The world of technology may be the future of healthcare

The world of technology is ever changing. New phones and computers are constantly being developed which can improve and also distract our lives. Healthcare can use this technology to its benefit. Mobile phones can be used to communicate information to patients that can help them manage their diseases better. Reminders for patients to make appointments and monitor conditions, such as checking blood glucose levels, can all be done via automatic text messages. I find this fascinating and powerful. Healthcare workers can use mobile devices to pass along information and reminders which empower patients to better manage their conditions, save money, and avoid potential deadly consequences from their diseases. 

One study done in Chicago demonstrates some of the positive outcomes from using automatic text messages to convey information to patients. This research shows us that it may benefit more healthcare clinics to use technology in this way because it can improve patient outcomes as well as save money.

 http://content.healthaffairs.org/content/33/2/265.full.pdf

Contact

What is the best way to help someone with type II diabetes to lose weight? This is a question that when answered could help many people suffering with type II diabetes. The current research shows that frequent contact with patients can best help them to lose weight.

I find this really interesting and very simple. This is something I can easily remember and apply when I am a RN. I do not need to worry if I am pestering my patients when I question them how their weight loss is coming along. I can spread information about weight loss support groups, and exercise support groups.  I can continue to teach proper eating habits. I can encourage regular exercise patterns and teach how these patterns help diabetes.  

These simple things, and my followup with patients about these habits, will make huge changes in patients health and how they feel. I can encourage my patients with all their positive health changes. By doing so, I can make a huge impact. 

https://implementationscience.biomedcentral.com/articles/10.1186/s13012-015-0354-6

Medications and Diabetes

Knowing how to manage medications with patients who have diabetes can be tricky. However, because diabetes can cause many comorbities, it often becomes necessary to juggle various medications. It is critical to remember that anytime a patient has kidney issues, their body will process medications differently. Also, weight loss through weight loss surgery and/or a diet lower in salt and sugar can be as effective in improving a patients health as medication. Patients need to be taught that healthy eating and exercise need to be taken as seriously and choosing and taking a medication. 

I think that the importance of teaching my patients about eating a healthy diet cannot be overemphasized! I will use this knowledge frequently as I care for my patients. 

Diabetes and Comorbities

Diabetes can cause all sorts of comorbities. Some of these are neuropathy, neuropathic joint disorders, oral health issues (such as gingivitis), emotional health issues, sexual dysfunctions, and more.  It is important after being diagnosed with diabetes to work closely with your primary care physician to correctly treat these various illnesses. Some of these diseases may not be completely within your control to avoid. However, by eating a well balanced diet, getting regular exercise, trying to maintain a healthy weight, drinking enough water, getting enough sleep, and keeping your stress levels down, diabetic patients can reduce the risk of many of the comorbities. Look at the link below for more information.

file:///Users/karinamcdonald/Downloads/Managing%20Diabetes%3B%20Complications%20&%20Comorbidities%20Part%202.pdf

Today let’s focus on one particular comorbitity of diabetes. One that may be a little less common. It is periodontal disease. Here is a link that has more details about it http://www.mouthhealthy.org/en/az-topics/g/gum-disease

Periodontal disease can actually lead to higher A1C levels. Even if you have your weight, diet and exercise managed, if you are dealing with periodontal disease your A1C levels could be high. It is really important to have routine dental cleanings so you can eliminate any pockets of infection that are forming. Ultimately, periodontal disease can damage your teeth. Keeping good oral hygiene through brushing your teeth after eating and also through regular dental cleanings can also help lower your blood glucose levels. 

The Importance of Being Active

This week I read an article about the importance of being active on blood glucose levels. The study in this article http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0055542 found that it is better to move around throughout the day than to sit for most of the day or to exercise for one hour and then sit the rest of the day.  The article states “One hour of daily physical exercise cannot compensate the negative effects of inactivity on insulin level and plasma lipids if the rest of the day is spent sitting. Reducing inactivity by increasing the time spent walking/standing is more effective than one hour of physical exercise, when energy expenditure is kept constant.” 

Our bodies are meant for activity. Activity helps blood flow and keeps blood glucose levels more constant. I can use this information in my nursing practice by encouraging activity. Activity in the form of exercise and activity in the form of moving around throughout the day. My patients will be more healthy if they can internalize this information. 

I feel passionate about the positive impact of regular exercise and think it cannot be stressed enough. It can lift depression and encourage healthy social interaction. I am surprised that it is better for insulin and plasma lipid levels for people to move around during the day than it is to exercise for one hour and then be sedentary. I thought one hour of exercise had more benefits than moving around during the day. However, I will pass along this information as it could potentially benefit my patients health. 

Educating Patients About Diabetes Self Care

I read an research article here http://www.sciencedirect.com.ezproxy.uvu.edu/science/article/pii/S1751991813001563?via%3Dihub  which discussed the importance of educating our diabetic patients about their disease.  Less than 50% of patients receive diabetes self-management education while in the hospital. Thus, many are going without proper education. If healthcare professionals can properly educate diabetic patients about signs and symptoms of hypo and hyperglycemia, how to count carbs, proper diet, and how exercise can benefit them, potentially many hospitalizations which result from a lack in managing diabetes, could be avoided. According to the research stated in this article, the patients who received education reported higher satisfaction than those who were not. Also, those patients had fewer hyperglycemic incidents while in the hospital and also once they were discharged. Educating patients about diabetes is an easy way nurses can help patients learn about the disease and avoid complications associated with it. 

As a future nurse, I need to be sure to educate my patients about their illnesses. It takes many exposures to any topic before a person can really have a grasp on the content. Certainly, any disease process, such as diabetes, deserves to be addressed multiple times by multiple people before sufficient understanding is obtained. Only when sufficient comprehension is achieved can a patient be capable of truly properly caring for their disease. 

Healthy living with diabetes

It is extremely important to have a healthy lifestyle when living with diabetes. Eating healthy, getting exercise, lowering stress, avoiding smoking, and getting regular check ups are all critical with this disease. 

Eat a diet that includes whole grains, protein, fruits and vegetables. Count your carbs and try to eat about the same amount of food at eat meal. Eat frequently to avoid drastic changes in your blood sugar. Limit your sweets and alcohol. 

Exercise is so important! Exercise allows your body to use the sugar in your blood without additional insulin. Aim for 30 minutes per day. 

Keep your stress down. When your cortisol levels (the hormone that measures stress) go up, your blood sugar also goes up. Keeping your stress levels down will help to keep your blood sugar levels lower.

Don’t smoke and if you already do, then STOP! It is not good for you when you have diabetes and it is not good for you if you don’t. 

Go to the doctor regularly to check you and be sure everything seems to be going fine. It is good for preventative health and it is also a good way to stop the progression of not-so-good-things that can be a part of the diabetic disease. 

http://www.heart.org/HEARTORG/Conditions/More/Diabetes/PreventionTreatmentofDiabetes/Living-Healthy-with-Diabetes_UCM_313880_Article.jsp#.WU7p7BPytTY

Asians and Diabetes

Did you know that Asians are at higher risk for developing diabetes? This was news to me. Sixty percent of the world’s diabetic population is Asian. Due to their small frame and low muscle mass, they are at higher risk for diabetes. Also, they tend to have a higher percentage of abdominal fat which makes them at higher risk. This was so interesting for me to learn and I will be sure to take extra care to educate those from Asian ancestry that they need to be sure to keep their BMI below 23 to minimize their risk of developing diabetes.

 

Here is a link with more information.

 http://asiandiabetesprevention.org/what-is-diabetes/why-are-asians-higher-risk

Pregnancy and Diabetes

This week we discussed pregnancy and diabetes.  It takes a little more vigilance to have a healthy pregnancy with diabetes, but it is possible and it is worth the effort. 

It is very important to closely examine what types of medications the patient is taking to be sure they are safe during pregnancy. One insulin, Irbesarten, is  not safe for pregnant women to take because it can cause injury and death to the fetus. However, lispro (Humalog), Levemir and aspart (NovoLog) are “reasonably” safe during pregnancy. 

Due to potential complications,  type 1 diabetes qualifies the pregnant woman as high risk. Having the patient use a continuous glucose monitoring system may be a good way to keep track of her blood glucose levels. If her blood glucose levels are too high, she can get hypertension, preeclampsia or her fetus could die. She could also have an overweight baby which could lead to a c-section. Her insulin needs may increase two to three times during the second and third trimesters so careful glucose monitoring can help detect any insulin changes that need to be made. 

This patient may need to eat frequent, small meals to keep her blood sugar stable and help with nausea. If she vomits what she eats then she is at risk for hypoglycemia. She should carry a fast acting source of carbohydrates with her. 

The pregnant diabetic patient needs to exercise frequently. Exercise will help keep her blood glucose levels down. It will also help her to avoid excessive weight gain. Walking briskly daily for 30 minutes is a good goal. This will also help to keep her blood pressure down and prevent pre-eclampsia. 

The patient will need to have regular check ups with her nephrologist and be monitored closely by her ObGYN. Her doctors can help monitor her blood pressure and any other issues that may arise and help make adjustments as needed. 

I will use the information I learned whenever I care for a pregnant diabetic patient. Because I am interested in working in labor and delivery, this may be frequently! I feel very passionate about helping women be healthy and feel good. Life is too short to feel poorly due to disease. 

https://diabetessisters.org/article/7-techniques-reduce-post-meal-spikes-during-pregnancy

The Non-English Speaking Patient

This week we discussed ways to care for non-english speaking patients with diabetes.

First, it is very important to establish trust with the patient. The person may feel vulnerable to be dealing with a medical issue in a country that doesn’t speak their primary language. If the patient trusts the nurses then he or she will be in a position to listen to what is being taught.

Second, a certified translator needs to be used for communication with the non-english speaking patient. The translator could be someone on staff with the hospital or could be remote. In addition, there are medical language translating websites that can be used such as http://www.online-translator.com/. English can be typed and then translated to a variety of languages automatically. The patient would need to be a proficient reader of his/her primary language for this website to be effective. 

Third, it is important to figure out what the patient already knows. This could be done in a variety of ways. The patient could demonstrate what he/she knows about caring for diabetes. If the patient is younger, a doll could be given to the patient for the patient to “teach” about diabetes.  Once it is established what the patient does and does not know, he/she can be taught in the areas where education is lacking.

Fourth, the patient needs to be thoroughly taught about how to properly care for diabetes. Diet, exercise, and signs of hypo and hyperglycemia need to be addressed.  Visual aids or pamphlets may be used to facilitate learning and understanding. 

Fifth, verify that the patient understands what was taught about caring for diabetes. This could be done with another demonstration. 

Diabetes can lead to life-threatening complications so education about the disease needs to be effective and thorough. Non-english speaking patients can make this a complicated situation. However, there are many resources and manners to help with educating this type of patient so they are able to learn to properly care for their medical condition. 

Here are some links for other articles that have ideas too!

http://scrubsmag.com/how-do-i-deal-with-a-non-english-speaking-patient/

http://www.rnnetwork.com/blog/travel-nursing-tips/tips-for-talking-to-patients-who-dont-speak-english/