Aims Of Diabetic Care
- Alleviation of symptoms.
- Minimization of complications.
- Reduction of early mortality.
- Quality of life enhancement.
- Education of the patient and family.
- Features of well organized care
- Use of a register and well maintained records.
- Regular review , following a proper protocol and provision of adequate time and open access for patients to review advice.
- Multidisciplinary team covering all aspects of diabetes care- GPs, diabetes nurses/assistants and educators.
- Continuing education for professional staff.
Each diabetic patient requires 6 monthly review or more frequently as necessary. This should include a through annual review of all aspects of disease and care.
- The indices of blood sugar control e.g HbA1c
- Dietary behaviors, physical activity and injection techniques.
- Foot care.
- Immunizations – infuenza and pneumococcal vaccination.
- Depression screening.
- Any complications like cardiovascular disease, nephropathy, neuropathy, eye disease, errectile dysfunction etc.
All patients with diabetes need a basic information about their disease. The important points are summarized here.
- Diabetes is a chronic condition and however well it is managed in the clinic , the patient has to manage his/ her own disease the rest of the time.
- Diet: Patients do not need a separate diet from the rest of the family or any expensive diabetes food product. A diabetic diet is a healthy diet in which >50% of calories should be taken from fiber rich carbohydrate with a minimum of fat , refined carbohydrate and alcohol. Spread food intake evenly across the day for patients controlled with tablets or diet.
- Exercise: Encourage regular exercise and advise that physical activity can increase insulin sensitivity, decrease B.P and improve blood lipid control.
- Smoking: Advice on and assistance with smoking cessation.
- Psychological problem: Discuss concerns underlying diagnosis of diabetes or development of complications. Arrange counselling as needed.
- Driving and Travel: Advice to take precautions during traveling. Manage changes in time zone, and arrange to transport insulin properly.