self management of diabetes

Question 1

what is a common complication of diabetes?

Answer 1

heart disease — can lead to early death

Question 2

how many times more likely is someone with type 2 diabetes to experience heart failure and have a heart attack compared to people without diabetes?

Answer 2

• 2.5 x more likely to experience heart failure
• 2 x more likely to have a heart attack

Question 3

what are risk factors for developing type 2 diabetes?

Answer 3

• obesity = biggest risk factor
• age
• family history
• ethnicity — people of African-Caribbean, Black African or South Asian descent are more likely to develop type 2 diabetes than white people
• depression

Question 4

what is self-management?

Question 5

according to Corbin and Strauss, what are the aspects of self-management?

Answer 5

• medical management
• behavioural management
• emotional management

Question 6

what different behaviours does self-management involve?

Answer 6

• physical activity
• eating behaviours
• checking blood sugar levels
• adhering to treatments

Question 7

how does physical activity help?

Answer 7

regularly exercising helps to lower blood glucose levels, reduce blood pressure, maintain a healthy weight and promotes feelings of better well-being and mental health

Question 8

Current advice from Diabetes UK suggests that people with diabetes should aim to do how much exercise?

Answer 8

at least 30 mins of exercise (eg. walking, cycling, swimming) 5 times a week

Question 9

what are the 2 tests that can be used to measure blood glucose levels?

Answer 9

1. the HbA1c test — carried out by a healthcare professional and measures the average blood sugar level over the past few months. Everyone with diabetes is eligible for this check, but under certain circumstances this may not be the most appropriate management (e.g., during pregnancy, in children)
2. the finger prick test — the individual can do this themselves several times a day to monitor their levels throughout the day to help them work out what they need to eat and how much medication they need to take (only some individuals with Type 2 diabetes will need to do this – NICE guidance states that the routine self-monitoring of blood glucose levels should not be recommended unless there are specific reasons

Question 10

what is the most common medication used to manage type 2 diabetes?

Answer 10

metformin

Question 11

what models might help us to understand why a patient may be struggling to self manage?

Answer 11

1. self-regulation model — illness cognitions
2. PRIME — rational and impulsive
3. COM-B — is he capable, is he motivation (for each task), does he have physical and social opportunity
4. health belief model

Question 12

describe the COM-B framework

Answer 12

Question 13

describe the PRIME theory

Answer 13

Question 14

describe the self-regulation model

Answer 14

Question 15

what is the link between diabetes and depression?

Answer 15

People with diabetes are twice as likely to experience depression and are more likely to be depressed for longer and more frequently. In addition, around 40% of people living with diabetes struggle with their psychological wellbeing, often because of the demands of diabetes

Question 16

what are the 4 As used in self-management conversations?

Answer 16

ASK
ASSESS
ADVISE
ASSIST