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Teaching Diabetes Self-Management to a Patient Living With Diabetes about Oral Hypoglycemic Agents

Diabetes mellitus (DM) is one of the top ten causes of death as reported by the World Health Organization. In specific, according to WHO, more than 346 million people globally have DM (Shrivastava, Shrivastava, & Ramasamy, 2013). One of the primary causes of DM is hyperglycemia arising from the absolute or relative deficiency of insulin. As such, Oral antihyperglycemic agents have been adopted in the lowering of glucose levels in the blood and the subsequent treatment of DM (Huber & Reich, 2016). Since most of the day to day care in diabetes is handled by the patients, it is vital that they are educated on the various reliable and valid measures that can use to ensure medication adherence to oral antihyperglycemic agents. This paper provides a discussion of how diabetic patients can be taught about self-management especially on the adherence to the intake of Oral antihyperglycemic agents.

Problem Statement

            According to a study by Polonsky & Henry (2016), at least 45 percent of patients with DM fail to achieve adequate control of glycemia because of poor medication adherence. In specific, the presence of combined drug therapy of various oral antihyperglycemic drugs can present various difficulties to the patients in terms of adherence. Some of the key causes of the low rates of adherence to oral antihyperglycemic drugs are the demographics of the patients such as their low levels of education (Beck et al., 2018). The results of poor adherence in medication to oral antihyperglycemic medications include increased morbidity and mortality as well as hospitalizations, increased healthcare costs, and associated health complications (Polonsky & Henry, 2016). As a result, a need arises for the education of patients living with diabetes in the best ways in which they can self-manage their adherence to oral antihyperglycemic drugs.

Assessment

The first step in the provision of education to patients about the self-management of DM especially on the use of oral antihyperglycemic agents is to measure their knowledge and health literacy and thus their ability to not only read but also understand the instructions concerning the medications (Shrivastava, Shrivastava, & Ramasamy, 2013). As such, the patients will be assessed by gauging their ability to read and comprehend the instructions on the medications, calculate the dosages, and understand the risks involved in the uptake of the oral antihyperglycemic medications. One key tool which could be used to evaluate the knowledge and health literacy of the patient on oral antihyperglycemic agents is the Comprehensive Medication Review (CMR) which will determine the patient’s knowledge of the prescriptions, medications, associated risks, and even dietary supplements (AHRQ, 2018).

Cultural Considerations

In the planning as well as the delivery of self-management education for diabetic patients with the oral hypoglycemic drugs prescription, cultural sensitivity is vital as it allows for the provision of culturally competent and sensitive teaching (Huber & Reich, 2016). The diverse demographics of the patients, as well as those of the healthcare providers, requires cultural competency and awareness in the patient education process. According to the American Association of Diabetes Educators. (2017), cultural sensitivity in teaching the diabetic patients will be a vital component in the development of the patients’ self-management education plans. Considering the culture of the patient will facilitate not only the development of successful interactions but also aid in the provision of culturally sensitive patient education program. In the present teaching, the traditions, beliefs, and customs of the patient will be considered and taken into account in the preparation and delivery of the teaching.

DSME Plan

            A diabetes self-management education plan aid in the patient in gaining knowledge, skills, and ability which is necessary for their self-care. In the present case, after the assessment of the patient’s knowledge and literacy, the education will focus on the areas of weakness of the patients in terms of their ability to adhere to the drugs (Beck et al., 2018). The education would entail explaining to the patient about the various types of oral hypoglycemic agents that they should take, the correct dosage that they should take, and the importance of adherence to the medications (Powers et al., 2017). Additionally, any adverse effects of the medications will be explained as well as any dietary supplements which should be taken. Any questions from the patient will be addressed and an assessment done at the end of the teaching to evaluate the comprehension of the self-management aspects taught.

Evaluation

            The effectiveness of the DSME will only be determined by an evaluation of whether the patient has mastered the necessary skills and competencies about oral hypoglycemic agents in terms of the dosage, the timing, dietary supplements, and any side effects. One of the strategies which can be used to evaluate the mastery of the drug adherence of the patients is teach-back. In specific, after the provision of the teaching, the patient will be asked to explain the materials and aspects which have been covered (Powers et al., 2017). Based on the response of the patients, it will be determined how much and how well they have comprehended the aspects taught.