Diabetes Care & Counseling

Need for Counseling in Diabetes

Diabetes is a chronic, incurable condition that has considerable impact on the life of each individual patient. Patient involvement is paramount for the successful care of diabetes. The principal task of the health care team is to give each patient knowledge, self- confidence and support. Patients with diabetes and their families provide 95% of their care themselves and, as a consequence, educational efforts to improve self- management are central components of any effective treatment plan.

The role of self-management behavior is clear even in studies that address relationships between pharmacologic treatment and outcomes at the physiologic level. For example, both the Diabetes Control and Complications Trial (DCCT) and the United Kingdom Prospective Diabetes Study, (UKPDS) required patients to adhere to complex and intensive treatments over long periods of time. The primary goals of DM management are to reduce the risk for microvascular and macrovascular disease complications, to ameliorate symptoms, to reduce mortality, and to improve quality of life. Appropriate care requires goal setting for glycemia, blood pressure, and lipid levels, regular monitoring for diabetic complications, dietary and exercise modifications, appropriate medications, appropriate self monitoring of blood glucose (SMBG), and laboratory assessment of the aforementioned parameters.

Studies have confirmed that the complications of diabetes can be reduced by proper control of blood glucose. The proper control is dependent on the patient’s adherence to medications, life style modifications, frequent monitoring of blood glucose, etc and can be influenced by proper education and counseling of the patient. Pharmacists, being one of the indispensable members of the health care team, have an immense responsibility for counseling these patients.

Diabetes, if untreated, can lead to various complications such as neuropathy, nephropathy, retinopathy, hyperlipidema, diabetic foot ulcers, infections, etc. These complications adversely affect the quality of life of the patient. Quality of life is a multidimensional concept referring to a person’s total well being, including his or her psychological, social, and physical health status. It is also well established that pharmacist provided patient counseling improves the quality of life of the diabetic patients.

Role of Pharmacists in Diabetes Management

Because of the rapid expansion of available therapeutic agents to treat diabetes, the pharmacist’s role in caring for diabetic patients has expanded. The pharmacist can educate the patients about the proper use of medication, screening for drug interactions, explain monitoring devices, and make recommendations for ancillary products and services.

The pharmacist, although not the health care professional to diagnose diabetes, is important in helping the patient maintain control of their disease. The pharmacist can monitor the patient’s blood glucose levels and keep a track of it. During their contact, the patients can ask the pharmacist any questions they did not ask the physicians and can get further information regarding diabetes. The pharmacist can also counsel the patients regarding insulin administration regularly so that the onset of complications can be postponed by having tight glycemic control. Another important role of pharmacist is always being available to answer the questions of the patients. Overall, it is the pharmacist’s role to help a diabetic patient in the best possible way to cope with their disease.