Summary
Until recently, care workers, the government, and other international organizations have devoted significant resources to combating infectious diseases (CDs) such as HIV. Noncommunicable diseases (NCDs) such as diabetes appeared to be neglected and gradually gained prominence until they became epidemics. According to global figures from the World Health Organization (WHO) for 2017, insulin resistance caused 1.6 million deaths worldwide in 2015. (Dong et al., 2019). According to Tucker et al. (2021), insulin resistance will be the sixth leading cause of death worldwide by 2030, with the condition spreading more rapidly in emerging nations. However, there is scant evidence of a substantial public awareness campaign regarding the effects of insulin resistance in expanding cultures (Corkey et al., 2021). In addition, no research examines the effects of teaching adult diabetic patients about insulin resistance. Nonetheless, multiple international studies highlight the significance of education in glycemic management (Howard et al., 2021). This study aimed to teach patients that insulin is a hormone, not a medicine, and to investigate the effects of this information on patients’ comprehension and behavior. Since patients must be aware of how to address and treat insulin resistance and its complications, the intervention’s effect on their lifestyle is expected to assist them in adhering to their treatment regimens and achieving optimal health.
Insulin Education and Knowledge
Patients with diabetes must have access to accurate information about insulin. Aoki et al. (2001) stated that knowledge about diabetes is crucial for self-care management. Patients with diabetes suffer when there is a lack of education about the disease, even though many of the problems may be prevented or treated by the patient themselves (Villaverde et al., 2021). Definition, hormonal imbalance, symptoms, and causes of diabetes; monitoring, which includes diabetic dietary habits and information on the nutritional content of diverse ethnic meal kinds; and the project’s conclusion. Lack of knowledge, biases, and stigmas are only some causes and consequences of insulin resistance that must be addressed (Gosh & Saboo, 2022).
People’s lack of knowledge of insulin resistance, which led them to suffer financially, contributed to a lack of knowledge about how diet and exercise may assist. The community’s attitudes toward comorbid illnesses like obesity were influenced by a lack of knowledge regarding their prevalence (Fang et al., 2016). According to Dong et al. (2019), societal and individual health would improve if this information gap could be closed. Individuals need help making ends meet because they are uninformed about insulin resistance and the positive effects that dietary and exercise adjustments can have on the condition.
Understanding insulin resistance is critical for treating the condition. While there is widespread agreement that a knowledge gap exists, it has been difficult to focus on diabetes education due to the scope and scale of insulin resistance as a medical condition and societal concern (Elliot et al., 2017). Nonetheless, when discussing insulin education, many researchers think about patient-to-patient training, which has been shown to have superior benefits for glycemic management (Laurenti et al., 2021). Rodriguez-Gutiérrez and Montori (2016) outlined a structured learning framework that included classes that lasted six weeks and four quarterly group meetings. Positive outcomes were also seen, suggesting that the glycemic control strategies had been effective. In a 2017 study, Lee et al. compared nurse-led training versus hospital treatment that included instruction and found that both increased insulin endurance. Healthcare providers may empower patients to take charge of their health by providing accurate information.
Peer support, lifestyle therapy treatments, sufficient training, and the right diet are examples of supplementary educational efforts that help patients feel more capable and have lower insulin resistance levels, in addition to the principles of education. According to Skjaervold et al. (2017), patients benefit from peer support when members of their social network provide motivation and serve as a call to duty. For instance, the client and their peers benefited from the help and guidance given, which decreased the overall levels of insulin sensitivity. Corkey et al. (2021) found that a diabetes awareness program that included education on healthy eating as part of a larger lifestyle change was associated with reduced insulin intolerance. Patients should be educated on effective management strategies and be actively engaged in their care once therapy has begun, as Villaverde et al. (2021) pointed out. Subsequent studies focused on educating patients on the benefits and dangers of specific meals and devising meal plans based on seasonal produce (Tucker et al., 2021). In order to educate the public about glucose intolerance and the special dietary needs of persons with diabetes, this study adopted a structured learning strategy. Patients benefit from increased confidence and lower levels of insulin resistance after participating in supplementary educational activities.
Research suggests that structured education effectively treats insulin resistance, helping patients achieve glucose control and sustain lifestyle adjustments. Patients with fewer cases of diabetes, for instance, may be more likely to have completed primary school with the help of a good educational program (Laurenti et al., 2021). Greenway et al. (2022) state that patient education about insulin resistance and therapy is critical for achieving glycemic control. As a result, a combined teaching effort on the part of nutritionists, physicians, and the client is required to achieve the desired outcomes related to blood sugar control.
Meal Planning
The effects of insulin sensitivity may not manifest for years in some people, but chronic elevation is hazardous since it increases the risk of cardiovascular complications. Those who suffer from glucose intolerance would do well to understand the physiological consequences of glucose and how to mitigate those effects through a balanced diet (Fang et al., 2016). Many diets exist, but a healthy, well-balanced diet is crucial for insulin (Elliot et al., 2017). Hence, nutrition is essential to treatments and a viable alternative to conventional pharmaceuticals.
People’s eating habits differ; thus, nutritional intervention plans should be flexible enough to accommodate them. Because of their potential impact on blood sugar levels, fat and energy are now factored into the carb count. Patients and doctors may need help deciding on the best diet because there is no standard to follow (Elliot et al., 2017). According to Howard et al. (2021), nutritional treatment goals should be tailored to the individual, considering their needs, background, way of life, religious beliefs, illness progression, and openness to change. A person’s eating habits should be assessed before meal planning can begin. People need guidance on how to frame the diabetic diet as a healthy eating plan for the whole family rather than a punishment (Howard et al., 2021). Calories, fat, fruits, vegetables, calcium, and water would all be staples in every meal. Foods also need to be affordable and accessible. For this reason, it is recommended that a patient plans their meals with the meal hierarchy, dish arrangement, feed exchanges idea, calorie tracking, and insulin response in mind.
Self-Efficacy
Patients who participated in the training reported feeling more confident in their ability to make good food choices and stick to a healthy diet based on the plate method, both effective in lowering insulin resistance. Self-efficacy assures a person can perform the advised action (Ghosh & Saboo, 2022). The engaging training provided in the current experiment gave the individuals the direction and support they needed to maintain a standard healthy diet utilizing the plate approach to reduce insulin resistance. For example, each person received instructions through group tasks to create nutritious foods using the provided plates, food replicas, and actual food to show that they understood the plate approach. Skjaervold et al. (2018) show that blood sugar seems reduced with a complete approach to insulin resistance education using lifestyle choices, including food and exercise. Several patients might struggle to commit to lifestyle modifications.
Theoretical Framework
The Health Belief Model (HBM) and the Transtheoretical Model serve as the overarching theoretical foundations for this investigation (TTM). Understanding how patients’ views regarding insulin resistance and its management can affect their behaviors is facilitated by the HBM. The TTM aids in pinpointing where patients are in the behavior change process and offers direction on how to tailor interventions to each individual’s wants and needs (Liu et al., 2021). Knowing how diabetes patients feel about insulin resistance and how it should be managed, including their thoughts on the pros and cons of different treatment choices, is essential.
The Health Belief Model is a tool that can be used to assess this level of knowledge (HBM). Also, by showing patients where they are in the change process, the TTM can motivate them to improve their behavior (Aoki et al., 2001). Healthcare providers can use this insight to develop individualized interventions (Rodrguez-Gutiérrez & Montori, 2016), such as offering education and encouragement to people in the deliberation stage and more specific methods to those in the preparation and action stages. Healthcare providers can personalize interventions for each patient by considering their perspective on insulin resistance and its treatment and their motivation to alter their lifestyle. These theoretical frameworks have special applicability in the setting of our focus population, adults with diabetes. One proven method of treating insulin resistance is teaching diabetic patients how to use insulin as a hormone to re-sensitize cell receptor sites.
The Health Belief Model
The HBM is an interactive cognitive health approach predicting how individuals or groups understand and view their wellness. The health belief model (HBM), first utilized by the US healthcare system in the 1950s, served as the foundation for this study (Dong et al., 2019). The HBM focuses on the mental and social hypothesis that claims that a person’s prognosis of a behavioral shift, such as a culture shift, predicates on the individual’s awareness of the hazard of a disorder, which prompts an ambition to avoid the ailment or get more robust if the individual is already ill (Fang et al., 2016). Hence, individuals would also make decisions depending on how they perceived the advantages of changing their behavior and any potential drawbacks.
The HBM has changed since its creation, as seen by the two new constructs that seem added to the initial four. According to the HBM, an individual’s decisions about whether to undertake action to mitigate a health issue depend on six key constructs (Villaverde et al., 2021). The six constructs are risk perception, severity, perceived advantages, perceived obstacles, and self-efficacy (Tucker et al., 2021). For instance, learners in education programs become aware of the dangers of unchecked insulin resistance. The results show how practical glucose intolerance and self-management classes enhance self-care competence. Diseases like insulin resistance, which the individual can better comprehend by adopting a healthy lifestyle and using their prescriptions as directed, can bring on complications and cardiac issues (Lee et al., 2017). Therefore, food habits are essential for training individuals to handle chronic illnesses like insulin resistance and reduce weight.
Through educating clients with high blood sugar levels to embrace their perception of the risk of problems of insulin resistance, albeit if they do not feel ill, the HBM supervised this effort. For instance, people must think that uncontrolled high blood sugar levels can result in heart issues, stroke, deformities, and other difficulties, including fatalities (perceived severity) (Laurenti et al., 2021). People may see that adhering to the prescribed diet can lessen these risks (perceived advantages) without experiencing any adverse effects or having trouble obtaining the suggested foods (perceived barriers) (Laurenti et al., 2021). The educational initiative should inspire and promote change (cue to action) (Laurenti et al., 2021). Patients who make dietary changes can ensure average glucose concentrations, boosting their self-confidence in self-care (self-efficacy).
Likelihood of Outcome/ Action
Researchers have examined the correlation between self-efficacy and the success of people with diabetes in controlling insulin resistance. According to Skjaervold et al. (2018), patients’ ability to put their knowledge about diabetes into practice is a key factor in the Health Belief Model’s (HBM) success in controlling the condition. Physical activity and healthy eating have been suggested as viable strategies for lowering the risk of diabetes-related problems. Dong et al. (2019) define self-efficacy as confidence in one’s ability to accomplish a goal despite obstacles and shifting priorities. An individual’s self-confidence, which in turn can have a major impact on their capacity to control diabetes, is said to be impacted by how others see them (Skjaervold et al., 2018). Improved patients’ perceptions of their ability to manage insulin resistance were the study’s focus since doing so improve outcomes and reduce blood glucose levels. With increased confidence, Howard et al. (2021) believe patients will be more likely to stick to their prescribed diet and activity plans. It was shown that participants with higher self-efficacy levels were more likely to succeed in their goals.
Synthesis
Researchers used the Health Belief Model (HBM) to account for respondents’ lack of knowledge and the negative effects of cultural variations on their actions. Using the most up-to-date ideas during planning and development is essential for achieving desired outcomes (Ghosh & Saboo, 2022). Education is a useful tool in treating insulin resistance in people with diabetes. As a strength of the research, patients with diabetes with education had better glycemic control, higher medication adherence, and more developed self-management abilities, as documented by Liu et al. (2021). Unfortunately, it is difficult to draw firm conclusions from the studies because of the limitations that exist in some of them. Some research, for instance, relies on participants’ self-reports, which could be inaccurate or biased, which is one of the study’s shortcomings. The difficulty in comparing the efficacy of education to that of other interventions or standard care is compounded by the fact that some studies need a control group. Furthermore, the effects of education on other outcomes, such as quality of life or healthcare utilization, are rarely evaluated in studies (Tucker et al., 2021). So, more studies are required to evaluate the long-term effects of education on insulin resistance treatment and its cost-effectiveness compared to alternative interventions. In addition, further research is needed to determine the best methods for customizing patient education to meet each person’s unique requirements.
References
Aoki, T. T., Grecu, E. O., Arcangeli, M. A., Benbarka, M. M., Prescott, P., & Ahn, J. H. (2001). Chronic intermittent intravenous insulin therapy: a new frontier in diabetes therapy. Diabetes Technology & Therapeutics, 3(1), 111-123. Web.
Corkey, B. E., Deeney, J. T., & Merrins, M. J. (2021). What regulates basal insulin secretion and causes hyperinsulinemia?Diabetes, 70(10), 2174–2182. Web.
Dong, S., Lau, H., Chavarria, C., Alexander, M., Cimler, A., Elliott, J. P.,… & Lakey, J. R. (2019). Effects of periodic intensive insulin therapy: An updated review. Current Therapeutic Research, 90, 61–67. Web.
Elliott, J., Zaias, N., Escovar, S., Deguzman, L., Counce, D., Dixit, R.,… & Holloway, W. (2017). Microburst insulin infusion: Results of observational studies—Carbohydrate metabolism, painful diabetic neuropathy and hospital/emergency department utilization. J. Diab. Metab. Disord. Contr, 4, 116–121. Web.
Fang, H. J., Zhou, Y. H., Tian, Y. J., Du, H. Y., Sun, Y. X., & Zhong, L. Y. (2016). Effects of intensive glucose lowering in treatment of type 2 diabetes mellitus on cardiovascular outcomes: a meta-analysis of data from 58,160 patients in 13 randomized controlled trials. International journal of cardiology, pp. 218, 50–58. Web.
Ghosh, S., & Saboo, B. (2022). The reversal model for metabolic syndrome (RMMS) studies The rationale and design. Journal of Diabetology, 13(2), 166. Web.
Greenway, F., Loveridge, B., Grimes, R. M., Tucker, T. R., Alexander, M., Hepford, S. A.,… & Lakey, J. R. (2022). Physiologic Insulin Resensitization as a Treatment Modality for Insulin Resistance Pathophysiology. International journal of molecular sciences, 23(3), 1884. Web.
Howard, S. W., Zhang, Z., Linomaz, J., Lam, W., Qian, Z., Thurman, J., & BeLue, R. (2021). Efficacy evaluation study for microburst insulin infusion: A novel model of care. Frontiers in Public Health, p. 9, 600906. Web.
Laurenti, M. C., Dalla Man, C., Varghese, R. T., Andrews, J. C., Jones, J. G., Barosa, C.,… & Vella, A. (2021). Insulin pulse characteristics and insulin action in non-diabetic humans. The Journal of Clinical Endocrinology & Metabolism, 106(6), 1702-1709. Web.
Lee, B., Song, T., Lee, K., Kim, J., Han, S., Berggren, P. O.,… & Jo, J. (2017). Phase modulation of insulin pulses enhances glucose regulation and enables inter-islet synchronization. PloS one, 12(2), e0172901. Web.
Liu, H., Yu, H., Qiao, J., Sun, L., Li, J., Tan, H., & Yu, Y. (2021). Oscillations of C‐peptide in the euglycemic clamp and their effect on the pharmacodynamic assessment of insulin preparations. Fundamental & Clinical Pharmacology, 35(4), 771-780. Web.
Rodríguez-Gutiérrez, R., & Montori, V. M. (2016). Glycemic control for patients with type 2 diabetes mellitus: our evolving faith in the face of evidence. Circulation: Cardiovascular Quality and Outcomes, 9(5), 504-512. Web.
Skjaervold, N. K., Knai, K., & Elvemo, N. (2018). Some oscillatory phenomena of blood glucose regulation: An exploratory pilot study in pigs. Plos one, 13(4), e0194826. Web.
Tucker, T., Hadley, J., Alexander, M., Lakey, J. R., & Loveridge, B. (2021). Case Series: Reversal of Diabetic Neuropathy Utilizing Physiologic Insulin Resensitization. Int J Diabetes Metab Disord 6 (2), 160–163. Web.
Villaverde, Z., Tucker, T., Hepford, S., Lakey, J., & Hinman, R. (2021). Improved kidney function following physiologic insulin resensitization treatment modality. J. Endocrinol. Disord, 5, 2640-1045. Web.