Diabetes Self-Management: Exercise and Nutrition

The Diabetes Association reports that it has been “…well documented that the average person who goes through a diabetes educational program reduces A1C levels by 1 and a half percentage points.” (2011) In fact, the average individual who goes through the program is able to reduce their A1C levels “by 2 points.” (Diabetes Association, 2011)

The purpose of this study is to ascertain the effectiveness of the Diabetes Self-Management for the individual with a focus on exercise and nutrition.

The research study proposed herein has as its primary objective and aim to conduct a research study on a sampling of individuals with diabetes in order to examine the effectiveness of the Diabetes Self-Management initiative with a focus on exercise and nutrition.

Methodology

The proposed methodology for the research study proposed is one of a qualitative nature that will firstly conduct a review of literature on this area of study and that will secondly conduct interviews among patients with diabetes following an educational course on self-management of diabetes through focusing on nutrition and exercise.

Initial Review of Literature

The Diabetes Association Self-Management Education Program involves three steps as follows:

(1) Step one is a one-hour visit with the nurse or dietician diabetes educator. This visit involves the conduction of a full assessment of the patients’ needs and begins the educational process.

(2) Step two is a full day class and described as a “comprehensive seven-hour course covering the basics of diabetes care and the prevention of complications. ” (Diabetes Management Association, 2011) Included are general nutrition guidelines, carbohydrate counting, label reading, and tips for dining out.

(3) The third step is a second one-hour visit with the registered dietician who assists in helping the individual make adjustments to their individualized meal plan. (Diabetes Management Association, 2011)

The work of Christensen, Steiner, and Whalen (2000 ) entitled “Contribution of Medical Nutrition Therapy and Diabetes Self-Management Education to Control Diabetes Control as Assessed by Hemoglobin A1c” reports that diabetes “is characterized by insulin insufficiency, lack of insulin production, and/or resistance to insulin. Lack of glycemic control leads to hyperglycemia and is associated with a variety of serious complications, including retinopathy, nephropathy, neuropathy, and cardiovascular disease.”

Affecting diabetes self-management are factors of “personal motivation, social support, continuity of care, and understanding of meals.” (Christensen, Steiner, and Whalen, 2000) Also affecting self-management of diabetes are factors such as “a busy schedule and holidays.” (Christensen, Steiner, and Whalen, 2000) Findings reported by Christensen, Steiner and Whalen (2000 ) in a diabetes self-management study include the fact that “registered dieticians contribute to improvement in diabetes.”

The stated requirements in self-management of diabetes include such as identification of goals. This specifically refers to what needs to be done to effectively self-manage diabetes including changes in diet, changes in exercise habits and other factors including smoking and drinking cessation. Nutrition and weight loss are of utmost importance in self-management of diabetes. (Arbuckle, 2010 ) Lifestyle changes are reported by Arbuckle (2010) to be the “most difficult diabetes self-management goals because “Many people can learn to eat healthy and add in activity, but their lifestyle sets them up for relapses into bad habits.” (Arbuckle, 2010)

It is reported that Medicare does cover the patient services for Diabetes Self-Management Training to include 10 hours of initial training plus an additional 2 hours of follow-up training. Stated as a requirement for Medicaid coverage to be payable on this training is that the training be inclusive of “blood glucose management, nutrition, physical activity, and preventing and treating complications of diabetes.

Summary of Findings

The initial and brief review of literature in this proposal for research indicates that self-management of Diabetes is possible in its effectiveness if the individual receives proper education in this area. Diabetes self-management educational and training is covered under Medicaid and includes 12 hours of training along with management of blood glucose, nutrition, physical activities, and the prevention and treatment of diabetes complications.

This study concludes that self-management of diabetes is an effective method of diabetes management and is one of the nature that needs to be researched in order to gauge its actual effectiveness.

References

Arbuckle, K.A. (2010) Setting Goals for Diabetes Self-Management. Bright Hub. 18 Oct 2010. Retrieved from: http://www.brighthub.com/health/diabetes/articles/91661.aspx

Christensen, Nedra K., Steiner, Julianne, and Whalen, Jack (2000) Contribution of Medical Nutrition Therapy and Diabetes Self-Management Education to Diabetes Control as Assessed by Hemoglobin A1c. Diabetes Spectrum Vol.13, No.2, 2000. Retrieved from: http://journal.diabetes.org/diabetesspectrum/00v13n2/pg72.htm

Diabetes Self-Management Education Program (2011) Diabetes Society. Retrieved from: http://www.diabetessociety.org/education/3-step

Medicare Coverage of Diabetes Self-Management Training and Medical Nutrition Therapy. Retrieved from: http://www.sdhdidaho.org/hpro/pdf/coverage_self_mgmnt.pdf