The American Journal of Nursing (AJN) in collaboration with the American Diabetes Association, the American Association of Diabetes Educators, Joslin Diabetes Center and the University of Pennsylvania School of Nursing - has sponsored a symposium that identified barriers to, and strategies for, more effective diabetes self management and reaffirmed the nurse's critical role to facilitate better patient self care.

The following are some of the identified barriers to, and strategies for, diabetes self-care:

Difficulty navigating the health care system

• Provide information and support to help patients and use a "patient navigator" to help patients and families work their way through the healthcare system.

Diagnosis of diabetes does not automatically lead to self-management education

• Make a referral for diabetes self-management education a standard component of care.
• Develop a process for tracking it in the inpatient or outpatient setting.

Time to see provider is limited; episodic versus comprehensive focus (acute versus chronic care)

• Use time in the waiting or examination room for education, incorporating audiovisual and creative techniques (such as computer-assisted education).
• Prioritize visit time on the basis of the patient's concerns and health care needs.

Patient education is undervalued by the health care system and payors

• Create a public relations awareness campaign for all stakeholders.
• Promote grassroots advocacy to support reimbursement for diabetes education programs.
• Conduct research to determine the cost-effectiveness of patient education.

The complexity of diabetes education

• Identify the components of diabetes self-management education (such as behavioral goal setting, skill training).
• Develop and disseminate evidence-based approaches to delivering education programs and teaching self-management skills.

Low level of health literacy

• Assume a low level of health literacy when choosing and developing educational materials.
• Use other media (such as DVDs) in addition to print.

The symposium, called "State of the Science on Nursing Best Practices for Diabetes Self-Management" was held in Philadelphia.

According to Katie Weinger, EdD, RN, co-editor of the report, director of the Center for Innovation in Diabetes Education and the Office of Research Fellow Affairs at Joslin Diabetes Center and an assistant professor at Harvard Medical School, Boston:

"We as health care professionals expect a lot from people with diabetes. They need to follow a structured meal, exercise and medication regimen.

Newer treatments to prevent complications can make self-care even more complex causing even the most conscientious patients frustration and leading clinicians to think that they are not properly managing their care."

The said report is published in a special supplement to the June issue of American Journal of Nursing (AJN).

Find more details from the full report.