030, 552 million people will have diabetes.
Developing countries such as SA are going to experience a massive
increase in the numbers of people with diabetes. Since the complications of diabetes are preventable with good diabetes control by a multidisciplinary team, it is essential that healthcare providers empower their
patients with the knowledge required to take care of their own diabetes
as they are the centre of the team.
Self-monitoring of blood glucose and adherence to medication
are vital components of diabetes care, especially in those taking insulin, said Dr Joel Dave, chairman of the Society for Endocrinology,
Metabolism and Diabetes of South Africa (SEMDSA).
“Diabetes is a chronic, manageable condition which requires major
changes in lifestyle to optimise its management. Motivating behaviour
change in diabetic patients is one of the most important, but also more
frustrating experiences for general practitioners.”
The link between urbanisation, sedentary lifestyles, unhealthy eating and rising levels of obesity and type 2 diabetes (T2DM) has been
demontrated universally, and effective prevention of obesity and
s
T2DM requires a paradigm shift from a patient-centred approach to
a ‘whole of government’ and a ‘whole of society’ approach, hence
government and non-government departments need to join forces in
preventing and combating diabetes, concluded Dr Dave.? SF
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November 2013 | The Specialist Forum