University Report: Diabetes Self-Management Education for New Clients

This report focuses on developing a learning plan for diabetes self-management education (DSME) for a newly diagnosed patient with Type 2 Diabetes (T2D). The report uses a case study approach, assessing a 22-year-old college student, Mr. Y, to understand his health needs and concerns. It utilizes Gordon's Functional Health Patterns to evaluate the client's holistic health. The learning plan emphasizes the importance of DSME in improving health outcomes, addressing patient's knowledge gaps, and providing support for self-management. The plan incorporates interactive teaching strategies, including the use of information and communication technology (ICT), and focuses on key areas such as health eating, physical activity, and blood sugar monitoring. The report also discusses the importance of psychosocial support and motivational interviewing to promote patient engagement and adherence to the self-management plan. The conclusion reflects on the educational session conducted, highlighting the importance of a holistic approach and the need to address potential barriers to care.

Running head: DIABETES SELF MANAGEMENT EDUCATION
Health promotion
Name of the student:
Name of the University:
Author’s note

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Table of Contents
Introduction:....................................................................................................................................2
Learning plan for diabetes self-management in recently diagnosed client......................................2
Overview of the client and implications of the disease on the future health of the person:........2
Assessment of client’s health:.....................................................................................................3
Learning plan for management of diabetes:................................................................................4
Conclusion.......................................................................................................................................6
References:......................................................................................................................................7

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Learning plan for diabetes self-management education in newly diagnosed patient
Introduction:
The main purpose of this report is to develop a learning plan on overall management of
diabetes for a newly diagnosed client with Type 2 Diabetes (T2D). To prepare an effective
learning plan for this, a client from the community will be used to assess his holistic health care
pattern. The Gordon’s Functional Health Pattern will be used to identify holistic health needs of
the client and a health promotion plan will be developed based on client’s expressed desire to
learn about type 2 diabetes. The main rationale for selecting learning needs of newly diagnosed
diabetes patient is that diabetes is the most chronic disease and recently diagnosed patients often
lack the knowledge about the disease leading to frustration and stress (Gardsten et al., 2018).
Hence, it would be beneficial to learn about the challenges faced by this people and increase
their abilities to mobilize their own strength. The paper will first give an overview of the client
and then engage in development of a plan to manage the issue.
Learning plan for diabetes self-management in recently diagnosed client
Overview of the client and implications of the disease on the future health of the person:
The client for whom the assessment is completed is Mr. Y, who is twenty two year
college student recently diagnosed with T2D. Currently, Mr. Y seems very distressed by the new
diagnosis and he is very confused about how to deal with the disease. He feels reluctant to take
any help from this friends or parents too. Before conducting the assessment on patient to know
his learning needs, understanding the implication of T2D diagnosis on his future health is
important. T2D is a chronic disease condition that affects the way the human body metabolizes
glucose, an important source of fuel for the body. It either impairs the effect or function of

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insulin on the human body or it affects the way insulin is produced for the maintenance of
normal glucose levels (Chaudhury et al., 2017). Unless and until Mr. X learns to self-manage the
disease, he is at risk of other complications too. This is said because T2D will damage his small
and large blood vessels which can increase the risk of other disease conditions such as heart
attack, stroke, kidney problem, eye problem like retinopathy and nerve problem like diabetes
nephropathy (Government of Canada, 2018). Pecoits-Filho et al. (2016) supports that diabetic
kidney disease is one of the most frequent complications of T2D which affects about one-third of
the patients. According to the World Health Organization (2018) report, the global prevalence of
diabetes is increasing and it is the major cause behind blindness, kidney failure, heart attack and
lower limp or foot amputation. In 2016, diabetes was the reason behind 1.6 million deaths. As
health diet, physical activity and maintaining normal body weight is vital to manage the disease,
identifying health education strategy to increase knowledge and self-management of T2D for Mr.
X is important.
Assessment of client’s health:
To understand overall effect of T2D diagnosis on Mr. X health outcome, assessment has
been completed using Gordon’s functional health assessment patterns. The significance of this
framework is that it helps to evaluate an individual perception or impact of any disease by 11
categories of health patterns. These 11 health patterns include health perception, nutritional,
elimination, activity, cognitive, sleep, role, self-perception, coping, sexuality and value (Mahnaz,
Shahin & Shahdoust, 2019). Current Mr. X’s health perception about diabetes is low and he is
not consuming adequate diet for the management of his blood sugar level. Due to emotional
burden, he has stopped engaging in recreational activities. As currently he has very low self-
esteem due to lack of knowledge about T2D and effective ways to self-manage it at home, there

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is a need to identify best method to increase his knowledge about overall management of
diabetes in accordance with his age and learning needs. The functional health pattern that is
important for newly diagnosed patient includes nutritional patterns, activity patterns and coping-
stress tolerance pattern. The learning plan will be developed focusing on this pattern.
Learning plan for management of diabetes:
Based on Mr. X’s health pattern assessment, the most important health needs for him is
that he lacks proper knowledge about T2D and the way to self-manage the disease on his own. In
his learning plan, self-management education will be prioritized and all support will be given to
him to ensure that he could adopt all behavior needed to improve health outcomes. According to
Chrvala, Sherr and Lipman, (2016)., Diabetes Self-management education (DSME) and support
provides the foundation to enable people with diabetes to navigate their decisions and activities
for better health outcomes. It is the process of building knowledge and skills necessary for
diabetes self-care. While designing the learning plan, it is important to address current health
beliefs, cultural needs, emotional concerns, health literacy and other factors that could influence
Mr. X’s ability to meet the challenges of self-management. The educational plan differs for a
recently diagnosed diabetes patient compared to more experienced T2D patient. As Mr. X is
overwhelmed with feelings of uncertainty and confusion, he needs to absorb a large amount of
information and develop skills to manage blood glucose level on a day to basis (Gardsten et al.,
2018). Hence, it is necessary to provide learning in a way that is easily understood and grasped.
The review of research literature related to the type of education given to T2D patient
with diabetes suggests that understanding patient’s perspective and working in a mutual way is
important to encourage patients during self-management. Empathetic and individual ongoing
support is also crucial to inspire Mr. X to self-manage the disease and develop the perception

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that the disease is controllable (Powers et al., 2016). This is supported by Gardsten et al. (2018)
too as the authors argue that personalized and comprehensive approach to DSME is necessary to
share the information required by diabetes patient to promote effective coping and self-
management. Patient-centered approach can fulfill both current and future needs. In addition to
this, it is planned to utilize interactive teaching strategies with the use of information and
communication technology (ICT) to ensure that smooth sharing of information takes place. Use
of internet based education minimizes barriers related to distance and limit access to diabetes
care services. There are many examples of studies which achieved positive results with the use of
ICT to promote self-management of diabetes. Booth et al. (2016) investigated about the impact
of a computer based program for people recently diagnosed with T2D and assessed diabetes
knowledge and goal setting post the intervention. The computer program resulted in a
statistically significant improvement in diet related knowledge. Another advantage of using ICT
or web based tool for diabetes education is that this resource is most commonly accepted by
patients and this tool can complement outpatient visits too (Shibuta et al., 2017).
The next vital part of the learning plan is designing appropriate teaching content. This has
been developed based on exploration of challenges faced by Mr. X in dealing with blood sugar
level currently. All the initial questions and concern of the client will be addressed by starting
with basic information about T2D, its causes, risk factors, preventive steps, medications and
technique to control the blood sugar level. The patient will be introduced to the fact that his role
is most important in controlled the disease. This will help in receiving the mutual support to
engage in self-directed goal setting (Powers et al., 2016). Similarly, based on his current
concerns, education will focus on self-care behaviors like health eating, being active and
monitoring blood sugar level regularly. Short term recommendations related to physical activity

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will be provided and a food plan will be made based on his cultural preferences. The initial
process of change is most challenging and supporting patient to cope with the burden of diabetes
will be crucial too (Powers et al., 2016). Hence, it is planned to be in touch with patient to review
behavior change and develop their problem solving skills so that they can easily manage the
challenge associated with diabetes. Psychosocial support by means of motivational interviewing
can be provided to Mr. X so that he could be motivated to sustain the change and get access to
positive information on diabetes management. Counseling for promotion of the use of problem-
oriented coping strategy is crucial for successful management of patients with diabetes early
during the course of the disease (Parildar, Cigerli & Demirag, 2015).
Conclusion
. Based on the above learning plan, the educational session was started with Mr. X. Since
the focus was to identify initial concerns and personal challenges for patient, various general
questions about the disease was asked. I patient was a bit uncomfortable in the beginning.
However, due to use of empathetic approach, he eventually became comfortable and honestly
made me aware about his main concerns post diabetes diagnosis. I am satisfied that focused on
holistic concerns of client instead of focusing on the physical health concerns only. This helped
to empower the client and convince him that he can actually take control over his health. Since,
he was a newly diagnosed patient, I started with broad information on disease, medications and
other self-care behaviors. However, one aspect that I could not identify was that why he did not
contacted anyone to get help. Exploring about this was important to identify any stigma related
issues and plan educational strategies accordingly.

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References:
Booth, A. O., Lowis, C., Hunter, S. J., Dean, M., Cardwell, C. R., & McKinley, M. C. (2016).
Development and evaluation of a computer-based, self-management tool for people
recently diagnosed with type 2 diabetes. Journal of diabetes research, 2016.
Chaudhury, A., Duvoor, C., Dendi, R., Sena, V., Kraleti, S., Chada, A., ... & Kuriakose, K.
(2017). Clinical review of antidiabetic drugs: implications for type 2 diabetes mellitus
management. Frontiers in endocrinology, 8, 6.
Chrvala, C. A., Sherr, D., & 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), 926-943.
Gardsten, C., Blomqvist, K., Rask, M., Larsson, Å., Lindberg, A., & Olsson, G. (2018).
Challenges in everyday life among recently diagnosed and more experienced adults with
type 2 diabetes: A multistage focus group study. Journal of clinical nursing, 27(19-20),
3666-3678.
Government of Canada (2018). Diabetes in Canada. Retrieved from:
https://www.canada.ca/en/public-health/services/publications/diseases-conditions/
diabetes-canada-highlights-chronic-disease-surveillance-system.html
Mahnaz, K., Shahin, T., & Shahdoust, M. (2019). Effects of applying a patient assessment form
based on the health functional patterns on nursing student's attitude and skills in
developing nursing process. International Journal of Nursing Sciences.

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Parildar, H., Cigerli, O., & Demirag, N. G. (2015). Depression, Coping Strategies, Glycemic
Control and Patient Compliance in Type 2 Diabetic Patients in an endocrine Outpatient
Clinic. Pakistan journal of medical sciences, 31(1), 19–24. doi:10.12669/pjms.311.6011
Pecoits-Filho, R., Abensur, H., Betônico, C.C., Machado, A.D., Parente, E.B., Queiroz, M.,
Salles, J.E.N., Titan, S. and Vencio, S., 2016. Interactions between kidney disease and
diabetes: dangerous liaisons. Diabetology & metabolic syndrome, 8(1), p.50.
Powers, M. A., Bardsley, J., Cypress, M., Duker, P., Funnell, M. M., Fischl, A. H., … Vivian, E.
(2016). 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. Clinical diabetes : a
publication of the American Diabetes Association, 34(2), 70–80.
doi:10.2337/diaclin.34.2.70
Shibuta, T., Waki, K., Tomizawa, N., Igarashi, A., Yamamoto-Mitani, N., Yamaguchi, S., Fujita,
H., Kimura, S., Fujiu, K., Waki, H. and Izumida, Y., 2017. Willingness of patients with
diabetes to use an ICT-based self-management tool: a cross-sectional study. BMJ Open
Diabetes Research and Care, 5(1), p.e000322.
WHO (2018). Diabetes. Retrieved from:
https://www.who.int/news-room/fact-sheets/detail/diabetes