A narrative review conducted by Shammah Omololu, a PhD candidate and Research Coordinator at the University of Cincinnati, College of Nursing, Cincinnati, Ohio, USA, has shed light on the crucial role of self-management in diabetes care.
The review aimed to identify ways individuals with diabetes adhere to self-management recommendations to achieve optimal glycemic control and reduce diabetes-related complications.
Ms. Omololu, who began her nursing education in Nigeria and then Ghana before proceeding to pursue her PhD in the US, was accepted as an American Diabetes Association scholar in the Fall of 2023 because of her contribution to the diabetes field. She stressed the importance of self-management in diabetes care, stating that diabetes is a complex chronic condition that requires consistent behavioural and lifestyle changes. Persons living with diabetes need to have optimal glycemic control to prevent diabetes-related complications and improve health outcomes, and self-management is critical in achieving these goals. These changes involve careful dietary planning, regular physical activity, medication adherence, and blood sugar monitoring. However, many patients struggle with these practices, leading to poor disease control and increased health risks.
Worldwide, diabetes is a major health concern, affecting millions, placing a heavy burden on healthcare systems, and imposing significant economic burdens. The International Diabetes Federation (IDF) reported 537 million people living with diabetes in 2021, and they expect this number to rise to 783 million by 2045. In the US, 38.4 million people have diabetes, contributing significantly to healthcare costs and lost productivity.
Ms. Omololu further stressed that Africa is also experiencing a growing diabetes crisis, with numbers projected to increase from 24 million in 2021 to 55 million by 2045.
The narrative review utilized various databases, such as EMBASE, PubMed, Ebsco, Medline, and Google Scholar, and focused on keywords related to diabetes management and education. The search aimed to identify strategies to improve adherence and self-care among diabetes patients, highlighting the global and national significance of effective diabetes management.
The review revealed the complexities of diabetes self-management, highlighting key barriers and activities associated with this crucial aspect of diabetes care.
One key takeaway is the identification of barriers to self-management, ranging from psychosocial challenges, inadequate self-efficacy, uncertainty about self-care regimens, tension with healthcare professionals, and personal and sociodemographic characteristics.
According to the researcher, these barriers posed significant obstacles to effective self-management, affecting individuals’ ability to adhere to recommended regimens and achieve optimal health outcomes while emphasizing the importance of tailored interventions and support systems to address individual needs.
On the other hand, the study also explored self-management activities, such as medication adherence, blood glucose monitoring, and dietary modifications. Adherence to medication regimens and regular blood glucose monitoring emerged as important self-management components, with varying levels of adherence reported across studies.
Additionally, dietary modifications were found to play a significant role in managing diabetes, with variations observed among different ethnic groups. From ensuring consistent medication intake to monitoring blood glucose levels and making dietary modifications, individuals with diabetes engage in a range of actions to maintain their health and well-being.
Despite the importance of self-management activities, many patients with diabetes face significant challenges in adhering to recommended regimens.
The challenges in observation include a lack of access to healthcare, inadequate health literacy, and limited resources. Consequently, diabetes remains a leading cause of morbidity and mortality worldwide, with an estimated 6.7 million deaths attributed to diabetes in 2021 alone.
Overall, the review findings, coupled with the high mortality rate associated with diabetes, underscore the urgent need for healthcare professionals to prioritize self-management education and support systems to help persons with diabetes achieve optimal glycemic control and reduce the risk of diabetes-related complications. By empowering individuals with diabetes with the necessary knowledge, skills, and resources, we can reduce the burden of diabetes and improve health outcomes for millions of people worldwide.
