On 14 November 2009, the Regional Director of WHO’s message to celebrate World Diabetes Day for the year said the campaign slogan was “Understand Diabetes and Take Control”. The WHO engages people in a worldwide campaign, focusing on diabetes advocacy, awareness and effective prevention and control. The preventive measures dwell much on proper knowledge of the disease and its management and control. This emphasises the importance of having adequate knowledge to be able to control the disease.
Based on the fact that diabetes is a serious chronic disease that imposes life-long demands on people living with it and their families – as well as the clinical team, of which nurses serve as fulcrum – the whole world is focusing on the role of nurses in the control of diabetes.
In December 2006, the United Nations General Assembly in a landmark resolution recognised diabetes as a chronic, debilitating and costly disease. This confirms the depth of disease burden of diabetes mellitus. This chronic disease impacts greatly on the individual, family and the government. The world at large is confronted with the challenges of the diseases burden costing great in terms of financial and infrastructure to combat the scourge of DM worldwide.
According to the WHO, within the past decades, the number of diabetics has been on the increase. The cases were estimated to be 30 million in 1985 and 150 million in 1995 had risen to about 250 million in 2009. It is estimated that currently, over 300 million people worldwide are at risk for type 2 diabetes as the most prevalent type of diabetes, whereas it is a preventable.
This call for a collaborative and concerted effort to create and raise awareness on effective prevention and control measures. There is the danger of the number of diabetics rising up to 360 million by 2025. However, the greatest concern is the number of the diabetics that will be pregnant women, adolescents and children.
In the WHO African Regional report, the number of cases is expected to double over the same period from 10.2 million in 2005 to more than 20 million by 2025. This projected explosion in the incidence of diabetes has the propensity to overwhelm healthcare systems universally and most especially the developing countries of Africa and Asia. The impact is capable of undermining the gains of economic development. In some communities there is a dangerous trend of underrating the burden of diabetes and it is in turn devastating the populace by reducing their healthiness and undermining their productivities, thereby causing economic downtrend.
Most type 2 diabetes cases can be prevented by educating and encouraging the vulnerable group who are at risk of contracting the disease to maintain a healthy lifestyle in diet, physical exercises, as well as avoidance of self-medication, alcohol, cigarettes and imported canned foods. Incidentally, there are locally available food items that can sustain a health-promoting life.
Moreover, there is the need to do regular medical check-up, monitor weight, and adopt a healthy diet rich in fruits and vegetables and with low sugar, fats and salt contents. All these require that diabetic patients and those at risk to be prepared to make informed decisions, adopt behavioural changes, and address the related psychosocial issues and challenges associated with diabetes.
The majority of cases of diabetes are community-based and thus the care required id individual and family centred. Also, adequate knowledge of the disease is very important to enhance an efficient self-care. In any case of self-care deficit, hospitalisation and eventual rehabilitation can pose an insurmountable task for a poverty ridden society like ours.
The nurse and diabetes
The theme of this year’s World Diabetes Day is “The Nurse and Diabetes”. The campaign aims to raise awareness around the crucial role that nurses play in supporting people living with diabetes.
According to the WHO:
Nurses accounts for 59 per cent of health professionals
The global nursing workforce is 27.9 million, of which only 19.3 million are professional nurses
The global shortage of nurses in 2018 was 5.9 million. 89 per cent of that shortage is concentrated in low- and middle-income countries
The number of nurses trained and employed needs to grow by 8 per cent a year to overcome alarming shortfalls in the profession by 2030. There must also be strategic planning and purposeful policies to empower and motivate nurses, as well as provision of improved condition of service to enhance retention and reduce attrition rate in the nursing workforce.
WHO estimates that the total investment required to achieve the targets outlined in the Sustainable Development Goals (SDGs) by 2030 stand at 3.9 trillion USD – 40 per cent of which should be dedicated to remunerating the health workforce. This will be an uphill task for countries where there is no particular human resources development for health programmes.
Investing in the health workforce, especially nursing and midwifery, will impact positively on universal health care coverage and also has the capacity to impact other SDGs on eradicating poverty, ensuring inclusive, adequate and equitable education, achieving gender equity through the employment and empowerment of women, promoting decent work and ensuring sustainable and inclusive economic growth.
`Nurses make the difference for diabetics
As highly valued members of the community, nurses do outstanding work to support people living with a wide range of health concerns. People who either live with diabetes or are at risk of developing the condition need the support of nurses. People living with diabetes face a number of challenges; and education and creation of awareness about diabetes is a very vital responsibility of nurses with the skills to support the clients.
Therefore, the International Diabetic Foundation has discovered the need to facilitate opportunities for nurses to learn more about the condition and receive training so that they can make a difference for people with diabetes.
Nurses play a key role in:
Diagnosing diabetes early to ensure prompt treatment.
Participating in training and education of various healthcare professionals in Medicine, Nursing, Nutrition and other supportive health workers in giving holistic care to diabetic patients and their families.
Providing self-management training and psychological support for people with diabetes to help prevent complications. The use of community mobilisation, especially with the involvement of nurses in public health specialisation will be of great advantage to the health workforce. It will also help to rebuild the strength of the healthcare system.
Tackling the risk factors for type 2 diabetes to help prevent the condition.
Collaborating with other professional colleagues in the field of Medicine, Pharmacy, and Laboratory Sciences in conducting research towards combatting the menace of diabetes. This collaborative effort is to include mentoring of younger professionals and supervision of nurse assistants on the field of clinical practices.
There is a very significant need for more empowerment, motivation, and scaling up of the nursing workforce. This will help in having effective education and funding to equip nurses around the world with the skills to support people living with diabetes and those at risk of developing type 2 diabetes.
The government, healthcare organisations, policy formulators and healthcare funding agencies must therefore recognise the importance of investing in the education and training of nurses and other frontline healthcare professionals.
With the right expertise, nurses can make the difference for people affected by or are prone to be affected by diabetes.
By Comrade (Nurse) Abdrafiu Alani Adeniji, mni.
President National Association of Nigeria Nurses and Midwives.