Introduction
Spanakis et al. (2012) suggests that Diabetes mellitus has reached an epidemic level in the developed nations. The metabolic disorder, typically presented as elevated blood sugar levels, is common in surgical intensive care units. Research has indicated that the frequency of diabetes within the setting can be between 50 and 70 percent of all hospitalized patients. Treatment for the disorder requires effective management, including careful monitoring of blood sugar for timely insulin therapy. While there has been a defined approach for the management of diabetes, implementation of the management procedures remains inadequate, placing the diabetic people at an even greater risk. Hospitalization for effective management is beneficial but costly for the individual patient and the healthcare system. Therefore, it is imperative to adopt technology that will allow effective management in the care settings, the transition to home, and ongoing care.
Literature Review
Management of diabetes can be performed effectively within the hospital and in home care. The developing clinical evidence shows that there has been a global increase in the efforts to come up with tight glycemic control for hospitalized patients, including the critically ill ones. Such procedures call for extensive nursing work, comprising training the patients and care providers on the management efforts, regular monitoring of blood glucose, guidance on intuitive decision-making, and most importantly, extra task in preventing hypoglycemic episodes. Conventional therapies for a diabetic patient seek to attain normal glycemia using synthetic insulin to control the level of blood sugar. In essence, the achievement of the process depends on the success in monitoring the levels (Spanakis et al., 2012).
Use of technology in facilitating self-management of diabetes is an idea that is not new. Additionally, patients are becoming increasingly technologically perceptive, enabling greater use of technological devices to monitor and manage the disorder in various settings. Technological self-management strategies are increasing with the development of new technologies (Hunt, 2015). It is worth noting that as a source of education and motivation to the user, the technology plays a critical role in easing the use of resources in health care services. The assistance through technology can be achieved by supporting self-management on a daily basis, monitoring blood glucose, healthy eating, exercising, taking drugs, monitoring complications, and problem-solving. Such initiatives are a source of successful treatment plans and self-management behaviors.
Description of the Case
A 50-year-old African American male is admitted in the ICU with a severe case of elevated blood sugar. The history of the patient indicates that he has had diabetes for the last 20 years after he was diagnosed at the age of 30 years. Since the diagnosis, the man has been in and out of the hospital, while in most cases, critically ill. The attending nurse indicates that the main reason for such history is the inadequacy in monitoring the blood glucose and the fact that the patient has been adamant to change his lifestyle, such as quitting smoking.
This patient’s case is not the only one in the hospital, as various other similar patients are unable to manage the condition adequately. In most of these cases, effective management is only available at the hospital. As a result, such cases are costing the health care system millions of dollars in treating and managing diabetes only (Yang et al., 2016). The reality indicates the importance of coming up with better ways of ensuring that the patients can take charge of their condition and attain a sufficient level of self-management.
Discussion
From the literature and as evident in the case, it can be concluded that lack of education and motivation is the basis for the situation of the patient who has diabetes. Hunt (2015) affirms that with evidence-based strategies, it is possible to achieve successful management of the disorder and allow the patients to have a long and productive life. Primary health care resources are limited and could be used in treating other critical conditions instead of being used up in treating a condition in which self-management is possible. Therefore, it is necessary to embrace strategies that can be helpful to the patients and the health care providers achieve success in the treatment and management of the condition (Hunt, Sanderson, & Ellison, 2014). Research has revealed that the solution lies in using technology, which can offer education, motivation, and the support necessary to achieve the self-management objective in diabetes care.
Summary of the Case
There are important facts that are evident in the case. The first one is that the patient is exposed to the health care system at a more regular rate than would be the case with effective self-management. Therefore, failure to implement self-management approaches enhances the increased cost for the health care system in managing lifestyle diseases such as diabetes. Another evident reality is that managing such disorders within the intensive care units has serious cost implications for the health care system. The limited resources should be used in treating and managing other disorders whose success in self-management has not been proven in research. The final reality is the need for effective technological approaches in providing education, support, and motivation towards self-management.
Proposed Solutions
Research shows that the most effective solution to the problem lies in the use of information technology and technological devices effective in achieving adequate transition from hospital to home care as well as the ongoing management of diabetes. Hunt (2015) has provided evidence for the use of technology in supplementing the health care provided in the hospital by offering educational and motivational support. The goal of education can be achieved using technological resources such that the patient understands the importance of adequate self-care and management, including monitoring the blood glucose levels. Clinical information provided through visual devices assists in improving the ability of the patient to recognize that their behaviors and decisions influence the disorder. It also works to augment problem-solving and decision making. While it is necessary to remain in touch with the providers of care, the self-care technologies will reduce the level of contact and the cost of the same. As such, various technologies can be used to achieve the desired goal.
With access to the internet, the patient has at hand adequate apps with information on proper management of the disorder (Hassan et al., 2016). Before leaving the hospital, information should be provided to the patient on the available apps, including BG Monitor Diabetes, Calorie Counter PRO, and Diabetes Pilot Pro, among many others. With the information, the patient will be able to achieve a change in lifestyle. However, the initiative is not enough since the patient should move further to understand the use of technology in monitoring their levels of glucose. IT-enabled diabetes management (ITDM) has evidence of effectiveness in research. Self-care management technologies used by the patients should be used in collaboration with the care providers to ensure a smooth transition and effectiveness in their use. Some of the available resources include automated phone systems with educational materials and electronic diaries for recording data (Hassan et al., 2016). The patient should also be able to use devices such as glucometers and other more modern technological devices such as insulin pens with built-in memory, continuous glucose monitoring (CGM), insulin pumps, and glucose meters with insulin calculators to monitor the level of glucose and manage the use of insulin.
Conclusion
As it is palpable from the above discussion, diabetes affects millions of individuals in the United States, with a huge percentage ending up in the intensive care unit. There is no known successful treatment for the disorder, but the only approach that works is managing the disease. Such is the basis for the proposal to use IT-enabled diabetes management, which research evidence has revealed as being successful in the management of the disorder. The technologies promise to improve care processes and save the health care resources by delaying complications relating to the disorder. Out of the current systems, many approaches have exhibited potential for success, including fully integrated provider-patient systems. In essence, the devices will work by providing the education, motivation and allowing better monitoring of glucose level.
References
Hassan, A., Shaari, N. S., Manaf, Z. A., Ali, N. M., Shahar, S., & Mohamed Ismail, N. A. (2016). Usage of mobile applications in diabetes management: A review. Malaysian Journal of Health Sciences / Jurnal Sains Kesihatan Malaysia, 14(2), 1-10.
Hunt, C. W., Sanderson, B. K., & Ellison, K. J. (2014). Support for diabetes using technology: A pilot study to improve self-management. MEDSURG Nursing, 23(4), 231-237.
Hunt, C. W. (2015). Technology and diabetes self-management: An integrative review. World Journal of Diabetes, 6(2), 225.
Spanakis, E. G., Chiarugi, F., Kouroubali, A., Spat, S., Beck, P., Asanin, S., & Thestrup, J. (2012). Diabetes management using modern information and communication technologies and new care models. Interactive Journal of Medical Research, 1(2), e8.
Yang, J. L., Carina Ka Yee, C., Siew Siang, C., Chirk Jenn, N., Paraidathathu, T., Kwing-Chin Lee, K., & Wen Huey Lee, S. (2016). Intervention for diabetes with education, advancement, and support (IDEAS) study: Protocol for a cluster randomized controlled trial. BMC Health Services Research, 16,1-9.
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