Diabetes Self-Management Across Life Stages: A Sociology Essay

This essay delves into the multifaceted aspects of diabetes, focusing on the concept of empowerment as a key facilitator for effective self-management. It examines diabetes mellitus (DM) and highlights the increasing global prevalence of the condition, emphasizing the importance of proactive management strategies. The essay explores the unique challenges and considerations across three critical life stages: adolescence, middle age, and older adulthood, recognizing that life transitions significantly impact an individual's lifestyle and health management. It underscores the role of diabetes self-management education as the foundation for an empowerment approach, enabling individuals to make informed decisions about their health. Furthermore, the essay investigates evidence-based strategies to empower patients and their families, promoting improved health outcomes and self-management skills during these life transitions. It also assesses the application of empowerment in consumer participation and health promotion, aiming to provide readers with a comprehensive understanding of chronic illness self-management, particularly in the context of diabetes. The analysis incorporates scholarly literature to support discussions on empowerment, patient-centered care, and the implementation of multidisciplinary strategies, including behavioral interventions and person-centered care, to enhance patient wellbeing and promote effective health management across different age groups.

Running Head: SOCIOLOGY
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Diabetes in social and psychological context
5/22/2019

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The essay brings about the discussion on the aspects of diabetes, and the approach of
empowerment, which facilitates in the self-management of the diabetes. Diabetes Mellitus
(DM), also known as diabetes, is defined as the group of metabolic disorders, which are
characterised by an increase in the levels of blood sugar over a period. According to the
national survey data, it has been found that around 415 million people are living or affected
by diabetes, around the world. However, amongst these 46% of the people are left
undiagnosed, and the number is expected to rise by the end of year 2040. In addition, the
discussion will assess the description of various stages of life transition, i.e. adolescence,
middle age and older adulthood. Life transitions are often challenging and involve lot of
changes in an individual’s lifestyle, and are considered as results of some events of life. It has
been analysed that diabetes self-management education determines the base or foundation for
the empowerment approach in context to the chronic illness (Sherifali et al., 2015).
The approach helps individuals or patients to take correct or right decisions for
making improvement in their health condition. Moreover, the essay will include and
determine the implementation the evidence based strategies, which will empower the patients
and their families. Implementation of these strategies will benefit the patient to improve their
state of health and self-manage their illness during different stages or transitions of life. In the
later part, the discussion will bring the assessment of the approach of empowerment in
context to consumer participation and health promotion. Thus, the readers will gain an
understanding of the self-management concept of chronic illness, diabetes, and implication of
various strategies leading to, social and emotional wellbeing. Hence, in the further sections
will conduct an in-depth of diabetes and strategies with the help of scholarly based literature.
Empowerment is the term defined as the patient-centred, collaborative approach,
which integrates the aspects of care with the aspects of diabetes. To define patient
empowerment, it helps the patient to discover and establish an inherent capacity to become
responsible for his or her own life. In other words, the approach of empowerment has been
used for the management and treatment of diabetes, wherein patients have the knowledge and
self-awareness to later their own behaviour and improve quality of their lives. There are three
key stages of life transition, i.e. childhood, adulthood, and old age. These three key stages are
also known as key life transitions which are involved in the study of self-management of
diabetes. Here, the discussion will be based on the three key stages or transitions, i.e.

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adolescence, middle age and older adulthood. Type 1 diabetes and type 2 diabetes, are the
chronic illness which needs to be managed over the period of life, and significantly involves
the concept of self-management and empowerment. The self-management of diabetes is
important to prevent the complications related to diabetes (McCarthy & Grey, 2018).
It also include the aspect of eating a healthy diet, engaging into physical activity or
exercise, intake of appropriate amounts of insulin and self-monitoring of the level of glucose.
Adult transition through several stages and the aspect of self-management may differ through
these stages. Firstly, the period of adolescence is between the age of 10-19 years, and during
this period, there is a greater role of family. The involvement of family or support members
help diabetic patient in the empowerment of the individual to self-manage their health (Zhou
et al., 2016). For empowering adolescents for self-management of diabetes, it has been found
that several aspects need to be undertaken. On the part of the role of healthcare providers, it
can be stated that they should be able to evaluate various aspects, such as educational,
behavioural, emotional, and psychosocial factors of wellbeing. The analysis of these aspects
or factors is essential as they help families along with the patients, to overcome the barriers or
challenges they face in managing their health condition (Whittemore & Dixon, 2013).
The process of diabetes education must occur at diagnosis, and during transition for
providing care to the adult diabetes. Moreover, the developing teenager must be educated
about the transition, in respect to diabetes care. the education to adolescents play a major
role with respect to medications to be taken, diet to be followed, and engaging into several
therapies. In addition, education is vital for changing their behaviour towards the self-
awareness for chronic illness. This will help in eliminating unnecessary stress and will better
cope with negative impacts on their health. The role of nutrition therapy is vital and
applicable to all three stages of life-transition (Buschur, Glick and Kamboj, 2017). As it is
important to explain adults understand the impact the food has on the glucose, and how it
interacts with exercise and insulin, and attain the glucose levels.
Besides, this education must be provided to the adults in the cases when they chose to
drink alcohol. They must be advised to do in moderation, as one drink per day, as it will
lead to reduce blood glucose to extreme levels, and it may further increase the diabetes
complications and risks. Adults or adolescents are advised to focus on physical exercise, for
atleast 150 minutes a week. Thus, it can be stated that benefits of involving into physical
activities help adults to make changes in their lifestyle, which depicts self-management of

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diabetes (RACGP, 2018). Now, the discussion will assess the empowerment leading to self-
management of diabetes, in context to middle-aged individuals. It has been found that the
middle-aged adults are focused on their careers, but are affected by the low levels of health.
Middle-aged adults, like other age groups, need to engage into exercises, as regular exercise
is one of the strategy to diabetes self-management. This is because regular exercising is
associated with better glycaemic control and reduces symptoms and other complications
(Łuczyński, Głowińska-Olszewska & Bossowski, 2016).
Discussing about the middle-aged groups it has been found that Type 2 diabetes has
high prevalence that affects their health and wellbeing. Middle-aged people are those who
belong to the age group of 45-65 years, i.e. the period between early adulthood and old age.
In the study conducted on the middle-aged people living with diabetes, it has been found that
poverty is associated with poor self-management. For this, government and several
community programs should aim to provide funds for personal care services to the diabetic
patients. The provision of services and other resources should be provided, specifically to the
low-income individuals. However, this may also include providing treatment to the patient
through placing them in nursing facilities (Lyons, Libman & Sperling, 2013).
In context to the role and approach of empowerment of individuals towards self-
management of diabetes, consist of several aspects. This includes socio-ecological approach
to self-management of diabetes, especially type 2-diabetes. The community members, health
care providers and family or support members must focus on developing and improving the
physical, social, and emotional wellbeing of the patient. The socio-ecological approach to
self-management of diabetes emphasizes the aspect of physical activity and dietary
intervention (The lancet, 2017).
Active lifestyle and regular exercise is considered important or highest public health
priority for the middle-aged people. The aspect of behavioural intervention that includes
analysing the culture, tradition, and lifestyle of the patients. Providing education to these
patients in context to the exercise, or intake of proper and healthy diet is essential in the self-
management. This will help them to analyse their low weight or diet, and therefore will
assist them to make further changes. Cognitive behavioural interventions include the element
of person-centred approach, which promote informed decision-making and developing ability
to self-manage their health condition (Inzucchi et al., 2015). To state about older age people,
a greater risk has been found for both, diabetes and pre diabetes. Type 2 diabetes has been

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found common in the old age individuals. Late adulthood, or old age is usually considered to
begin at 65 years of age, and many of the health disorders are found common at this age.
However, it can be stated that the aspect of empowerment and self-management is essential
to help old aged people manage, and improve their health (Diabetes Care, 2018).
It has been found through research that older adults have unique issues and difficulties
managing their illness and indicate cognitive impairment. The issue of cognitive dysfunction
is observed in older people, which makes it difficult for them to perform complex care tasks
related to diabetes. The complex care tasks include glucose monitoring, and adjusting insulin
doses. Therefore, family is the major component in the act of empowerment, as they need to
be encouraged and informed for intake of healthy diet, and medications on proper time.
Health literacy and facilitating older people to make correct decision for the treatment is also
an important component of self-management of health from chronic illness (Grady &
Gough, 2014).
From the above discussion, the role of empowerment & support from the family has
been analysed facilitates diabetes self-management through different stages of life transitions.
Now, the following section will include identification of the strategies applied in healthcare
with the efforts of multidisciplinary team leading to impact on populations.
Multidisciplinary approaches are important for the effective management of diabetes, which
involves the role of allied health professionals.
One of the important strategies that aim at diabetes care, initiates by the healthcare
teams involves ‘Behavioural strategy’ (Rivera-Hernandez, 2014). The term behavioural
strategy involves goal setting, problem solving, and considering the issues related to an
individual’s emotional health and wellbeing. It will help them to manage stress, anxiety as
people in the older age also face the problem of depression. The use of behavioural strategy
by community members will enable developing goals to improve their health. Moreover, it
will change their belief towards the illness and the process of treatment. It also state about the
implementation of cognitive behavioural therapy to manage with diabetes (Kalra, Jena &
Yeravdekar, 2018).
Person-centred care or approach can be used as another vital strategy for the patients living
with diabetes. This approach involves the efforts of multi-disciplinary team in listening,
informing, and involving the patients in their care. In this approach, the role of healthcare

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team ensures responding to the needs, preferences, and values of the patient (The health
foundation, 2016). Through person-centred care, approach patients develop their
knowledge, and skills they need to effectively manage in order to make informed decisions
for their health. The approach also ensures that they are treated with equal dignity, and
respect. Furthermore, the approach also includes the element of person-centred
communication skill, which resolves the queries of the patients, helping them develop strong
emotional wellbeing (McGill et al., 2017).
In the context of diabetes management, working alliance or therapeutic relationship is
understood as the collaborative effort between patient and healthcare provider. The research
on the chronic illness and their varying impact has been analysed from the quality of “patient-
carer” relationship, as it forms the base of self-management (Powell, Hilliard & Anderson,
2014). Many patients find it difficult to adhere to the lifestyle, or behavioural changes
including the intake of proper diet. Therefore, it can be stated that the patient with high
motivation leading to desired change in their lifestyle. In fact, the client-therapist relationship
is central to the treatment outcome. Thus, it can be stated the strategy of patient-centred care,
and therapeutic alliance is effective to the diabetes care largely in different life-stages
(Clinical Diabetes, 2018).
The above-mentioned discussion stated about strategies and interventions used in the
clinical practice to assist families and patients living with their diabetic condition. Now, third
section of the essay will explain concept of empowerment or self-efficacy in context to
consumer participation and health promotion. The term self-efficacy determines the extent to
which people believe, they have the ability to perform specific behaviours to attain certain
goals. The aspect of self-efficacy influences the efforts made by an individual to change their
risk behaviour, despite the barriers and other issues in health condition (Payne et al., 2015).
Self-efficacy involves the aspect of self-management of chronic illness, and it play
vital role inducing motivation determining the health promoting behaviour. Therefore, it can
be stated that self-efficacy is very important in initiating and maintaining self-care behaviour
process. Under this, patients establish self-management system through which they exert
control on their emotions, behaviour, especially determining their food- self-care behaviours
(Baptista et al., 2016).

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Moreover, empowerment or self-efficacy also leads to hygienic behaviour, and
associated with glycaemic and weight control. Thus, it has been understood that self-efficacy
affects the patient’s behaviour and performance in context to health. The aspect of self-
efficacy also relates to health promoting behaviours, such as practising physical activities or
exercise on regular basis, maintaining healthy body weight, and avoiding alcohol and intake
of other substances. For an example, in context to older aged people, the aspect of self-
efficacy is associated to the adequate intake of nutrition, which represents one factor
influencing health promoting behaviour (Burke, Sherr & Lipman, 2014).
Change or involvement into positive behaviour towards self-management of diabetes,
explains the level of consumer participation. In health care, engaging patient, at all the key
stages (adolescence, middle-age adulthood, and old-adulthood) has become a priority for the
policy makers. The goal behind involving or engaging the patient in the process of treatment
or care is to improve the healthcare delivery system, ensuring high degree of efficacy (NDSS,
2018). Affordable Care Act (ACA) has been established which provides the provision to
engage participants or patients, who are empowered in maintaining their good health and
leading to effective management of chronic diseases such as diabetes. The aspect of
empowering the patient engagement is to be focused, particularly amongst minor racial and
ethnic groups. Hence, the factor of empowerment and self-efficacy acts as major determinant
achieving success in diabetes self- management, and promoting health behaviour (Diabetes
Care., 2015).
In the last section, the essay will move on to the analysis of management of diabetes,
in respect to people from different backgrounds (cultural or age groups), and within
vulnerable populations. To discuss about the prevalence of diabetes, in Australia, it has been
found that male, specifically elder people are most affected by the Type 2 diabetes in the
country. Moreover, it is mostly found amongst the males, indigenous Australians including
those living in the socially disadvantaged areas. Therefore, to state prevention, control and
management of the chronic illness, diabetes is preventable through the lifestyle intervention
amongst these population.
According to the National Diabetes Strategy Advisory Group, it has been found that
many of the cultural programmes has been organised for the aboriginals (AIHW, 2018).
Moreover, the government of Australia also ensures the community have access to different
facilities. This includes access to the diabetes support, education, and services to help

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managing complications of diabetes, and attaining positive health outcomes. Moreover, it
has been found that the management of type 2 diabetes within indigenous peoples is
undertaken through primary care. The health care established that focus on primary care of
the patients by increasing the efficiency and effectiveness of medical services, particularly for
those at the risk of poor health. The aspect or goal of diabetes management is undertaken
from the overall efforts of a team or team care in context to the populations living with
diabetes in Australia (Diabetes Australia, 2018).
Furthermore, the aspect or approach of managing diabetes for the people from
diverse backgrounds in Australia involves implementing various strategies and clinical
interventions. In this context, an example of the NDSS i.e. The National Diabetes Services
Scheme refers to an initiative taken by the government of Australia, which is governed or
administered by Diabetes Australia. The role of NDSS is central to the management and
care for the diabetic patients, as they provide diabetes related products at reasonable or
subsidised rates. In addition, they also provide the relevant and important information to the
people living with diabetes. Therefore, it assists people especially, living in the backward
section or socially disadvantaged section of the society.
Provision of the devices, medical care services and other facilities help in managing
the chronic illness, i.e. diabetes for people in a prolonged period. This acts as major aspect of
management of diabetes mellitus (DM) amongst indigenous peoples and other cultural and
social groups, and within different age groups. Use of the approach of patient-centred care,
lifestyle management in context to the primary care will reduce complications and other risks
associated with diabetes. Thus, it can be stated that successful management or care of
diabetes, requires the attention to different elements such as behavioural, psychological, and
social aspects of the health condition (American Diabetes Association, 2018).
To conclude the above discussion it can be stated that the prevalence of diabetes has
been rapidly rising in middle and low-income countries. It is considered as one of the major
causes of blindness, kidney failure, heart disease or heart attack, and other illness. Diabetes in
Australia has been the leading cause of disability and long-term impaired health, determining
death of individuals. The discussion above has mentioned the prevalence and impact of the
chronic illness on the health of population across regions. The issue of diabetes has been
linked to the concept of empowerment, which further determines the significance of self-
management of the illness. Empowerment is an important approach in the care and

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management of the complications and impact of diabetes on health and wellbeing. The essay
has also described several strategies or approaches that are used by clinicians in the
healthcare, which integrate with the diabetes self-management. From the above analysis over
the chronic illness, it has been understood that lifestyle is the key to diabetes self-
management. The patients of diabetes must focus on making appropriate changes in their
lifestyle and eating habits, i.e. diet to lead positive outcome of the treatment. The role of self-
efficacy and the relationship with the consumer or patient participation has been also
described in the discussion.
It can be stated that health care providers or community nurses play a vital role in
reducing the complications and helping patient to manage their health condition. Thus, the
management of diabetes, in different age groups, cultural or ethnic groups, and in respect to
aboriginals has been associated to the therapies and primary role. Therapeutic relationship
has been identified as a major component of the care provided to the diabetic patients at all
ages, within Australia. Providing care to the patients, in healthcare settings or at home
essentially require the engagement of the patient, to lead positive health outcomes. Hence, an
equal participation of the consumer or patient along with the contribution, and services of
health providers ensures effective management of diabetes, leading to enhanced quality of
health and wellbeing.

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