Diabetes Education And The Increase In Diabetes
Diabetes is becoming a worldwide epidemic. It is one of the biggest health challenges that the United Kingdom (UK) is facing today with one person being diagnosed with diabetes every 3 minutes (Diabetes UK, 2009). The latest data indicates that there are now 2.8 million of people with diabetes in UK and nine out of ten people diagnosed with diabetes are Type 2 diabetes (2.5 millions). According to health experts, UK is now facing a huge public health problem and the figure is set to rise to four million by the year 2025. (Diabetes UK, 2010).
The alarming increase in diabetes prevalence is a great cause of concern and has a devastating economic effect. Recent estimate shows that 10% of National Health System (NHS) spending equivalent to 9 billion pounds a year, 1 million pounds per hour goes on diabetes (Diabetes UK, 2008). The direct and indirect cost to the NHS of caring for people with Type 2 diabetes and its complications are staggering and will continue to rise with the increasing incidence of the disease. As a result of this health crisis and significant financial burden, the NHS needs to respond to this massive strain by looking at more effective and efficient ways of providing diabetes care. It is therefore of primary importance for our local primary care diabetes services to identify ways to deliver an effective quality care for people with diabetes to counter this worrying trend.
1.1 Diabetes Education
Diabetes education has been considered as one of the key components of diabetes care since the 1930s and has been increasingly recognised as an integral part of the disease (Atak & Arslan, 2005). Nicolucci et al (1996) demonstrated that people who have never received diabetes education had a striking fourfold increased risks of developing major diabetes complications. Furthermore, the study done by Rickiem et al (2002), showed that diabetes education has an overall positive effect on the health and psychosocial outcome. It helps to improve patients’ skills and knowledge on the condition and enables beneficial change in the behaviour. Diabetes education has a profound effect on glycemic control, quality of life and treatment satisfaction (clinical governance support team, 2004). Stratton et al (2000) suggested that improving Hba1c by just 1% through diabetes education can significantly reduce risk of complications.
In view of all the evidence, the importance of diabetes education has been highlighted and well advocated by the National Service Framework (NSF) and National Institute of Clinical Excellence (NICE, 2003) . The NSF emphasizes that diabetes education should be made available from the point of diagnosis onwards and proposes that education should involve a structured program for people who have been newly diagnosed. This has been encouraged by NICE which recommends that all patients received structured education at initial diagnosis and then on a regular basis according to need (NICE, 2003).
However there is insufficient evidence currently available to recommend a specific type of education or provide guidance on the setting for, or frequency of, sessions. In this context, how best to provide structured education to people with diabetes is an important question. NICE acknowledge the limited evidence to suggest which approach is most appropriate and state that to achieve maximum effectiveness, some principle of good practice should be in place(NICE, 2003).
According to NICE criteria, diabetes education should reflect the principle of adult learning, provided by trained educators including a DSN or practice nurse with diabetes experience, and a dietitian, use a variety of techniques to promote active learning, be accessible to the broadest range of people taking into account their ethnicity, culture and beliefs.
1.2 Aim of Diabetes Education
The National Institute for Health and Clinical Excellence (NICE, 2003) states that the aim of...
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