Diabetes Management A Manual for Patient-Centred Care

Diabetes is a chronic disease involving self-management by the patients. This book teaches providers the skills to translate and transfer complex medical information to empower patients to participate in making well-informed decisions about their own care on a daily basis, as directed by the American Diabetes Association. It provides the basic knowledge around the pathophysiology of diabetes, different management options including insulin management and calculations, information on how foods affect blood sugars and how to address cardiovascular risk factors. This book aims to change clinical outcomes through its unique presentation of information and its approach to awareness.

Key Features

• Follows a unique approach in imparting techniques that bring long-term patient behaviour changes, making the provision of chronic disease management more efficient and satisfying
• Serves to help professionals in their day-to-day patient management to achieve better outcomes
• Addresses the area of need for primary care and helps to make well-informed decisions by understanding the essential cost of care

INTRODUCTION

1. THE PHYSIOLOGY OF GLUCOSE METABOLISM

There are two sources of glucose

There are two 'kinds' of insulin - basal and bolus

Other hormones assist with glucose homeostasis

The kidneys also play a crucial role

2. THE PATHOPHYSIOLOGY OF DIABETES

Type 1 diabetes

Type 2 diabetes

Monogenic diabetes

Gestational diabetes

Other types of diabetes

3. MAKING THE DIAGNOSIS OF DIABETES

Criteria for the diagnosis of diabetes

Screening: testing for diabetes in asymptomatic patients

Management following a positive test

4. ORAL MEDICATIONS

5. INSULINS AND INSULIN MANAGEMENT

Insulin pharmacokinetics

Insulin delivery

Insulin dose calculations

Essential teaching points

6. SURGICAL MANAGEMENT OF DIABETES

Metabolic/bariatric surgery

Transplantation

7. CONSIDERATIONS WHEN APPROACHING DIABETES MANAGEMENT

Consider the patient as a whole

Consider underlying pathology when selecting management options

Consider the durability of management

Determining the patient’s type of diabetes and underlying pathologies

8. GLYCAEMIC MANAGEMENT Medical management of glycaemia

Individualisation of HbA1c target

Self-monitoring of blood sugars

Blood glucose management

Remission of diabetes

9. LIFESTYLE MANAGEMENT

Exercise

Foods

10. CARDIOVASCULAR RISK MANAGEMENT

Diabetes

Blood pressure

Cholesterol

Smoking

Weight

Renal protection

Aspirin use

11. PROVIDING PATIENT-CENTRED CARE

Establish a working relationship

Find a common language

Understand the patient

Acknowledge the patient as the expert

Find common ground

Empower the patient

12. EMPOWERING THE PATIENT FOR LIFELONG SELF-MANAGEMENT

Provide opportunity for ongoing education

Ensure supports and safety nets are in place - for both patient and provider

Hand over the controls

PATIENT HANDOUTS

Janet Titchener, MD, is the Medical Director of GPSI Diabetes Ltd, New Zealand, and provides care for all types of diabetes, across all age groups. Her clinical practice adheres to the principles of patient-centred clinical medicine so that each patient is considered the expert with regard to knowing which management approach will best fit with their life and life’s choices.