International Diabetes Nursing

Comparing perceived and actual diabetes knowledge among nurses: A rapid review

Colter K. Clayton — 2024-07-05

Introduction: Nurses are valuable care providers to people with diabetes, yet day-to-day diabetes management most heavily relies on self-care practice. Inaccurate self-perceptions of diabetes knowledge among nurses may be linked to inadequate adherence to self-care practice among people with diabetes.

Methods: The present study is a rapid review of perceived and actual diabetes care-related knowledge among nurses since an unusual inverse correlation of perceived and actual knowledge was first reported by Drass and colleagues in 1989.

Results: Seventeen studies in 10 countries met the eligibility criteria for full review.

Discussion: Low-to-moderate positive correlations revealed a discrepancy between perceived and actual knowledge among various nursing fields.

Conclusion: Nurses with an accurate assessment of their own diabetes knowledge may be better equipped to not only treat people with diabetes, but also promote self-care practice through formal or informal interaction.

Excessive daytime sleepiness and associated factors in patients with type 2 diabetes mellitus: a cross-sectional study

Jing Huang — 2024-10-10

Aim: This study aimed to assess the prevalence and associated factors of excessive daytime sleepiness (EDS) in patients with type 2 diabetes mellitus (T2DM).

Methods: We conducted a cross-sectional study in Beijing, China, from November 2015 to October 2016, and patients with T2DM were invited to participate. Structured questionnaires were used to collect data. EDS was assessed using the Epworth Sleepiness Scale (ESS), and anxiety and depression were assessed using the Hospital Anxiety and Depression Scale (HADS). Logistic regression analysis was used to evaluate factors associated with EDS.

Results: Of the 224 patients with T2DM, 24 (10.7%) had EDS. The proportions of anxiety, depression, and comorbid anxiety and depression were significantly different between the EDS and non-EDS groups. ESS scores, anxiety scores, and depression scores were positively correlated. Logistic regression analysis showed that mild anxiety (OR 11.055; 95% CI 2.272–53.785; P = 0.003), moderate to severe anxiety (OR 33.223; 95% CI 4.896–225.440; P < 0.001), and mild depression (OR 6.227; 95% CI 1.319–29.399; P = 0.021) were associated with EDS in patients with T2DM. These associations remained significant after adjustment for age, sex, body mass index, diabetes duration, and apnoea–hypopnoea index. In addition, the severity of obstructive sleep apnoea–hypopnoea syndrome was not significantly associated with EDS, anxiety, depression, and comorbid anxiety and depression in this study.

Conclusions: The prevalence of EDS was high in patients with T2DM, and anxiety and depression were significantly associated with EDS. When developing interventions to improve EDS in patients with T2DM, healthcare providers may need to consider interventions that target anxiety and depression.

The experiences of professional footcare among adults living with type 2 diabetes in Switzerland: a qualitative study

Astrid Castelberg — 2024-05-30

Background: Foot ulceration is a common complication of type 2 diabetes, which can lead to amputations and earlier mortality. National footcare guidelines recommend routine foot surveillance, preventative self-management patient education and prompt referral to professional footcare services when complications occur. However, little is known about how people living with type 2 diabetes experience diabetes footcare in Switzerland. The aim of this study was to explore the experiences of people living with type 2 diabetes who are at high risk for foot complications, when accessing and using professional footcare, in the context of the Swiss healthcare system.

Method: Individual, in-depth semi-structured telephone interviews were conducted with adults with type 2 diabetes (n = 9) recruited from two regional hospitals and two primary care practices in the German-speaking region of Switzerland. Data were analysed thematically using Framework Analysis.

Results: Three themes with subthemes were generated from the data: 1) footcare, the neglected component of diabetes management; 2) perceived roles of healthcare professionals; and 3) signposting within the healthcare system. The findings illustrated ambiguity and lack of consistency in the provision of services, which do not always align to national guidelines, as well as a lack of clarity of the roles of healthcare professionals in relation to diabetic footcare.

Conclusion: The experiences of participants in this study highlight the need for increased awareness and new ways of working, including alignment to national guidelines and a clarification of the roles and responsibilities of multidisciplinary healthcare professionals, including general practitioners, diabetes nurses and specialist podiatrists within primary care in Switzerland.

Tailored care by diabetes nurses is not enough to overcome disparities in the regulation of type 2 diabetes between Dutch natives and ethnic minority groups

Mohamed Ahdi — 2024-04-12

Background: Differences in diabetes regulation between patients from different ethnic background have been described. This may be reduced by regular visits to a diabetes nurse (RVDN) with the same mother tongue. We explored whether equal access to diabetes-related care, including RVDN with the same mother tongue, may result in similar diabetes regulation among ethnic minorities and Dutch natives.

Methods: Patients with type 2 diabetes and an annual comprehensive diabetes evaluation were included in this study. For the analysis, we emphasized on the data of patients with RVDN and used descriptive statistics and nonparametric tests for between group comparisons.

Results: From a total of 983 patients, 581 patients had RVDN of whom 266 (46%) Dutch natives, 199 (34%) Turks/Moroccans, and 116 (20%) patients from other ethnicities. Within the group of patients with RVDN, Turks/Moroccans had higher median fasting plasma glucose levels as compared with Dutch natives and other ethnic minorities (8.4 vs 7.9 and 7.3 mmol/L, P < 0.001), and a higher HbA1c level was found for both the Turks/Moroccans and other ethnic minorities, as compared to Dutch natives (62 vs 55 mmol/mol, P < 0.001). In addition, only 22% of Turks/Moroccans and 26% of other minorities achieved the American Diabetes Association/European Association for the Study of Diabetes (ADA/EASD)-recommended HbA1c target ≤53 mmol/mol, compared to 39% in Dutch natives.

Conclusions: In patients with RVDN with the same mother tongue, we still found disparities in HbA1c levels between Dutch natives, Turks/Moroccans and other ethnic minorities. Other factors beyond Dutch language skills are likely to interfere.

Type 1 diabetes and menopause, what women would like to know: a public and patient involvement exercise

Rita Forde — 2024-04-12

Introduction: Managing the impacts of the menopause can be a tedious experience for many women, and when coupled with diabetes, the challenges are multiplied. Literature searches confirm a dearth of information and support to help women with these dual conditions.

Methods: A Patient Public Involvement exercise involving an online survey disseminated electronically via social media amongst the Type 1 diabetes online community. It comprised five closed questions and one open question to elicit priority needs. The survey was supplemented with a subsequent Twitter chat. The paper conforms to the guidance for reporting of patient and public involvement in health and social care research (GRIPP).

Results: Of the 184 women who completed the survey across the United Kingdom, most were aged between 40 and 59 years (n = 167, 90.8%). Although 137 (72.8%) women reported that menopause had impacted on their diabetes, only a minority (n = 50, 27.2%) indicated that it had ever been discussed with them. The overarching theme from the open question was of an overall Lack of awareness about the impacts of menopause, with the following subthemes: 1) Need for information about menopause, 2) An additional burden, 3) Symptoms of diabetes or menopause? and 4) Communication – expectations of care.

Conclusions: Women need information, support and guidance during this phase of life. This oft overlooked aspect of care is engendering frustration and suboptimal diabetes management and will be a topic raised with increasing frequency in general practice and diabetes specialities. The management of diabetes and menopause deserves more attention across the diabetes community.