November is National Diabetes Awareness Month which is celebrated around the world to raise awareness and education about this chronic disease. The theme of World Diabetes Day 2020 – November 14th – is The Nurse and Diabetes. Nurses account for over half of the world’s health workforce. They do exceptional work to support those living with diabetes and those who are at risk of developing the condition. As the number of people with diabetes continues to rise around the world, the role of nurses and other health professional (dietitians) and support staff (community health workers) become increasingly important in managing the impact of diabetes.
Evidence continues to support the importance of a multidisciplinary and interprofessional team with training in diabetes within the primary care setting. The team works collaboratively with the primary care provider (PCP). In adults with type 2 diabetes, this care model has been associated with improvements in A1c, blood pressure (BP), lipids, and care process compared to care delivered by a specialist or PCP alone. A reduction in diabetes-related emergency room visits has also been noted when the team includes a nurse trained in diabetes care. Studies found that case management led by specialist nurses or dietitians improved both glycemic control and cardiovascular risk factors (Clement M, et.al). A large, randomized control trial found that nurse-led collaborative-care management was associated with improvements in A1c, lipids, BP and depression in people with depression and type 2 diabetes and/or CHD (Clement M, et.al).
Nurses are greatly involved in educating patients to manage their diabetes. The care of the person with diabetes is complex, challenging, and requires specialized knowledge of diabetes and its comorbidities. Nurses help educate patients about their new situation, informing about diabetes, possible complications and test results. This is facilitated when working with strong teams, with the person with diabetes as the centre of the team. Diabetes educators serve as community resources and diabetes experts, providing professional education to less-experienced caregivers including non-specialist health care providers, medical assistants and community health workers.
Diabetes educators are also an advocate for the individual living with diabetes and their family. Diabetes is an expensive disease. Many individuals struggle to take their medications or to obtain appropriate medical care due to lack of resources. Educators help identify covered medications and supplies, identify resources for supplies and food, and providing ongoing support services and clinical resources. In addition, nurses act as a psychological support. This is an important aspect in diabetes management for patients to feel secure and hopeful.
Nurses are essential in diabetes prevention by helping identify those at risk. Without a doubt, individuals with diabetes will be more successful living with diabetes if they have the support for their diabetes nurse (and team). Providing education and counselling using a team approach is vital in 21st century health care in diabetes management.
Clement M, Filteau P, Harvey B, Jin S, Laubscher T, Mukerji G, Sherifali D. Diabetes Canada 2018 Clinical Practice Guidelines for the Prevention and Management of Diabetes in Canada: Organization of Diabetes Care. Can J Diabetes 2018;42(Suppl 1):S27-S35.