People with blood sugar that is not controlled constitute a significant health risk for primary care doctors. The general population of diabetes includes those who have been medically diagnosed as having either type 1 or type 2. Untreated diabetes gives rise to severe outcomes in the form of complications such as cardiovascular diseases, neuropathy, nephropathy, and retinopathy, to name a few (Krop et al., 2023).
Adherence, failure to take recommended medications, and adopting a healthy lifestyle are the most common health behaviors noticed in this group. The reasons for this behavior can be either a lack of comprehension of the importance of medication adherence, low health literacy, poverty, cultural beliefs, psychological issues, or other social determinants such as access to a wholesome diet or secure spaces for physical activities (Letta et al., 2021). Risk factors for these patients are a sedentary lifestyle, old age, and non-adherence to the medication.
Access to healthcare services, such as follow-up visits, purchasing medicines, and diabetes education, is proportionately related to the proper management of blood sugar levels (Letta et al., 2021). These barriers, such as lack of health insurance, issues with transportation, long waiting lists, language problems, and the scarcity of doctors in the rural parts of a country, may be the main ones.
For this particular health problem, one of the aims is to obtain the best compliance with the medication and the management of the conditions of diabetes by the patients through educational and supportive programs. Effective health promotion services/programs, including diabetes self-management education and support programs, are essential in improving glycemic control, decreasing the risk of diabetes-related complications, and improving the quality of life of people with diabetes (Ernawati et al., 2021).
The importance of diabetes self-management education and support (DSMES) for such patients in primary care settings is undoubtedly enormous. They provide such necessary tips as giving the proper medication dosage, performing constant blood sugar checkups, including healthy food, exercising, and problem-solving. Moreover, the DSMES programs are not only about giving patients wise diagnoses, but they also help emotionally as well as motivate them to take charge of their lives. DSMES classes specific to the management of diabetes treatment, in fact, have been shown to result in better control of blood glucose levels, increased use of healthcare facilities, reduced risk of diabetes-related complications, and an overall better quality of life (Ernawati et al., 2021).
Introducing diabetes self-management education and support (DSMES) programs in primary care settings for individuals with out-of-control blood sugar levels is challenging due to access, especially for those living in rural or underprivileged areas. Therefore, not all patients will be able to get a good chance of using these services. Moreover, the cost could be set at a limit as well when health insurance does not cover DSMES, and patients cannot pay the co-pays or the out-of-pocket expenses. Also, multicultural programs could have low effectiveness and attendance levels for patients if they differ in terms of beliefs and preferences for a specific treatment, which could discourage both patients and health providers (Ernawati et al., 2021). Although the programs might face funding issues, which are required to run the programs, training staff and establishing relationships with the community organizations and healthcare providers is essential.
For the administration of patients with uncontrolled blood glucose in primary care facilities, the model of care involves integrated services, including counseling on medication adherence, education and training for patients using the DSMES programs, and overcoming the barriers to healthcare services. DSMES could be considered one of the most efficient ways to prevent complications in patients with diabetes. Nevertheless, these programs have numerous challenges with regard to accessibility, professional expenses, cultural acceptability, and sustainability that have to be resolved to run these programs successfully and reach the intended beneficiaries.
Ernawati, U., Wihastuti, T. A., & Utami, Y. W. (2021). Effectiveness of diabetes self-management education (DSME) in type 2 diabetes mellitus (T2DM) patients: Systematic literature review. Journal of Public Health Research, 10(2), 198–202. https://doi.org/10.4081/jphr.2021.2240
Kropp, M., Golubnitschaja, O., Mazurakova, A., Lenka Koklesova, Nafiseh Sargheini, Steve, K., Eline de Clerck, Polivka, J., Pavel Potuznik, Polivka, J., Stetkarova, I., Kubatka, P., & Thumann, G. (2023). Diabetic retinopathy as the leading cause of blindness and early predictor of cascading complications—risks and mitigation. EPMA JOURNAL, 14(1), 21–42. https://doi.org/10.1007/s13167-023-00314-8
Letta, S., Aga, F., Yadeta, T. A., Geda, B., & Dessie, Y. (2021). Barriers to Diabetes Patients’ Self-Care Practices in Eastern Ethiopia: A Qualitative Study from the Health Care Providers Perspective. Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy, Volume 14(12), 4335–4349. https://doi.org/10.2147/dmso.s335731