Diabetes Care: A Person/Family-Centered and Holistic Approach

This essay discusses person-centered and family-centered care for diabetes management. It explores the importance of a healthy diet, regular exercise, and self-care education. It also emphasizes the significance of regular check-ups and monitoring glucose levels for diabetic patients. The essay applies the Dahlgren and Whitehead model to suggest solutions to a case scenario of a 32-year-old Afro-Caribbean woman with type 2 diabetes mellitus.

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DIABETES CARE
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Introduction
Person-centered care is where the caregivers allow the client to assume an active role in
their medical treatment (Entwistle, and Watt, 2013). However, family-centered care is when the
caregivers involve the relatives of the patient in decision-making towards the health and well-
being of the patient (Rose et al., 2017). Person-centered care and Family-centered care coexist
and depend on one another for holistic function. The case scenario presents a 32-year-old Afro-
Caribbean woman who has type 2 diabetes mellitus. Anne Baptiste is showing non-proliferative
diabetic retinopathy signs. The diabetic condition has made the patient experience
microaneurysms. Additionally, Anne complains about blurred vision in her right and left the eye.
The patient also suffers from bilateral neovascularisation. The diabetic interference with visual
acuity prevents the client from performing her work-related duties. She is unable to read the
dentist notes at work. This essay will critically appraise an article that discusses care towards
diabetes. It will also apply the Dahlgren and Whitehead model to suggest solutions to Anne's
situation.
Critical Appraisal of the Article
According to Aveyard, Sharp, and Woolliams (2011), the six questions for critical
thinking are where, what, how, who, when, and why. The article is assessed through a systematic
research. The researcher, Jean Maydalyne Gumbs found out that, African-American women with
diabetes mellitus do not embrace self-care behaviors and self-management education. Gumbs,
(2012), arrived at the conclusion after a conclusive research. Jean Gumbs, who is a PhD
graduate, wrote the article in the year 2012. The author wrote the article to enlighten the diabetic
African-American women about the essence of self-care behaviors and self-management
education.

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Person/Family-Centered and Holistic Approach
One of the individual factors in the Dahlgren and Whitehead Model is diet. Therefore, the
first approach of decreasing the severity of diabetes is to ensure that the patient takes a healthy
diet (Gumbs, 2012). The family should seek the help of an experienced dietitian to suggest the
appropriate meals to the patient. The foods consumed by diabetic patients should maintain the
level of blood sugar at the acceptable limits. The diet should also achieve a lipoprotein and a
lipid profile that decreases the chances of getting vascular complications. In the case scenario,
Anne admits that she is struggling to maintain the diet recommended by her dietitian. A key
nutritional recommendation for diabetic patients involves adjusting the doses of insulin to match
the intake of carbohydrates. The patient should also ensure that she maintains the level of
carbohydrate intake on a daily basis. Excessive carbohydrate intake worsens the symptoms of the
complication insulin resistance. The client should increase her fiber intake and limit taking meals
having trans-fats. Taking fatty foods can lead to obesity which is a risk factor for diabetes
(Micha et al., 2017). The family members should monitor Anne to ensure that she lowers both
sodium and cholesterol intakes per day. On the other hand, the patient should increase her
consumption of vegetables, fruits, legumes, and lean meats which lower the symptoms of
diabetes.
According to the model by Dahlgren and Whitehead (2006), a sedentary lifestyle is a risk
factor for complications like diabetes. Therefore, Ann should conduct a regular physical exercise
to reduce the severity of complications like blurred vision. Physical activity controls diabetes and
maintains the levels of blood sugar at acceptable limits (Hansen et al., 2018). Furthermore,
managing the amounts of blood glucose prevent long-term complications like kidney diseases

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and nerve pains. When an individual is conducting the physical exercise, the muscles rely on the
blood glucose for the provision of energy. Therefore, the conversion of glucose to energy lowers
the levels in circulation. Exercise also improves the effectiveness of insulin thereby reducing
insulin resistance. Physical activity also assists an individual in maintaining the amounts of good
cholesterol in blood circulation (Duignan, and Duignan, 2017). Exercise helps a diabetic
individual to relieve stress and lower the levels glucose in blood circulation. Physical exercise
also strengthens the bones, muscles, and the heart. An individual who exercises regularly
develops an improved mood and quality sleep. Physical activity also decreases the blood
pressure of a diabetic patient.
The family members should urge Anne to visit the caregivers regularly for check-ups and
follow-up care. In the case scenario, Anne admits that she does not check her blood glucose
levels due to her busy schedule and forgetfulness. After being diagnosed with non-proliferative
diabetic retinopathy (NPDR), the client failed to visit the diabetic consultant for the second time.
Her failure to honor the specialist's appointment worsened her condition. Initially, the patient had
complications in the right eye, but failure to visit the doctor regularly led to vision difficulty in
the left eye. After NPDR and Proliferative retinopathy diagnoses, the patient failed to visit the
diabetic specialist for follow-up. The failure to visit the caregiver further complicated her
situation as she encountered bilateral neovascularisation. Visiting the caregiver for monitoring
prevents the severity of diabetic signs and symptoms. The caregiver can recommend a healthy
diet that decreases the severity of the complications (Ley et al., 2016). The care provider can also
prescribe drugs that prevent the progression of the NPDR. The husband and the daughter of
Anne should encourage her to visit the specialists for follow-ups. Additionally, the relatives
should accompany the patient to the various health facilities.

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The patient should also monitor her glucose level to maintain it at the normal range. The
health specialists should train the patient on how to control her sugar levels (Schnell et al., 2017).
The health facility should provide the equipment for monitoring diabetes. The family members
should ensure that the patient checks her blood glucose levels on a daily basis. After reviewing
the standards, the patient should take appropriate actions to bring the sugar levels to the normal
range. The remedies include exercising, proper diet among other solutions. Adequate
implementation of the remedies leads to a drop in the HbA1C in the blood. Recent research has
shown that a 1% decline in HbA1C has numerous advantages to diabetic patients. Firstly, the
reduction leads to a 40% decrease in diabetic complications like cardiovascular diseases. In the
case scenario, the patient complains of bilateral neovascularisation which can decline with the
reduction of blood glucose. The decrease in HbA1C also leads to a 90% reduction in diabetic
retinopathy that leads to blindness. The patient has blurred vision in both eyes which can reduce
with a decrease in HbA1C levels. The decline in the levels of HbA1C by 1% also reduces renal
and vascular diseases by 50% and 40% respectively. The reduction in sugar levels also lowers
the mortalities from vascular complications by 40%.
Self-care Management training of diabetic patients is another person-centered care
towards the complication. The family members of diabetic patients should urge the patients to
seek self-care education to reduce the severity of the difficulty. A recent study has indicated that
support and training towards diabetic patients are cost-effective as it decreases hospital
admissions (Powers et al., 2017). Self-management education also reduces the amounts of
hospital readmissions. Patients who attend the education sessions always learn about the
appropriate lifestyles to manage their condition. Such patients tend to adopt a healthy eating
pattern which prevents the emergence of risk factors like obesity. An informed diabetes client

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knows the benefits of regular exercises. Therefore, the education on self-care makes the patients
conduct daily physical activities. The management education also empowers the patients and
enhances their self-efficacy. An enlightened diabetes patient can adopt a healthy coping with the
condition. The training on diabetes management also enables patients to avoid stress due to the
complication. Depression is a mental complication that can affect the diabetic patients without
proper education on self-care management.
Diabetic patients should attend both regular dilated eye and annual foot check-ups to
prevent the emergence of other complications. In the case scenario, Anne admits that she finds it
hard to read dentist notes. Her daughter should encourage her to go for the tests to improve her
visual acuity. Diabetes mellitus causes blindness to the adults in the US. Therefore, the purpose
of the examinations is to detect possible blindness and look for appropriate interventions.
Regular eye tests for diabetic patients decreases the chances of developing diabetes-related
blindness (Fisher et al., 2016). Anne developed proliferative retinopathy due to lack of dilated
eye examination. Annual examination of the foot is an essential exercise for diabetic patients.
The test enables the caregiver and the patient to pinpoint high-risk conditions of the foot (Pop-
Busui et al., 2017). The test should involve the checking of foot components like skin integrity,
vascular status, and foot structure. Individuals with numerous foot conditions require a periodic
examination and evaluation. Foot complications can prevent diabetic patients from having an
efficient movement.
Conclusion
Diabetic patients deserve person/family-centered care as a holistic approach to decreasing
the severity of the complication. The patients should take a healthy diet to manage the severity of
signs and symptoms. The patient should take an elevated amount of fruits and vegetable and

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reduce the intake of carbohydrate-rich foods. The client should also conduct a regular physical
exercise. The exercise has numerous benefits that include reducing the levels of blood sugar and
increasing the levels of good cholesterol. The patient should visit the caregivers regularly for the
check-up and follow-up care. The caregivers can prescribe appropriate medications and advice
the patient on the proper diet. The diabetic client should also monitor glucose levels. Afterward,
the patient should take appropriate remedies to reduce the glucose levels to the normal range.
The clients should also attend self-care education on managing diabetes. Finally, annual foot and
eye examination are necessary for the patients.

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References
Aveyard, H., Sharp, P. and Woolliams, M., 2011. A beginner's guide to critical thinking and
writing in health and social care. McGraw-Hill Education (UK).
Duignan, M. and Duignan, O., 2017. Physical activity: is it time for emergency department
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Entwistle, V.A. and Watt, I.S., 2013. Treating patients as persons: a capabilities approach to
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Fisher, M.D., Rajput, Y., Gu, T., Singer, J.R., Marshall, A.R., Ryu, S., Barron, J. and MacLean,
C., 2016. Evaluating adherence to dilated eye examination recommendations among patients
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Gumbs, J.M., 2012. The relationship between diabetes self-management education and self-care
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EXPERT working group. Sports Medicine, pp.1-17.

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Ley, S.H., Ardisson Korat, A.V., Sun, Q., Tobias, D.K., Zhang, C., Qi, L., Willett, W.C.,
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