Chronic complications of diabetes: a creative management approach.

The chronic hyperglycemia of diabetes is associated with long-term damage to and failure of various organs, especially the eyes, kidneys, heart, blood vessels, nerves, and, eventually, the individual's sense of well being. With the new diagnostic criteria for diabetes, the incidence of clinical disease is expected to soar. This article will focus on creative management techniques aimed at lessening these complications of diabetes by using the clinical visit efficiently.

Enhancing self-care in diabetes management using self-regulatory processes.

Findings from recent research on the self-regulatory process in Type II diabetes mellitus have clinical relevance for nurses and other diabetes educators. We analyzed a symptom self-regulation model and its relationship to demographic and therapeutic variables in persons with Type II diabetes mellitus. The model suggested that when such diabetic clients experienced disease-related symptoms, they used these symptoms as signals of abnormal blood glucose and took action to relieve these symptoms and improve their blood-glucose level. These actions were often judged by the investigators to have no immediate effect on blood-glucose level or, in some cases, to potentially worsen blood glucose. In this article, intervention strategies for nurses and other professionals engaged in diabetic education are developed to improve objective validation of symptom accuracy and to modify some perceptions held by the client with noninsulin-dependent diabetes and, in particular, those clients using oral agents.

Comparison of five glucose meters for self-monitoring of blood glucose by diabetic patients.

This study collected data regarding the accuracy of five currently marketed meters for home use of self-monitoring of blood glucose (SMBG). Data regarding ease of operation of each glucose meter as well as cost and availability of meters and necessary materials were compiled. Fasting blood glucose (BG) samples were drawn from patients in the adult and pediatric diabetes clinics at the University of Kansas College of Health Sciences and Hospital. Specimens were tested by a clinical laboratory as well as by each meter. Unadjusted meter readings of whole BG were plotted against laboratory readings of serum glucose and displayed in scattergrams. Scattergrams showed decreased machine accuracy in upper and lower BG ranges. Whole BG values (meter readings) were adjusted to serum glucose levels by multiplication by 1.12. Adjusted values were compared with laboratory serum values using ANOVA for repeated measures and Dunnett's Multiple Comparisons Test: ANOVA and Dunnett's Multiple Comparisons Test showed only Glucochek II (Medistron, Ltd., West Sussex, England; distributed in U.S. by Larken Industries, Lenexa, Indiana) using Dextrostix reagent strips (Ames Division, Miles Laboratories, Elkhart, Indiana) having a statistically significant difference from laboratory values (P less than 0.01). This meter was recently revised and may show changed accuracy readings. Each meter exhibited inherent advantages and disadvantages regarding price, calibration, strip utilization, and ease of operation, which must be considered before recommendation by the health care provider.

Symptom use and self-regulation in type II diabetes.

A model of self-regulation that explains the health behavior of type II diabetic patients was tested by examining the use of symptoms as indicators of perceived blood glucose levels in 38 outpatients. Results of the study supported the self-regulation model by demonstrating that patients use symptoms to monitor blood glucose levels and to guide diabetes-related actions. Implications of the model for planning interventions with type II diabetes are discussed.