Poulsen P, Kyvik OK, Improve exercise stamina A, Nielsen-Beck H: Heritability of type II diabetes mellitus Enhancing nutrient absorption abnormal glucose cobtrol — controol population-based twin study. Implementation Considerations It is important that patients understand the benefit of diabetes self-management activities. Many people with type 2 diabetes need to take more than one medicine to control their blood sugar. Diabetes Type 2 Diabetes in Children and Teens.

Self-care techniques for better diabetes control -

Realizing the multi-faceted nature of the problem, a systematic, multi-pronged and an integrated approach is required for promoting self-care practices among diabetic patients to avert any long-term complications.

Astrid N. van Smoorenburg, Dorijn F. Hertroijs, … Marijke Melles. Diabetes mellitus DM is a chronic progressive metabolic disorder characterized by hyperglycemia mainly due to absolute Type 1 DM or relative Type 2 DM deficiency of insulin hormone[ 1 ]. DM virtually affects every system of the body mainly due to metabolic disturbances caused by hyperglycemia, especially if diabetes control over a period of time proves to be suboptimal[ 1 ].

Until recently it was believed to be a disease occurring mainly in developed countries, but recent findings reveal a rise in number of new cases of type 2 DM with an earlier onset and associated complications in developing countries[ 2 — 4 ].

Diabetes is associated with complications such as cardiovascular diseases, nephropathy, retinopathy and neuropathy, which can lead to chronic morbidities and mortality[ 5 , 6 ].

World Health Organization WHO estimates that more than million people worldwide have DM. According to WHO report, India today heads the world with over 32 million diabetic patients and this number is projected to increase to One of the biggest challenges for health care providers today is addressing the continued needs and demands of individuals with chronic illnesses like diabetes[ 12 ].

The importance of regular follow-up of diabetic patients with the health care provider is of great significance in averting any long term complications. Studies have reported that strict metabolic control can delay or prevent the progression of complications associated with diabetes[ 13 , 14 ].

Some of the Indian studies revealed very poor adherence to treatment regimens due to poor attitude towards the disease and poor health literacy among the general public[ 15 , 16 ]. The introduction of home blood glucose monitors and widespread use of glycosylated hemoglobin as an indicator of metabolic control has contributed to self-care in diabetes and thus has shifted more responsibility to the patient[ 17 , 18 ].

Self-care in diabetes has been defined as an evolutionary process of development of knowledge or awareness by learning to survive with the complex nature of the diabetes in a social context[ 20 , 21 ]. There are seven essential self-care behaviors in people with diabetes which predict good outcomes.

These are healthy eating, being physically active, monitoring of blood sugar, compliant with medications, good problem-solving skills, healthy coping skills and risk-reduction behaviors[ 26 ]. These proposed measures can be useful for both clinicians and educators treating individual patients and for researchers evaluating new approaches to care.

Self-report is by far the most practical and cost-effective approach to self-care assessment and yet is often seen as undependable. Diabetes self-care activities are behaviors undertaken by people with or at risk of diabetes in order to successfully manage the disease on their own[ 26 ].

All these seven behaviors have been found to be positively correlated with good glycemic control, reduction of complications and improvement in quality of life[ 27 — 31 ]. In addition, it was observed that self-care encompasses not only performing these activities but also the interrelationships between them[ 32 ].

Diabetes self-care requires the patient to make many dietary and lifestyle modifications supplemented with the supportive role of healthcare staff for maintaining a higher level of self-confidence leading to a successful behavior change[ 33 ]. Though genetics play an important role in the development of diabetes, monozygotic twin studies have certainly shown the importance of environmental influences[ 34 ].

Individuals with diabetes have been shown to make a dramatic impact on the progression and development of their disease by participating in their own care[ 13 ]. This participation can succeed only if those with diabetes and their health care providers are informed about taking effective care for the disease.

It is expected that those with the greatest knowledge will have a better understanding of the disease and have a better impact on the progression of the disease and complications.

The American Association of Clinical Endocrinologists emphasizes the importance of patients becoming active and knowledgeable participants in their care[ 35 ].

Likewise, WHO has also recognized the importance of patients learning to manage their diabetes[ 36 ]. The American Diabetes Association had reviewed the standards of diabetes self management education and found that there was a four-fold increase in diabetic complications for those individuals with diabetes who had not received formal education concerning self-care practices[ 37 ].

A meta-analysis of self-management education for adults with type-2 diabetes revealed improvement in glycemic control at immediate follow-up.

However, the observed benefit declined one to three months after the intervention ceased, suggesting that continuing education is necessary[ 38 ]. A review of diabetes self-management education revealed that education is successful in lowering glycosylated hemoglobin levels[ 39 ].

Diabetes education is important but it must be transferred to action or self-care activities to fully benefit the patient. Self-care activities refer to behaviors such as following a diet plan, avoiding high fat foods, increased exercise, self-glucose monitoring, and foot care[ 40 ].

Changes in self-care activities should also be evaluated for progress toward behavioral change[ 41 ]. Self-monitoring of glycemic control is a cornerstone of diabetes care that can ensure patient participation in achieving and maintaining specific glycemic targets.

The most important objective of monitoring is the assessment of overall glycemic control and initiation of appropriate steps in a timely manner to achieve optimum control.

Self-monitoring provides information about current glycemic status, allowing for assessment of therapy and guiding adjustments in diet, exercise and medication in order to achieve optimal glycemic control. Irrespective of weight loss, engaging in regular physical activity has been found to be associated with improved health outcomes among diabetics[ 42 — 45 ].

The National Institutes of Health[ 46 ] and the American College of Sports Medicine[ 47 ] recommend that all adults, including those with diabetes, should engage in regular physical activity. Treatment adherence in diabetes is an area of interest and concern to health professionals and clinical researchers even though a great deal of prior research has been done in the area.

In diabetes, patients are expected to follow a complex set of behavioral actions to care for their diabetes on a daily basis. These actions involve engaging in positive lifestyle behaviors, including following a meal plan and engaging in appropriate physical activity; taking medications insulin or an oral hypoglycemic agent when indicated; monitoring blood glucose levels; responding to and self-treating diabetes- related symptoms; following foot-care guidelines; and seeking individually appropriate medical care for diabetes or other health-related problems[ 48 ].

The majority of patients with diabetes can significantly reduce the chances of developing long-term complications by improving self-care activities. In the process of delivering adequate support healthcare providers should not blame the patients even when their compliance is poor[ 49 ].

One of the realities about type-2 diabetes is that only being compliant to self-care activities will not lead to good metabolic control. Research work across the globe has documented that metabolic control is a combination of many variables, not just patient compliance[ 51 , 52 ].

In an American trial, it was found that participants were more likely to make changes when each change was implemented individually. Success, therefore, may vary depending on how the changes are implemented, simultaneously or individually[ 53 ].

Some of the researchers have even suggested that health professionals should tailor their patient self-care support based on the degree of personal responsibility the patient is willing to assume towards their diabetes self-care management[ 54 ].

The role of healthcare providers in care of diabetic patients has been well recognized. Socio-demographic and cultural barriers such as poor access to drugs, high cost, patient satisfaction with their medical care, patient provider relationship, degree of symptoms, unequal distribution of health providers between urban and rural areas have restricted self-care activities in developing countries[ 39 , 55 — 58 ].

Another study stressed on both patient factors adherence, attitude, beliefs, knowledge about diabetes, culture and language capabilities, health literacy, financial resources, co-morbidities and social support and clinician related factors attitude, beliefs and knowledge about diabetes, effective communication [ 60 ].

Because diabetes self-care activities can have a dramatic impact on lowering glycosylated hemoglobin levels, healthcare providers and educators should evaluate perceived patient barriers to self-care behaviors and make recommendations with these in mind. Unfortunately, though patients often look to healthcare providers for guidance, many healthcare providers are not discussing self-care activities with patients[ 61 ].

Some patients may experience difficulty in understanding and following the basics of diabetes self-care activities. When adhering to self-care activities patients are sometimes expected to make what would in many cases be a medical decision and many patients are not comfortable or able to make such complex assessments.

It is critical that health care providers actively involve their patients in developing self-care regimens for each individual patient. This regimen should be the best possible combination for every individual patient plus it should sound realistic to the patient so that he or she can follow it[ 62 ].

Also, the need of regular follow-up can never be underestimated in a chronic illness like diabetes and therefore be looked upon as an integral component of its long term management. A clinician should be able to recognize patients who are prone for non-compliance and thus give special attention to them.

On a grass-root level, countries need good diabetes self-management education programs at the primary care level with emphasis on motivating good self-care behaviors especially lifestyle modification. Furthermore, these programs should not happen just once, but periodic reinforcement is necessary to achieve change in behavior and sustain the same for long-term.

While organizing these education programs adequate social support systems such as support groups, should be arranged. As most of the reported studies are from developed countries so there is an immense need for extensive research in rural areas of developing nations.

Concurrently, field research should be promoted in developing countries about perceptions of patients on the effectiveness of their self-care management so that resources for diabetes mellitus can be used efficiently.

To prevent diabetes related morbidity and mortality, there is an immense need of dedicated self-care behaviors in multiple domains, including food choices, physical activity, proper medications intake and blood glucose monitoring from the patients. World health organization: Definition, diagnosis and classification of diabetes mellitus and its complications.

Geneva: World health organization; Google Scholar. Kinra S, Bowen LJ, Lyngdoh T, Prabhakaran D, Reddy KS, Ramakrishnan L: Socio-demographic patterning of non-communicable disease risk factors in rural India: a cross sectional study.

BMJ , c Article PubMed PubMed Central Google Scholar. Chuang LM, Tsai ST, Huang BY, Tai TY: The status of diabetes control in Asia—a cross-sectional survey of 24 patients with diabetes mellitus in Diabet Med , 19 12 — Article CAS PubMed Google Scholar.

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World health organization: Diabetes — Factsheet. Mohan D, Raj D, Shanthirani CS, Datta M, Unwin NC, Kapur A: Awareness and knowledge of diabetes in Chennai - The Chennai urban rural epidemiology study. J Assoc Physicians India , — Wild S, Roglic G, Green A, Sicree R, King H: Global prevalence of diabetes: Estimates for the year and projections for Diabetes Care , 27 5 — Article PubMed Google Scholar.

Pradeepa R, Mohan V: The changing scenario of the diabetes epidemic: Implications for India. Indian J Med Res , — CAS PubMed Google Scholar. Katulanda P, Constantine GR, Mahesh JG, Sheriff R, Seneviratne RD, Wijeratne S: Prevalence and projections of diabetes and pre-diabetes in adults in Sri Lanka - Sri Lanka Diabetes, Cardiovascular Study SLDCS.

Diabet Med , 25 9 — Wagner EH, Austin BT, Davis C, Hindmarsh M, Schaefer J, Bonomi A: Improving chronic illness care: translating evidence into action. Health Aff Millwood , 20 6 — UKPDS: Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes UKPDS Lancet , — Article Google Scholar.

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Diabetes Res Clin Pract , 28 2 — Shobana R, Augustine C, Ramachandran A, Vijay V: Improving psychosocial care: The Indian experience. Diabetes Voice , 50 1 — Chew LD: The impact of low health literacy on diabetes outcomes. Diabetes Voice , 49 3 — Grey M, Thurber FW: Adaptation to chronic illness in childhood: diabetes mellitus.

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Diabetes is a progressive disease, which means that it can worsen over time. The ADA recommend using a combination of medication and nutrition therapy to reach blood sugar targets. The basis of meal planning involves portion control and favoring healthful foods.

The diabetes plate method is one tool designed to help people control their calorie and carbohydrate intakes. It involves mentally dividing the plate into three sections. Half of the plate should contain nonstarchy vegetables , a quarter can contain grain-based and starchy foods, and the remaining quarter should contain protein.

Research has shown that exercise can help control blood sugar levels, reduce cardiovascular risk factors, promote weight loss, and improve well-being. Researchers behind one study found that engaging in a structured exercise program for at least 8 weeks lowered glycated hemoglobin levels by an average of 0.

The ADA recommend exercising for at least 10 minutes per session and getting a total of at least 30 minutes of exercise on most days of the week.

If a person exercises every day — or lets no more than 2 days pass between workouts — this may help reduce insulin resistance. Members of a diabetes healthcare team can help develop and tailor an exercise plan that is safe and effective. In addition to exercising regularly, it is important to avoid spending long periods in a seated position.

Breaking up sedentary periods every 30 minutes can help with controlling blood sugar. The ADA advise all people with prediabetes or diabetes to avoid tobacco products, including e-cigarettes.

People with diabetes who smoke have higher risks of cardiovascular disease , premature death, and diabetes complications , as well as less blood sugar control, compared with people who do not smoke.

If a person with diabetes does not take their medication as recommended by a doctor, it can lead to:. A diverse range of issues can contribute to medication nonadherence.

Some may relate to psychological, demographic, and social factors. Key elements can include the cost of treatment and difficulties with healthcare providers and the healthcare system.

Doubt about the seriousness of diabetes and the effectiveness of a treatment plan can keep a person from taking their medication, and this can lead to complications. Nonadherence seems to be more common among people who have chronic diseases with symptoms that are not obvious.

Also, complex treatment plans can be challenging to follow. The quality of the patient-doctor relationship is often a key factor in nonadherence. Likewise, it is important to raise concerns about diabetes treatment with the doctor, who can adjust the plan to help ensure that targets are being met and no complications develop.

Researchers have estimated that the collective cost of medication nonadherence for diabetes, high blood pressure , and high cholesterol in the U. Diabetes is not curable, but a person can help manage it at home. This often involves following nutrition and medication plans.

A person with diabetes or prediabetes should also be physically active and maintain a healthy weight. A diabetes care team can help develop and tailor an exercise plan. Blood glucose meters and continuous glucose monitors can help a person track their progress and see the effects of self-management techniques.

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Medical News Today. Health Conditions Health Products Discover Tools Connect. How to manage diabetes. Medically reviewed by Maria Prelipcean, M.

Self-monitoring Healthy weight Nutrition Exercise Stop smoking Take medication regularly Takeaway While there is no cure for diabetes, with treatment and self-management strategies, a person can live a long and healthy life.

Share on Pinterest People can self-monitor their diabetes with a blood glucose meter. Maintain a healthy weight. Get good nutrition. Exercise regularly.

Medindia » Articles » Contrlo » Bettdr Practices in Diabetes Management. Diabetes Selff-care DM Self-care techniques for better diabetes control a chronic progressive Self-care techniques for better diabetes control disorder characterized Self-car hyperglycemia due to impairments in Oxidative stress-induced diseases release, insulin technisues or both. Diabetes mellitus was believed to be a disease occurring mainly in developed countries, but recent findings reveal a rise in number of new cases of type 2 DM in developing countries with an earlier onset and associated complications. Diabetes-associated complications can lead to chronic morbidities and mortality. World Health Organization WHO estimates that more than million people are affected with DM worldwide.

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Ask the Experts: How to Lower Your Risk for Heart Disease if You Have Type 2 Diabetes Learn more doabetes the different tools ofr Improve exercise stamina people rechniques diabetes. Eating healthy food is part Diabetic retinopathy vision impairment living a Selff-care life. However, having diabetes does't Self-care techniques for better diabetes control you from eating your favourite foods or going to your favourite restaurants. But you need to know that different foods affect your blood sugar differently. Activity has many health benefits in addition to losing weight. Physical activity lowers cholesterol, improves blood pressure, lowers stress and anxiety, and improves your mood. Being active can also keep your blood glucose levels in check and your diabetes under control.