Abstract
This study focuses on the issue of diabetes among the people of Asian origin. It begins by describing diabetes as a recent pandemic that has imposed a significant burden on diabetic patients and healthcare providers. Diabetes is primarily a metabolic disorder that elevates the level of blood sugar and, hence, causes various complications, including death. The disease is common in Asian communities due to genetic factors, diet, and lifestyle trends. Thus, there is a need for skilled medical professionals, such as nurses, to increase diabetes awareness, encourage the adoption of preventive measures, and promote diabetes care among Asians. As such, this paper examines the role of diabetes specialist nurses (DSNs) in the prevention and management of diabetes with a particular emphasis on Asian communities. Finally, the study concludes that governments and healthcare providers should increase the DSNs’ workforce in order to minimize the prevalence of diabetes in Asian populations.
Diabetes is a modern epidemic associated with a significant social and economic burden for diabetic patients and healthcare services throughout the world. It involves the absence or insufficient production of insulin in the body, which causes the development of hyperglycemia or elevated blood sugar levels (Sturgeon et al., 2016). The disease is a major cause of death and diabetes-related complications in many countries (Dunning, 2014). In 2013, researchers estimated that over 380 million people worldwide had diabetes with the prevalence expected to reach 592 million by 2035 (Nanditha et al., 2016). Generally, eighty percent of diabetic people reside in middle- and low-income countries with over 60% of the patients living in Asia. In recent decades, investigators have shown that the prevalence of type 2 and type 1 diabetes has augmented considerably with the type 2 diabetes being relatively more widespread (Nanditha et al., 2016). According to Asian Diabetes Prevention (2013), Asians have a “higher risk of developing type 2 diabetes, when compared with people of European ancestry.” Furthermore, Asians have a relatively higher likelihood of developing the disorder even when their BMI is low. Although some Asian communities have a low prevalence of obese and overweight individuals, they include “a disproportionately high percentage of people with diabetes” (Asian Diabetes Prevention, 2013). Often, the increased risk of diabetes in Asian communities is attributed to an increased susceptibility to insulin resistance because Asians have a relatively higher likelihood of developing more abdominal fat and less body muscle (Asian Diabetes Prevention, 2013). For instance, although the mean body weight of Indian infants is often lower than the average weight of white newborns, higher insulin and body fat levels are observed in the Indian infants. Nurses that care for Asian American patients have also reported that most of their diabetic patients “do not meet the published criteria for obesity or even overweight” (Hsu et al., 2015, p. 151). Therefore, although a link exists between the level of BMI and the risk of diabetes in Asians, the risk shifts to low BMI levels. Hsu et al. (2015) concluded that the conventional definition “of at-risk BMI for overweight and obesity” seems to be unsuitable for defining the risk of diabetes in Asian communities (p. 151). Thus, the management of diabetes in Asian populations poses a significant challenge for patients, as well as community nurses. In this study, I examine the role of specialist nurses in preventing, diagnosing, and managing diabetes in Asian communities.
Role of Nurses in Diabetes Care
Typically, the provision of effective care to diabetic patients involves the services of a multidisciplinary team. Nevertheless, diabetes specialist nurses (DSNs) have a central role in the delivery of care and support to patients, as well as the patients’ families (Priharjo, 2014). During care provision, DSNs offer patient-centered care that addresses the patient’s spiritual, social, and physical needs. Moreover, the nurses create an interface between diabetic patients and other specialists. However, the complexities associated with modern health care and the constant evolution of the responsibilities and roles of DSNs have created significant challenges for the nurses. Studies suggest that barriers to the self-management of diabetes, as well as diabetes care, include the difficulty of determining the risk of diabetes due to the patient’s life context and ethnic background (Harwood et al., 2013). Nonetheless, such obstacles can be minimized by providing adequate patient-centered care (Flannery et al., 2015). Additionally, nurses should employ efficient methods of detecting diabetes or determining the risk of diabetes. Caregivers working with Asian communities often adopt alternative methods of diagnosing the disease instead of relying on BMI calculations. For example, nurses encourage Asians to measure waist circumference in order to predict their diabetes risk accurately (Asian Diabetes Prevention, 2013). In healthy individuals, the waistline circumference should not exceed eighty centimeters in women and ninety centimeters in men. However, Asians that have not exceeded the target waist circumference may still face a high diabetes risk due to their lifestyle trends and diet. For instance, modernization and urbanization have minimized the levels of physical activities like biking and walking. Furthermore, over fifty percent of adult Asians smoke regularly, which intensifies their risk of suffering from diabetes (Asian Diabetes Prevention, 2013). DSNs, therefore, are expected to encourage Asian communities to avoid smoking, as well as sedentary lifestyles, in order to forestall or delay the onset of diabetes development. Another leading cause of the high rate of diabetes among Asian communities is their daily consumption of large proportions of refined grains like white rice. In addition, Asians often use cooking oils rich in saturated fats and trans fats, which increase their abdominal fat (Asian Diabetes Prevention, 2013). Lastly, air pollution, which is a significant problem in Asian countries, may increase the risk of developing insulin resistance. Thus, nurses working with Asian communities should encourage adults and children to adopt healthier lifestyles and minimize their exposure to air pollution in order to lower their risk of developing diabetes.
Although preventive measures are often successful in reducing the development of diabetes in Asian communities, the treatment of the disease continues to pose a grave medical challenge (Shen et al., 2013). Usually, patients with diabetes have a variety of healthcare needs that require regular assessments and multiple holistic interventions (Priharjo, 2014). As a result, the service provided by DSNs is crucial to the management of the disease, as well as the delivery of quality care. The DSNs’ responsibilities include the provision of clinical services and health education, as well as the referral of patients to clinical psychologists, dieticians, podiatrists, doctors, and other professional teams (Davis, 2015). In particular, the nurses help in identifying diabetic individuals and providing the affected people with knowledge on how to regulate blood sugar and blood pressure levels. They also assist in the management of complications associated with all forms of diabetes. DSNs working in Asian communities care for every age group of the affected people, especially during pregnancy, hospital admissions, and emergencies (Shen et al., 2013). Since the primary focus of diabetes management involves transferring the care of patients with long-term complications to communities, DSNs’ pivotal role includes offering support to such patients with the aim of reducing the impacts of diabetes on the patients’ family members and friends (Flannery et al., 2015). Typically, diabetes is one of the most common long-term conditions that require the patient to perform daily self-care. Hence, the promotion of self-care among diabetic patients is paramount. For instance, DSNs provide instructions on the recognition of signs of disease complications, as well as the significance of nutrition, disease monitoring, and weight management (Flannery et al., 2015). The specialists also assess and review service provisions in order to offer personalized care that addresses the particular needs of patients with multiple and complex requirements.
Despite the DSNs’ qualification and expertise in the management of diabetes, the nurses encounter difficulties in acquiring new skills that match the current environment of healthcare commissioning. Such necessary skills include the laying out of relevant plans, pricing and developing various services, and making bidding proposals, as well as embedding digital technology into health care to ameliorate convenience and accessibility (Davis, 2015). Therefore, the incorporation of advanced technology into healthcare has a vital role in the provision of quality services to diabetic patients in Asian communities (Mohan et al., 2013). For example, Telehealth devices like Smartphones, which give health advice and provide text-based reports about a patient’s blood sugar level, are essential to supporting self-care in the current age of advanced technologies (Balkhi et al., 2015). Since role changes can place a substantial demand on caregivers, DSNs are expected to develop their interpersonal and clinical skills continuously to accelerate the DSNs’ transition from traditional nurses to modern caregivers (Davis, 2015). Such improvements require educational support from universities and other institutions of higher learning to assist the nurses in adopting their new roles.
Recent studies have identified an urgent need for more DSNs in Asian communities due to the high prevalence of diabetes in such populations (Davis, 2015). The demand for healthcare givers continues to augment due to a sporadic decline and upsurge in DSNs’ recruitment globally (Davis, 2015). The enlistment of specialist nurses on temporary contracts, as well as the vacant posts that remain unfilled due to cost saving measures or retirement procedures, is an additional factor that contributes to a decrease in the DSNs’ workforce. Therefore, there is a need for the implementation of measures aimed at expanding the nurses’ workforce (Davis, 2015). DSNs also require continuous training to ensure the provision of cost-effective and quality services to diabetic patients, in addition to establishing valuable therapeutic relationships with patients (Flannery et al., 2015). Such developments are crucial to sustaining the beneficial effects of the care provided to diabetic patients. Accordingly, there is an urgent need for stakeholders, governments, and healthcare providers to address the declining DSNs’ workforce in order to minimize the prevalence of diabetes in Asian communities.
Conclusion
This paper has described diabetes as a modern pandemic that continues to impose a heavy social and economic burden on patients and healthcare services globally. Furthermore, the study has noted that the majority of patients suffering from the disease reside in Asian countries, as well as Asian communities living abroad. The high incidence of the malady among the people of Asian origin is attributed to their relatively greater risk of developing the disorder. Although the delivery of care to patients suffering from diabetes involves a multidisciplinary team, DSNs play a pivotal role in providing care and support to patients and other affected persons. In particular, the nurses offer a holistic patient-centered care and liaise with other specialists in the disease. Although the DSNs working in Asian communities have expertise in diabetes care, they encounter a variety of challenges in their profession. Such difficulties include an inadequate use of modern technology in healthcare delivery and insufficient nursing workforce. Consequently, there is an urgent need for the relevant authorities and healthcare givers to establish and implement measures aimed at increasing the DSNs’ workforce and, hence, minimize the prevalence of diabetes in Asian communities.
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