- With Mayo Clinic diabetes educators
Nancy Klobassa, R.N., and Peggy Moreland, R.N.
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Nancy Klobassa, R.N., and Peggy Moreland, R.N.
Nancy Klobassa and Peggy Moreland
Nancy Klobassa, R.N., B.S.N, C.D.E
Nancy Klobassa is a registered nurse who has worked in diabetes education for 14 years. She is a certified diabetes educator (C.D.E.) and is currently in graduate school working on a Master of Science in Nursing (M.S.N.) and Health Care Education.Nancy works with adults who have type 1, type 2 and other forms of diabetes. Nancy is coordinator of the Diabetes Unit's intensive insulin therapy program within the Division of Endocrinology, Diabetes, Nutrition & Metabolism at Mayo Clinic in Rochester, Minn. Nancy has worked extensively with insulin pump therapy and continuous interstitial glucose sensing.
Peggy Moreland, R.N., M.S.N.
Peggy Moreland is a diabetes educator in the Division of Endocrinology, Diabetes, Nutrition & Metabolism at Mayo Clinic in Rochester, Minn.Peggy graduated with a Master of Science in Nursing and Health Care Education from the University of Phoenix and is a member of the American Association of Diabetes Educators and the American Diabetes Association. Peggy enjoys working with patients to set and achieve diabetes self-management goals.
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Living with diabetes blog
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Oct. 2, 2009
Diabetes self-management difficult to juggle
By Nancy Klobassa, R.N., and Peggy Moreland, R.N.
It's not uncommon for patients to tell me they don't have time for many of the recommended requirements for diabetes self-management.
You're busy with work, family, school, church, organizations, outside interests, and the general struggles of life. Don't I know, I'm trying to juggle all these things myself and I don't even have to contend with the constant demands of managing a chronic disease.
Honestly, I really don't know how you do all the recommended requirements of diabetes self-management. There are many variables involved that seem to determine how much time people are willing to commit to diabetes self-management — such as personality types, health care beliefs, a basic understanding of diabetes and the education, fears, support systems, acceptance, level of personal importance, healthcare provider input, financial issues, physical abilities, mental abilities, and the list goes on.
The Mayo Clinic has a diabetes simulation program for the endocrine/internal medicine fellows, in which the fellows are to pretend they have diabetes and are instructed to follow a specific scenario using a multiple daily injection program.
They monitor blood glucoses, count carbohydrates, take injections of saline, deal with hypothetical hypoglycemia, keep a food diary, and record insulin and blood glucose readings. I have to say, we've had a few wimps in the program. All in all, it helps give these young budding physicians a taste of the daily grind of diabetes self-management.
A study in "The Journal of the American Board of Family Practice" (July/August 2005) looked at estimated time required for recommended care. The study by a group of certified diabetes educators shows the estimated time required for daily diabetes care to be 122 minutes. This is based on estimated time for patients with stable diabetes who are on oral agents and testing blood glucose once a day. I wonder how many more minutes/hours a day it takes for people on intensive insulin programs, insulin pumps and continuous glucose monitors to manage their diabetes?
Use this chart:
| Estimated time required for recommended care | |||
|---|---|---|---|
| Task | Minutes (ADA) | Your current time spent | Time feasible for you |
| Home glucose testing | 3 | ||
| Record keeping | 5 | ||
| Taking oral medications | 4 | ||
| Foot care | 10 | ||
| Oral hygiene, flossing | 1 | ||
| Problem solving | 12 | ||
| Meal planning | 10 | ||
| Shopping | 17 | ||
| Preparing meals | 30 | ||
| Exercise | 30 | ||
| Other | |||
| Other | |||
| Total time | 122 | ||
Questions:
- To what extend does the time required for diabetes self-management diminish your willingness to follow recommendations?
- Are there ways to make it more manageable?
Are all these expectations realistic for everyone? Of course not. Not everyone is on the same page. I think that one of our jobs as diabetes educators is to assist our patients as to what will work best in their life as far as time commitment.
Let us know your opinions. Have a good week and take care.
Regards,
Nancy
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