Breaking down the barriers to good glycaemic control in type 2 diabetes: a debate on the role of nurses

Authors

  • H Nesbeth
  • C Ørskov
  • W Rosenthall

DOI:

https://doi.org/10.1002/edn.129

Keywords:

Glycaemic control, diabetes nurse specialist, glycosylated haemoglobin (HbA1c), patient education, patient support

Abstract

Abstract

The number of people with diabetes worldwide is projected to reach 380 million by 2025, with 90% of these cases attributed to type 2 diabetes. Diabetes can cause a range of long-term complications, including heart disease, stroke and blindness. Studies have shown that poor glycaemic control can increase the risk of developing these complications and guidelines have been developed that provide recommendations on how best to manage diabetes and encourage good glycaemic control. However, a number of barriers to achieving good glycaemic control remain and in many parts of the world treatment is suboptimal. It is generally agreed that glycosylated haemoglobin (HbA1c) testing represents the best way to monitor blood glucose levels. Yet many doctors lack the time and resources required to implement recommended guidelines on HbA1c monitoring. Consequently, patients have a lack of understanding of HbA1c testing and do not achieve target levels. Nurses have an important role to play in treating diabetes. Evidence demonstrates that, through patient support and education, nurses have a notable, positive impact on the proportion of patients achieving HbA1c targets. Given the epidemic proportions of diabetes worldwide, the importance of nurses in diabetes management is likely to increase further in the coming years.

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References

Economist Intelligence Unit Silent Epidemic: An Economic Study of Diabetes in Developed and Developing Countries. London: Economist Intelligence Unit, 2007.

Zimmet P, Alberti KG, Shaw J, Global and societal implications of the diabetes epidemic. Nature 2001; 414: 782–787.

Stratton IM, Adler Al, Neil HA, et al. Association of glycaemia with macrovascular and microvascular complications of type 2 diabetes (UKPDS 35): prospective observational study. BMJ (Clinical research ed) 2000; 321: 405–412.

AACE. American Association of Clinical Endocrinologists medical guidelines for clinical practice for the management of diabetes mellitus. Endocr Pract 2007; 13 Suppl 1: 1–68.

ADA. American Diabetes Association. Standards of medical care in diabetes, 2007. Diabetes Care 2007; 30: S4—S41.

International Diabetes Federation Global Guideline for Type 2 Diabetes: recommendations for standard, comprehensive, and minimal care. Diabet Med 2006; 23: 579–593.

Guidelines. National Institute of Clinical Excellence. Diabet Med 2005; 22 Suppl 1: 5–6.

Khaw KT, Wareham N, Luben R, et al. Glycated haemoglobin, diabetes, and mortality in men in Norfolk cohort of European prospective investigation of cancer and nutrition (EPIC-Norfolk). BMJ (Clinical research ed) 2001; 322: 15–18.

Selvin E, Marinopoulos S, Berkenblit G, et al. Metaanalysis: glycosylated hemoglobin and cardiovascular disease in diabetes mellitus. Ann Intern Med 2004; 141: 421–431.

UK Prospective Diabetes Study (UKPDS) Group. Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33). Lancet 1998; 352: 837–853.

Abrahamson MJ. Optimal glycemic control in type 2 diabetes mellitus: fasting and postprandial glucose in context. Arch Intern Med 2004; 164: 486–491.

Type 2 diabetes practical targets and treatments. //www.idorg/webdata/docs/T2D_practical_tt.pdf [Accessed 12 Oct 2007].

Miedema K. Towards worldwide standardisation of HbA,c determination. Diabetologia 2004; 47: 1143–1148.

Hoelzel W, Weykamp C, Jeppsson JO, et al. IFCC reference system for measurement of hemoglobin Al c in human blood and the national standardization schemes in the United States, Japan, and Sweden: a method-comparison study. Clin Chem 2004; 50: 166–174.

Liebl A, Neiss A, Spannheimer A, et al. Complications, co-morbidity, and blood glucose control in type 2 diabetes mellitus patients in Germany: results from the CODE-2 study. Exp Clin Endocrinol Diabetes 2002; 110: 10–16.

Monnier L, Grimaldi A, Charbonnel B, et al. Management of French patients with type 2 diabetes mellitus in medical general practice: report of the Mediab observatory. Diabetes Metab 2004; 30: 35–42.

Prevost G, Phan TM, Mounier-Vehier C, et al. Control of cardiovas-cular risk factors in patients with type 2 diabetes and hypertension in a French national study (Phenomen). Diabetes Metab 2005; 31: 479–485.

Comaschi M, Coscelli C, Cucinotta D, et al. Cardiovascular risk factors and metabolic control in type 2 diabetic subjects attending outpa-tient clinics in Italy: the SFIDA (survey of risk factors in Italian diabetic subjects by AMD) study. Nutr Metab Cardiovasc Dis 2005; 15: 204–211.

Resnick HE, Foster GL, Bardsley J, et al. Achievement of American Diabetes Association clinical practice recommendations among U.S. adults with diabetes, 1999-2002: the National Health and Nutrition Examination Survey. Diabetes Care 2006; 29: 531–537.

Nitiyanant W, Tandhanand S, Mahtab H, et al. The Diabcare-Asia 1998 study: outcomes on control and complications in type 1 and type 2 diabetic patients. Curr Med Res Opin 2002; 18: 317–327.

Raheja BS, Kapur A, Bhoraskar A, et al. DiabCare Asia - India Study: diabetes care in India - current status. J Assoc Physicians India 2001; 49: 717–722.

Chuang LM, Tsai ST, Huang BY, et al. The status of diabetes control in Asia: a cross-sectional survey of 24 317 patients with diabetes mellitus in 1998. Diabet Med 2002; 19: 978–985.

Charpentier G, Genes N, Vaur L, et al. Control of diabetes and cardio-vascular risk factors in patients with type 2 diabetes: a nationwide French survey. Diabetes Metab 2003; 29: 152–158.

Eliasson B, Cederholm J, Nils-son P, et al. The gap between guidelines and reality: type 2 diabetes in a National Diabetes Register 1996-2003. Diabet Med 2005; 22: 1420–1426.

Mainous AG, 3rd, Diaz VA, Saxena S, et al. Diabetes management in the USA and England: comparative analysis of national surveys. J R Soc Med 2006; 99: 463–469.

Kilpatrick E, Orskov C, Berntorp K, Koblik T. HbAic: the gap between guidelines and clinical reality across eight countries. EASD, 2007; Amsterdam, The Netherlands. A1028.

Cramer JA. A systematic review of adherence with medications for diabetes. Diabetes Care 2004; 27: 1218–1224.

Siminerio LM, Funnell MM, Peyrot M, et al. US nurses' perceptions of their role in diabetes care: results of the cross-national Diabetes Attitudes Wishes and Needs (DAWN) study. The Diabetes Educator 2007; 33: 152–162.

Peyrot M, Rubin RR, Siminerio LM, et al. Physician and nurse use of psychosocial strategies in diabetes care: results of the cross-national Diabetes Attitudes, Wishes and Needs (DAWN) study. Diabetes Care 2006; 29: 1256–1262.

Deakin TA, Cade JE, Williams R, et al. Structured patient education: the diabetes X-PERT Programme makes a difference. Diabet Med 2006; 23: 944–954.

Krakow D, Feulner-Krakow G. LINDA: the diabetes self-management training programme for people with type 1 or type 2 diabetes. Eur Diabetes Nursing 2007; 4: 106–112.

Steuten LM, Vrijhoef HJ, Landewe-Cleuren S, et al. A disease management programme for patients with diabetes mellitus is associated with improved quality of care within existing budgets. Diabet Med 2007; 24: 1112–1120.

Pishdad GR, Pishdad R, Pishdad P, A nurse-managed diabetes care programme. Int J Clin Pract 2007; 61: 1492–1497.

Kim HS, Oh JA. Adherence to diabetes control recommendations: impact of nurse telephone calls. J Adv Nurs 2003; 44: 256–261.

Wong FK, Mok MP, Chan T, et al. Nurse follow-up of patients with diabetes: randomized controlled trial. J Adv Nurs 2005; 50: 391–402.

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Published

2009-09-01

How to Cite

Nesbeth, H., Ørskov, C., & Rosenthall, W. (2009). Breaking down the barriers to good glycaemic control in type 2 diabetes: a debate on the role of nurses. International Diabetes Nursing, 6(1), 29–33. https://doi.org/10.1002/edn.129

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Section

Research Article