How empowered are patients with type II diabetes?
NM Martin, CN Jayasena, DL Morganstein, D Devendra & A Dornhorst
The National Service Framework (NSF) for Diabetes requires that type II diabetes patients are actively involved in their diabetes management. The use of patient-held, integrated care plans is envisaged to encourage patients to actively participate in their diabetes management and to facilitate the flow of information between primary and secondary care. However, the utility of such schemes may be limited by the current level of patient education regarding the data recorded in these care plans.
We studied the responses of 52 type II diabetes patients (20 male and 32 female, aged 32–83 y) attending outpatients. Although most of type II diabetes (94%) patients described performing home blood glucose monitoring regularly (3 or more times a week), only 48% had brought a record of this to clinic. The majority of patients (79%) did not understand what an HbA1c was. Similarly, two thirds of patients did not understand the significance of blood pressure measurement in type II diabetes. There was no difference in responses when data were analysed according to age (below or above 60 y) and sex.
Although parameters such as HbA1c and blood pressure are often discussed with type II diabetes patients at the time of diagnosis, reinforcement is clearly needed. Our type II diabetes patients may require specific education before patient-held, integrated-care diabetes records could empower them to manage their own diabetes. Patient educational workshops may be better forums for this than time-pressured outpatient clinics. However, an absence of ringfenced funding to implement NSF standards such as patient empowerment may limit options for improved patient education.