Diabetes Management and Insulin Administration
Summary of Teaching Plan
In recent years, an increase in demand for expansion of education programs for diabetes patients as also for Federal Government or third party payers to support these programs has been observed. A survey by Veterans Administration Hospital conducted a survey to evaluate the capability of patient for diabetes management reported lack of formal training in over 35% of patients interviewed (Miller, Goldstein & Nicolaisen, 1978, p. 275). Therefore, some recommendations for training patients to administer insulin therapy, which reflect best practices, are as follows:
• The therapy should be initiated after a thorough patient assessment, including numeracy skills and health literacy. Therapy initiation should be followed by follow-up phone calls.
• Treatment adherence should be measured during follow-up visits to recognize adherence issues, changing barriers or other problems due to poor recall of instructions etc. Injection practice should also be observed and re-trained, if required.
• They should be well-instructed about the site rotation and its importance; also sites inspection is crucial for any signs of lipohypertrophy or lipoatrophy during all follow-up visits.
• Appropriate language should be used while teaching injection technique avoiding terms like "spearing" or "throwing a dart." Moreover, psychological discomfort can be reduced by minimizing delay in injecting.
• Dose should be prepared by insulin inspection, manufacturer's directions for rolling to suspend insulin and evading air bubbles.
• Insulin-mixing should follow the prescription laid down by American Diabetes Association.
• Different creative strategies in insulin storage like applying colored dots or rubber bands, or colored vial sleeves to insulin vials, may be helpful in avoiding patient's confusion about different insulin types.
• Risk stratification table can be used to identify patient's target blood glucose level.
• Vials unused needs to be refrigerated. Recapping is critical while reusing the needles, while needles should be removed in extreme climates (Siminerio et al., 2011, pp. 5-6).
Epidemiological rationale
Timely intervention and delay or evasion of development of type 2 diabetes proves enormously beneficent for patients, in terms of improving their quality of life and increasing life expectancy; and possibly for health-care payers and society in economic terms. The International Diabetes Federation (IDF) Taskforce organized a consensus workshop in 2006 on Epidemiology and Prevention of diabetes. The resulting consensus paper launched in Barcelona in April 2007 at the 2nd International Congress on Prediabetes and the Metabolic Syndrome, published in Diabetic Medicine in the May 2007 issue, reflected significant changes in the health of a...
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