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Many Factors Make Type 2 Diabetes a Challenge
This press release is an announcement submitted by EurekAlert, and was not written by Diabetes Health.
The study shows that “psychosocial, socioeconomic, physical, environmental and cultural factors” get in the way of effective care.
There's a perception out there that people with type 2 could control their disease if they just tried hard enough. But self-control and will power are not the whole story. A new study published in this month's Journal of Nursing and Healthcare of Chronic Illness includes "eating out, lack of social support and high-risk lifestyles" as just a few of the roadblocks that stop patients with type 2 diabetes from controlling their condition.
The research reviewed information from 8,900 patients and 4,550 healthcare providers from 28 countries.
Major barriers identified by the review included:
- Financial. Even if healthcare was free or funded by insurance, patients still had to spend more money on healthy food, home glucose monitoring kits and transport to and from healthcare appointments.
- Social support. Patients who received support from family, friends and diabetes clinics appeared to handle self-care better than those who did not
- Patient provider gaps. Care was more effective when patients and healthcare providers worked together to devise treatment plans that patients could stick to.
- Meals out. Eating out in restaurants was a frequently mentioned problem and being offered inappropriate food when visiting others was also an issue.
- Favorite foods. Healthcare professionals did not always appreciate that patients disliked being denied their favorite foods and would cope better if they were incorporated in eating plans.
- Exercise. Attitudes toward exercise, physical limitations and discomfort prevented people from taking regular exercise. These need to be taken into account when devising exercise programs.
- High-risk lifestyles. Behavioral and psychiatric disorders and cultural and language barriers, among both patients and family members, can impede effective treatment.
- Medication. Some patients forgot to take their medication and others ran out. Others were also reluctant to carry out regular glucose tests.
- Psychological wellbeing. Psychological problems are common among people with diabetes, but providers don't always have the resources to manage this aspect of their patient's care.
- Understanding. Patients often lack knowledge about their condition and don't always understand the relevance of diet and care plans.
- Frustration. Being unable to maintain good glucose control can cause helplessness and frustration, as can the progression of the disease
"There are various barriers to achieving optimal self-care in type 2 diabetes," said co-author Professor Vivien Coates, from the Institute of Nursing Research at the University of Ulster, UK in a press release. "Some stem from limitations within the healthcare team, some from ineffective communication between providers and patients and some from the patient's lack of empowerment, motivation and involvement in their treatment.
Researchers from Hong Kong and Northern Ireland studied research carried out between 1986 and 2007 to try and identify what could be improved. They developed a three-point plan for nurses involved in diabetes care:
- Nurses should provide patients with enough information about their condition and its treatment to enable them to make informed decisions about their care.
- Patients need to be motivated to take action to ensure that they manage their diabetes and prevent complications.
- Nurses need to approach diabetes care in a holistic way that takes account of a wide range of physical, psychosocial, cultural, financial and environmental factors.
Sources: EurekAlert, Journal of Nursing and Healthcare of Chronic Illness
Categories: Diabetes, Diabetes, Diets, Exercise, Food, Psychology, Type 2 Issues
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Comments
The primary reason that type-2 diabetics fail is that most health providers put them on low-fat diets, which requires a high-carb diet. Ideally carbs should be limited to 30 grams per day, but the American Diabetes Association recommends 5 to 7 times that amount. Since carbs are converted into glucose, the diabetic absorbs far too much glucose to remain healthy.
What about genentics? It has nothing to do with diet or exercise. This article makes it sound like you make it all disapear with diet and exercise and some oral meds. What if oral meds don't work, insulin can only do
so much, and they want you to eat 300 carbs per day. Really hard to do and control blood sugars as you still have peaks and lows. It seems like TYPE 2 is really so widely defined that you just can't put everyone in the same 'bucket'. It seems like a whole lot of research continues to be done.
As for education, most diabetes nurses are NOT diabetic and can only go on what they are taught and not what they experience. Problem is, everyone is different and there is no One solution.
Why do they always show overweight people when talking about type 2 diabetes? Al lot of thin people have it too! Weight is not always the cause of type 2 diabetes!!
I wholeheartedly agree with the comment posted by sheashore. We need to contain grain-carbohydrates to a daily maximum of 30 grams. That should not preclude carbs from green and colorful, nonstarchy vegetables.
At the same time, we must raise public awareness that nearly 1 in 2 North-Americans (90% of Hispanics) carry the HLA-DQ2 or HLA-DQ8 gene. That means that they cannot digest grain-carbs and may even be intolerant to gluten present in wheat and other grains.
Gluten (as well as casein in lactose) is an opioid exorphin. Carbohydrate-addiction, therefore, is "real." A patient who will be taught about this link may stand a better chance of overcoming cravings and resistance to change.
That one in two individual carrying one of these genes MUST stay away from ALL gluten-containing grains in addition to keeping below 30 grams daily of grain-carbs. Nobody has come off addiction by continuing to consume the drug they are addicted to. For the diabetic this "drug" is anything made from grains.
This article is so poorly written I can barely decide whether I agree or disagree with its conclusions (I think I disagree). The premise "self-control and will power are not the whole story," is followed by a list of "roadblocks" that prevent Type 2's from controlling their condition. The said "roadblocks" are things that can only be addressed through self-control and willpower.
At the end, the recommendation to nurses to "provide patients with enough information about their condition and its treatment to enable them to make informed decisions about their care," should be standard nursing practice. This is hardly news.
If you limit carbs to 30 grams per day, your brain cannot function properly! Talk about putting people into "one bucket"-what about making generalizations about diet?!? We, as humans, need at least 130 g carb per day FOR OUR BRAINS TO FUNCTION CORRECTLY. This is not voodoo, it is a fact. And no, people with diabetes are not told to eat 300 g carb per day. If they go to a dietitian, they are given a meal plan that includes a BALANCE of carbs, protein, and fat...the same recommendations for ANYONE. It's not rocket science, it's nutrition.
I am a Registered Dietitian and get frustrated with all this low carb mumbo jumbo. It's not low carb and it's not low fat...it's healthy eating!!!!!!!
I agree. Restricting your carbs is hard work and does create memory loss. I read a study were half the women went on low carb and the other half low calorie. After 3 weeks, the women on the low carb diet lost just as much as the low calorie dieters, but had a big drop in their memory and cognitive skills.
Carbs are necessary - just stick to the low GI ones. If you do a Google search on "low carb diets affect memeory", you will see what I mean.
Kellie - My Blood Glucose
This is interesting I never knew about HLA-DQ2-8 genes, never heard about it before. Is that the reason why persons are unable to lose weight even though they are eating whole wheat bread?. I recently visited a home for the aged and was appalled when the manager told me she ensures that Diabetic inmates are not given any sugar in their tea or even any sweets with their meals. Come on these are people too they need deser. Why is it hard for people to understand that if you eliminate one carb (rice/pasta)from your meal it is ok to have a slice of cheesecake.
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