Diabetes Management and Education

This assignment covers a range of topics related to diabetes management and education, including the management of hypoglycemia during treatment, assessment of national diabetes education programs, and digital health interventions for adults with type 2 diabetes. It also discusses patient perspectives on diabetes self-management education and support, as well as strategies for improving glycemic control in patients with diabetes.

Running head: PATIENT EDUCATION
PATIENT EDUCATION
Name of the student:
Name of the university:
Author note:

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PATIENT EDUCATION
Patient education is the procedure by which healthcare professionals and others impart
health related information to patients and their caregivers. This is helpful in altering the health
behaviors of the patients and family members that thereby help in improving their health status.
Patient education is an individualized, structured and systematic process that helps in proper
assessment and imparting of knowledge regarding health of the patients1. This helps the patient
in being careful about their activities and help in development of skills that will help to modify
the incorrect habits and bring out changes in behaviors. The main goal of patient education is to
increase comprehension as well as participation in proper self-management strategies and health
care needs2. The following assignment will show how patient education is important in ensuring
good health of patients. It will also show the procedure by which healthcare education is given to
patients.
1 Powers, M.A., Bardsley, J., Cypress, M., Duker, P., Funnell, M.M., Fischl, A.H., Maryniuk,
M.D., Siminerio, L. and Vivian, E., 2015. Diabetes self-management education and support in
type 2 diabetes: a joint position statement of the American Diabetes Association, the American
Association of Diabetes Educators, and the Academy of Nutrition and Dietetics. Journal of the
Academy of Nutrition and Dietetics, 115(8), pp.1323-1334.
2 Coppola, A., Sasso, L., Bagnasco, A., Giustina, A. and Gazzaruso, C., 2016. The role of patient
education in the prevention and management of type 2 diabetes: an overview. Endocrine, 53(1),
pp.18-27.

2
PATIENT EDUCATION
Situation, importance of client education and aim of the patient education:
An old woman was admitted to the hospital after she faced a fall. She was not hurt as she
had the fall on her bed. She was lying on the bed after her meal. She was about to step off the
bed when she felt uneasy and fell on the bed with her back. Immediately, her son and daughter in
law admitted her to the healthcare center. It was diagnosed that she had an insulin shock.
Although, she was safe in the healthcare center after treatment, it could have resulted her more
suffering if she had this fall elsewhere like in garden, stairs or floors. It was also noticed that she
had no knowledge about her disorder and did not know why he she was taking medicines and
insulin injections. She had grown old and tends to forget her medicines or takes them more than
once. For these reasons, on the day of the accident, the patient had taken insulin twice - once
before and once after the meal. This had resulted in overdose of insulin and excessive decrease in
sugar level in blood. This affected her physiological systems. Therefore, it was necessary to
teach her and her family caregiver about the disorder, ways it affects human beings, issues it may
cause and ways to overcome the issues with proper medication. Dosing is very important which
is not followed properly, can lead to detrimental errors3. Therefore, the main aim of the health
education plan is to make the patient understand the disorder in details and teach her the correct
3 Inzucchi, S.E., Bergenstal, R.M., Buse, J.B., Diamant, M., Ferrannini, E., Nauck, M., Peters,
A.L., Tsapas, A., Wender, R. and Matthews, D.R., 2015. Management of hyperglycemia in type
2 diabetes, 2015: a patient-centered approach: update to a position statement of the American
Diabetes Association and the European Association for the Study of Diabetes. Diabetes
care, 38(1), pp.140-149.

3
PATIENT EDUCATION
medication intake so that insulin shock or high blood sugar level due to forgetting of medication
do not take place.
Scope of practice and initiatives to develop a plan for proper health education:
Scope of practice can be defined as the procedure, processes as well as actions that every
health care professional are permitted to undertake for the safety care of patients. This should
follow the proper guidelines, laws, and boundaries of their professional license. Every healthcare
professional should follow a particular procedure that in order to provide proper patient
education 4.
The first step is called the proper assessment of the learning needs of the patient. It is
important for the healthcare professionals to assess the learning needs, style of learning and
readiness of the patient to learn. This would include what the patient already knows what they
want to or need to learn. They should also have the idea about what the patients are capable of
learning. The nurse should also develop the knowledge about the best ways by which they can
educate the patients. Proper open-ended questions can be asked in the interviews. This will help
the caregiver to know the lifestyle of the patient and would help in assessing her needs5.
4 Chrvala, C.A., Sherr, D. and Lipman, R.D., 2016. Diabetes self-management education for
adults with type 2 diabetes mellitus: a systematic review of the effect on glycemic
control. Patient education and counseling, 99(6), pp.926-943.
5 Bell, K.J., Smart, C.E., Steil, G.M., Brand-Miller, J.C., King, B. and Wolpert, H.A., 2015.
Impact of fat, protein, and glycemic index on postprandial glucose control in type 1 diabetes:
implications for intensive diabetes management in the continuous glucose monitoring
era. Diabetes Care, 38(6), pp.1008-1015.

4
PATIENT EDUCATION
Moreover, the nurse should also ask question to identify the patient’s learning style so that she
can correctly develop the teaching strategies as closely as possible for the patient’s preferred
style. Questions for patient’s readiness to learn should be also known.
The next step would be developing the learning objectives. The healthcare professionals
should be able to define the outcomes that she herself and the patient are expecting from the
teaching learning procedures. Learning objectives are very different from learning goals, as they
are not general and long-term. Rather they are specific, attainable, measurable and short term. In
case of the patient noted, an example can be provided6. The learning goal of the patient would be
to make her learn how to maintain the blood sugar levels between 70 and 150 mg/dl at all times
of the day. However, reaching to such goals will never be successful until the patient develops
learning objectives that will help him to achieve the goal. The patient in such situation should set
objectives like where she would be able to state five symptoms of hypoglycemia after the
completion of program by the time of discharge. She should understand linking her medications
with her physical conditions by the need of education proper discharge and similar others.
The next important step would be planning and implementing teaching. The teaching
plan will have a number of aspects. The teaching plan will be based on when the teaching would
be conducted. This would include the length of hospital stay or the number of home health visits
6 Cryer, P.E., 2016. Management of hypoglycemia during treatment of diabetes
mellitus. UpToDate, Waltham, MA.(Accessed on March 25th, 2014.) Retrieved from http://www.
uptodate. com/contents/management-of-hypoglycemia-during-treatment-of-diabetes-mellitus.

5
PATIENT EDUCATION
available in the patient’s account7. The plan will also state when the teaching will be conducted
which would be based on the patient’s comfort and her privacy. The healthcare professional
would also plan the ways by which she would teach. This would involve different teaching
methods like one on one sessions, small group discussions, and demonstrations and return
demonstrations, role playing, programmed instruction and games. The different teaching
materials would be using of models, pamphlets and brochures, posters and flip charts,
transparencies, audiocassettes, computer assisted instructions and internet CDS, videos and
closed circuit televisions and many others8. These are the best resources and tools which will
bring put positive outcomes.
The next step would be evaluating teaching and learning procedures adapted by the
professional and the patient. This is the last phase of the teaching procedures. This is mainly an
ongoing appraisal of the learning progress of the patient during and after the education. This step
7 Inzucchi, S.E., Bergenstal, R.M., Buse, J.B., Diamant, M., Ferrannini, E., Nauck, M., Peters,
A.L., Tsapas, A., Wender, R. and Matthews, D.R., 2015. Management of hyperglycaemia in type
2 diabetes, 2015: a patient-centred approach. Update to a position statement of the American
Diabetes Association and the European Association for the Study of
Diabetes. Diabetologia, 58(3), pp.429-442.
8 Pal, K., Dack, C., Ross, J., Michie, S., May, C., Stevenson, F., Farmer, A., Yardley, L.,
Barnard, M. and Murray, E., 2018. Digital Health Interventions for Adults With Type 2
Diabetes: Qualitative Study of Patient Perspectives on Diabetes Self-Management Education and
Support. Journal of Medical Internet Research, 20(2), p.e40.

6
PATIENT EDUCATION
mainly helps to evaluate if the patient has successfully learnt what had been taught to them. This
would be done by maintaining a proper checklist which the healthcare sector had prepared for
evaluating the patients health literacy skills. This may vary from one to another healthcare
center. The nurse will need to observe return demonstrations of what the patients had learnt
regarding the necessary skills9. The patient can be asked to restate the instructions in their own
words. The patient should be confirmed whether she needs more training in any area. Simple
questionnaires of education on diabetes can be asked to the patient to develop ideas about her
knowledge. The patient can be also taken in practical sessions where the professional can review
her own record of self-monitored glucose levels in blood, how she injects insulin, how she
schedules her timings for medication and others. If any reminder apps are advised, the educator
would also check whether she is able to use the app successfully or not.
Content of the teaching session:
Some of the important points that should be inculcated in the teaching sessions should be
jotted down prior to the development of education tools and resources for the patient. The patient
was seen not to have any ideas about the entire disorder of diabetes and therefore large amount
of information should be provided to patients10. The content should contain material that would
9 Devchand, R., Nicols, C., Gallivan, J.M., Tiktin, M., Krause‐Steinrauf, H., Larkin, M. and
Tuncer, D.M., 2017. Assessment of a National Diabetes Education Program diabetes
management booklet: The GRADE experience. Journal of the American Association of Nurse
Practitioners, 29(5), pp.255-263.
10 Rosland, A.M., Kieffer, E., Spencer, M., Sinco, B., Palmisano, G., Valerio, M., Nicklett, E.
and Heisler, M., 2015. Do pre-existing diabetes social support or depressive symptoms influence

7
PATIENT EDUCATION
help the students to understand exactly about the disorder of diabetes and the procedure by which
this disorder affects the physiological system of the body. Secondly, it should contain
information about the ways of working o medicines for diabetes. The education plan would also
contain ways by which the patient would be able to educate themselves about the types of food
he would take and how meals should be planned. It would also contain suggestion charts, apps as
well as other tools that would help in providing reminders and helping in tracking progress. It
would also provide ways about how the patient could handle stress and solve different problems
arising from diabetes treatment. She should be educated about oral medication like metformin
and insulin injections as she is to pursue combined dose of oral medication and insulin.
Community services required for the patient:
 Social care worker helping her with her daily activities until she gets fit
 Weekly monitoring sessions held by communities where overall health can be checked
 Community workshops for lifestyle management 11
 Weight and diet management sessions as obesity has associations with diabetes
 Regular checkups by GP
Documentations:
the effectiveness of a diabetes management intervention?. Patient education and
counseling, 98(11), pp.1402-1409.
11 Xiang, Y., Luo, P., Cai, X., Tang, Y. and Wu, Z., 2017. results of a pilot study of patient-to-
patient education strategy on self-management among glycemic uncontrolled patients with
diabetes. Patient preference and adherence, 11, p.787.

8
PATIENT EDUCATION
Documentation is very important as it helps in meeting purposes like communicating
patients’ progress across all team members, maintain continuity of care, prevent duplication of
teaching, serving of evidences of fulfillment of teaching requirement according to policies and
procedures and others. It can be done in flowcharts, checklists, care plans, traditional progress
notes and many others. The document would contain:
 Readiness of the patient to learn and patient’s preferred learning style.
 Learning needs of the patient
 Information and skills that are taught
 Patient’s current idea and knowledge about her condition and healthcare managements
 Learning objectives and goals set by the patient and professional 12
 Teaching methods that had been used
 Evaluation results.
Conclusion:
When a nurse follows these procedures of educating patients in a planned manner, she or
he can provide the safest care to the patients ensuring that the patient leads better quality life.
Every nursing professional should try to learn and apply proper steps for educating patients.
Patients with health literacy show better quality lives than those who do not have proper health
literacy.
12 Sohal, T., Sohal, P., King-Shier, K.M. and Khan, N.A., 2015. Barriers and facilitators for type-
2 diabetes management in South Asians: a systematic review. PloS one, 10(9), p.e0136202.

9
PATIENT EDUCATION
References:
Bell, K.J., Smart, C.E., Steil, G.M., Brand-Miller, J.C., King, B. and Wolpert, H.A., 2015.
Impact of fat, protein, and glycemic index on postprandial glucose control in type 1 diabetes:

10
PATIENT EDUCATION
implications for intensive diabetes management in the continuous glucose monitoring
era. Diabetes Care, 38(6), pp.1008-1015.
Chrvala, C.A., Sherr, D. and Lipman, R.D., 2016. Diabetes self-management education for adults
with type 2 diabetes mellitus: a systematic review of the effect on glycemic control. Patient
education and counseling, 99(6), pp.926-943.
Coppola, A., Sasso, L., Bagnasco, A., Giustina, A. and Gazzaruso, C., 2016. The role of patient
education in the prevention and management of type 2 diabetes: an overview. Endocrine, 53(1),
pp.18-27.
Cryer, P.E., 2016. Management of hypoglycemia during treatment of diabetes
mellitus. UpToDate, Waltham, MA.(Accessed on March 25th, 2014.) Retrieved from http://www.
uptodate. com/contents/management-of-hypoglycemia-during-treatment-of-diabetes-mellitus.
Devchand, R., Nicols, C., Gallivan, J.M., Tiktin, M., Krause‐Steinrauf, H., Larkin, M. and
Tuncer, D.M., 2017. Assessment of a National Diabetes Education Program diabetes
management booklet: The GRADE experience. Journal of the American Association of Nurse
Practitioners, 29(5), pp.255-263.
Inzucchi, S.E., Bergenstal, R.M., Buse, J.B., Diamant, M., Ferrannini, E., Nauck, M., Peters,
A.L., Tsapas, A., Wender, R. and Matthews, D.R., 2015. Management of hyperglycemia in type
2 diabetes, 2015: a patient-centered approach: update to a position statement of the American
Diabetes Association and the European Association for the Study of Diabetes. Diabetes
care, 38(1), pp.140-149.

11
PATIENT EDUCATION
Inzucchi, S.E., Bergenstal, R.M., Buse, J.B., Diamant, M., Ferrannini, E., Nauck, M., Peters,
A.L., Tsapas, A., Wender, R. and Matthews, D.R., 2015. Management of hyperglycaemia in type
2 diabetes, 2015: a patient-centred approach. Update to a position statement of the American
Diabetes Association and the European Association for the Study of
Diabetes. Diabetologia, 58(3), pp.429-442.
Pal, K., Dack, C., Ross, J., Michie, S., May, C., Stevenson, F., Farmer, A., Yardley, L., Barnard,
M. and Murray, E., 2018. Digital Health Interventions for Adults With Type 2 Diabetes:
Qualitative Study of Patient Perspectives on Diabetes Self-Management Education and
Support. Journal of Medical Internet Research, 20(2), p.e40.
Powers, M.A., Bardsley, J., Cypress, M., Duker, P., Funnell, M.M., Fischl, A.H., Maryniuk,
M.D., Siminerio, L. and Vivian, E., 2015. Diabetes self-management education and support in
type 2 diabetes: a joint position statement of the American Diabetes Association, the American
Association of Diabetes Educators, and the Academy of Nutrition and Dietetics. Journal of the
Academy of Nutrition and Dietetics, 115(8), pp.1323-1334.
Rosland, A.M., Kieffer, E., Spencer, M., Sinco, B., Palmisano, G., Valerio, M., Nicklett, E. and
Heisler, M., 2015. Do pre-existing diabetes social support or depressive symptoms influence the
effectiveness of a diabetes management intervention?. Patient education and counseling, 98(11),
pp.1402-1409.
Sohal, T., Sohal, P., King-Shier, K.M. and Khan, N.A., 2015. Barriers and facilitators for type-2
diabetes management in South Asians: a systematic review. PloS one, 10(9), p.e0136202.

12
PATIENT EDUCATION
Xiang, Y., Luo, P., Cai, X., Tang, Y. and Wu, Z., 2017. results of a pilot study of patient-to-
patient education strategy on self-management among glycemic uncontrolled patients with
diabetes. Patient preference and adherence, 11, p.787.