Diabetes self-management: How are we doing?

Abstract

Modern management of diabetes places a high burden on patients. New insulin delivery devices and blood glucose monitoring equipment may aid self-care, but only if they are used appropriately and do not malfunction. This study of 130 insulin treated patients aimed to assess their skills in using, their knowledge of and the functioning integrity of their diabetes equipment. Each patient had a one-hour appointment with a diabetes nurse specialist. Patients were interviewed using a structured questionnaire assessing knowledge of self-care and were asked to demonstrate use of their meter and their insulin injection technique. In total, 80% of patients felt confident with the condition of their equipment and ability to use it appropriately. This contrasted with the assessment of the diabetes nurse specialist. Only 8/130 patients did not demonstrate any problems with blood glucose testing, meter use or insulin administration. In all, 19% carried no form of identification to say they have diabetes and up to 40% were inadequately prepared to manage episodes of hypoglycaemia. Disposal of sharps is another area for concern, with 50% of patients disposing of sharps directly into the household waste. Empowering patients to manage their diabetes relies on providing effective education. Our study demonstrates that despite patient perceptions there is a significant shortfall in self-management skills and understanding. Addressing this shortfall remains a challenge for the future. Copyright © 2003 John Wiley & Sons, Ltd.