The interpersonal communication skills of the Diabetes Educator are the essential tools in empowering people with diabetes to better self-manage their condition. Supporting a person to better manage their diabetes is a complex process, and involves the educational, emotional, social and behavioural domains. The early stages of care are critical for the person with diabetes in setting in place positive habits in self-care and in accessing health care.
The purpose of this task is for students to apply the complex processes of the empowerment approach for people with diabetes in clinical practice.
You will be provided with a Case Study on a person newly diagnosed with diabetes. You are required to analyse the Case Study using the questions provided to submit a report in the format of an essay.
Diabetes Self-Management Support 1:
Jack is a 64-year-old man of Lebanese background and owns and runs a grocery shop. He visits his doctor only when he has a health problem. Jack’s daily routine is to drive to work where he serves people in his shop and then returns home to watch TV with his wife Margaret. Margaret is a homemaker and loves to cook for her family. All their children are now married and have left home. Margaret has urged Jack to get a check-up from the family doctor as she was concerned about his health. He has put on weight over the last few years and is increasingly breathless when he walks up the stairs of their home. Jack attributes his breathlessness to his smoking (he has smoked since he was 19 years) and recent weight gain -he now weighs 99 kg and stands at 173 cms. He made an appointment and saw Dr Cummings, his longstanding GP, who did the general check-up of bloods, BP and ECG.
A few days later Jack returns to get his results- most of which are normal except his fasting blood glucose level which is 7mmols/L and his HbA1c is 9. 9%. Dr Cummings said he has Type 2 Diabetes and said Jack will need to start tablets straight away. Jack is commenced on Metformin 500mg once a day initially and will progress to two. He is advised to lose at least 5% of his total weight, and exercise regularly (up to 30-60 minutes per day). Dr Cummings said that if he looks after himself now and keeps his blood glucose controlled it will stop him from having diabetes related complications in the future. Dr Cummings told Jack the type of complications he might get if he doesn’t look after himself and his glucose levels.
Though not normally demonstrative, Jack was quite upset with the diagnosis stating he ‘didn’t want to go on injections’. Dr Cummings reassured him he will be alright and that he won’t have to go on insulin now and there are making huge advances in the treatment for diabetes especially in terms of choice of oral medication. Dr Cummings told Jack the Metformin may upset his stomach so take tablets during or after meals. Jack is not sure even wants to take the Metformin either as he often forgets to take his medications.
Dr Cummings also told Jack that he will need to come back regularly for 3-6 monthly blood tests for HbA1c as this will give Dr Cummings an idea how Jack is doing and he can then adjust his medications (in accordance with the RACPG guidelines). Dr Cummings told Jack that Medicare will give him five free visits per year to other health professionals so that Jack could be further educated, and supported in managing his diabetes. Dr Cummings recommended that Jack see a Diabetes Educator and Dietitian to begin with.
You are one of the five health professionals Jack has elected to see (Diabetes Educator/Nurse, Dietitian, Podiatrist, Pharmacist, Exercise Physiologist).