Introduction
Diabetes, being the seventh cause of death in the United States, is a complex condition that, apart from being dangerous on its own, serves as a contributing condition to such severe diseases as cancer, kidney and liver diseases, and dementia (Centers for Disease Control and Prevention [CDC], 2019). For this reason, there is a need to develop an extensive framework for preventing diabetes, especially with more than 80 million US residents living with prediabetes (CDC, 2020). The latter stands for the phenomenon of people having high blood sugar rates, but such an amount of blood sugar cannot be yet justified as diabetes per se. In the research conducted by Moin et al. (2018), the authors attempted to define the scope of efficiency of such a tool as an online diabetes prevention program in the prevention of diabetes among obese/overweight population with prediabetes.
Intervention tool
The intervention tool chosen for the study by Moin et al. (2018) is an online diabetes prevention program (DPP) that focuses on the reduction of diabetes risk, including excessive weight, lack of physical activity, and poor nutrition. The primary motivation to create this tool is based on the limitation that many people with prediabetes cannot be reached in person, so they fail to receive meaningful intervention and quality education on diabetes prevention. According to Moin et al. (2018), online DPP is “a 12-month intensive lifestyle intervention with weekly modules (educational materials on healthy eating and exercise) delivered asynchronously through a web-based platform” (p. 586). The primary premise of the program is to provide patients with prediabetes with a web-based platform curated by professional health mentors specializing in nutrition, psychology, and exercise physiology.
Patient population
The population of the present non-randomized trial encompassed three groups of people with prediabetes recruited from the Veterans Administration. The population of the research was divided into three major groups: online DPP, in-person DPP, and the Administration’s personal program on weight loss called MOVE! (Moin et al., 2018). The first two groups constituted approximately 260-275 people each, with the MOVE! program being half as much. Over the course of a year-long intervention, the participants were divided into groups in order to secure peer support and a sense of community. The participation included a series of online meetings with coaches and video materials on the matter of physical and nutritional education.
Main findings
The primary goal of the intervention was to enhance the inclusiveness in terms of access to educational resources, peer and educational support for the patients unable to reach out to the assisting resources in person. Hence, in the process of the trial, the researchers aimed at identifying the extent to which online intervention could replace real-life education and progress tracking. Based on such variables as weight loss and the average amount of physical activity calculated in minutes, it was established that online DPP secures the same efficiency rates as the other interventions, making it a relevant and beneficial alternative for people unable to reach out to the professionals personally (Moin et al., 2018). Hence, the findings of this study demonstrate that the implementation of online DPP can become an asset in terms of diabetes prevention among the ones who have a predisposition to the development of this condition at some point in life.
Integration
The implementation of online DPP may be beneficial for people with prediabetes as well as the ones who are at moderate risk of the condition emergence. For example, if it is identified over the course of physical assessment that the patient has a genetic predisposition to the condition, excessive weight, or has irregular and unhealthy eating habits, the patient may be at moderate risk of diabetes development. The introduction of online DPP, in this case, may serve as a beneficial educational and health-promoting tool that does not require regular in-person checkups and interactions with doctors. By receiving wireless scales and access to the educational materials, the patients gain autonomy over their health, but they have the ability to reach out to their physician if they realize they require additional assistance. Hence, this tool may be implemented as a beneficial risk-reduction tool.
Besides reducing primary risks, online DPP is a beneficial tool to manage people with prediabetes or already existing diabetes. Indeed, the control of overweight, nutrition, and physical activity are critical in terms of maintaining normal health conditions and avoiding health complications. For this reason, this tool should be introduced to diabetes patients along with the existing medical treatment and in-person cooperation with the treating physician. In such a way, the patients will be able to have constant access to control over their well-being, as in most situations, it is physically impossible to communicate with one’s physician every day on the matter of weight management progress or the amount of physical activity, By recording these data on the web-based resource, the doctor will have the ability to connect the patient’s condition during the checkup, their blood sugar rate, and the daily patterns of physical activity and diet in order to reconsider the existing treatment and interventions. In essence, online DPP is an additional beneficial tool for both primary and secondary prevention of diabetes.
Psychological aspects of diabetes
Diabetes has a severe psychological strain on the patient due to two primary reasons: self-management and social perception. Indeed, the modern social context fails to recognize diabetes as a serious health condition it is, as the notion of diabetes is stigmatized with the idea that people living with the disease are unable to control their dietary habits and consume many sugary products (Davies, 2019). Moreover, diabetes management puts much responsibility on the individual, as they become in charge of their lifestyle in order to prevent further complications. In this case, it is the nurse’s primary responsibility to provide support and assistance while supporting the patient’s autonomy (Davies, 2019).
Cultural aspects of diabetes
The cultural aspect of diabetes is also important to consider, as this disease is currently more prevalent in ethnic and racial minorities (Moin et al., 2018). For this reason, ethnically diverse patients may be at higher risk of developing diabetes over the life course. It is also crucial for the practitioners to design culturally sensitive interventions regarding the lifestyle and nutrition habits peculiar to a certain ethnic group.
Spiritual aspects of diabetes
Religiosity also plays a significant role in diabetes management, as many people find spiritual beliefs a motivation to come to terms with their disease and value their life. According to Darvyri et al. (2018), “participation in church and spiritual beliefs, which imply the belief in the existence of God, seems to have an ameliorating effect on stress levels and, thus, on glycemic control of these patients” (p. 740). For this reason, nurses should encourage the patients to reach out to the patient’s spiritual communities to find support and rediscover the value of human life.
Conclusion
Diabetes is a highly complex and challenging healthcare condition that requires constant control over one’s habits and lifestyle. The intervention presented in the study may become an asset in terms of assisting such control and education on the matter. Moreover, the facilitation of self-management contributes to the better psychological condition of the patient, which impacts the patient’s progress.
References
Centers for Disease Control and Prevention [CDC]. (2019). Diabetes report card[PDF document]. Web.
Centers for Disease Control and Prevention [CDC]. (2020).Prevalence of prediabetes among adults.Web.
Darvyri, P., Christodoulakis, S., Galanakis, M., Avgoustidis, A. G., Thanopoulou, A., & Chrousos, G. P. (2018). On the role of spirituality and religiosity in type 2 diabetes mellitus management—A systematic review.Psychology, 9(4), 728-744. Web.
Davies, M. (2019). Psychological aspects of diabetes management.Medicine, 47(2), 131-134. Web.
Moin, T., Damschroder, L. J., AuYoung, M., Maciejewski, M. L., Havens, K., Ertl, K., Vasti, E., Weinreb, J. E., Steinle, N. I., Billington, C. J., Hughes, M., Makki, F., Youles, B., Holleman, R. G., Kim, H. M., Kinsinger, L. S., & Richardson, C. R. (2018). Results from a trial of an online diabetes prevention program intervention.American Journal of Preventive Medicine, 55(5), 583–591. Web.