The Huge Significance In Of Maintenance And Follow-Up Therapy In The Treatment Of Diabetics

Funom MakamaStarred Page By Funom Makama, 21st Mar 2014 | Follow this author | RSS Feed
Posted in Wikinut>Health>General Health>Diseases & Infections

The management of diabetic hypertension poses special problems for the medical community. Although patient adherence is often a major barrier to successful management, physicians’ belief and prejudices also negatively impact treatment. In addition, healthcare organizations need to provide better support to physicians who feel isolated in their efforts to manage diabetic hypertension.

Management Therapy

• To maintain adherence and compliance with lifestyle measures and medications.
• To monitor BP control during clinic visits and encourage self measurements at home.
• To monitor glycemic control with fasting blood glucose and glycated hemoglobin (Hb Alc)
• Self monitoring of blood glucose which is an integral component of therapy.
• Periodic tests for the presence of microalbuminuria.
• Periodic tests for the presence of microalbuminuria
• Periodic screening and preventive practices for neuropathy and retinopathy (by ophthalmologists).
• Health care team education is vital-multidisciplinary approach is recommended
• Patient education is critical. All women patients of child bearing potential should be educated on the need for good ante-natal care when pregnant.

More Management Control

Depression is associated with diabetes and hypertension. It is a major problem. Patients who are depressed tend not to take good care of themselves. They might not refill their medications or stay on their diet or continue exercise. Proper attention is needed.

Patients should take actions to decided to control risk factors, negotiate goals with physician and monitor progress, resolve problems that block achievement of goals. Providers should give clear, direct messages about importance of behaviour and therapy, include patients in decision about goals, counseling, assess adherence at each visit and develop reminder systems, provide both verbal and written instructions, including rational for treatment, develop multi- component strategies (cognitive and behavioural), develop and use skills in communication and counseling, anticipate barriers to adherence and discuss solutions.

The management of diabetic hypertension poses special problems for the medical community. Although patient adherence is often a major barrier to successful management, physicians’ belief and prejudices also negatively impact treatment. In addition, healthcare organizations need to provide better support to physicians who feel isolated in their efforts to manage diabetic hypertension. Reductions of morbidity and mortality are achievable goals but require aggressive treatment and improved adherence if they are to be reached.

At this point, optimal management of the hypertensive patient is expected to be achieved, especially when the treatment regimen is simplified. However, if the desire blood pressure and blood glucose control goal levels are not reach within a reasonable time, referral to the expert is mandatory.

Opportunities

Specific actions on the part of the patient, the doctor and healthcare organizations are required to increase adherence and improve management. The following strategies may be helpful:
• Provide both verbal and written instructions, including rationale for treatment
• Develop and use skills in communication and counseling.
• Use individually tailored plans and contracts
• Negotiate goals and plans
• Anticipate barriers to adherence and discuss solutions
• Become an active listener by giving a feedback on what you hear.
• Develop multi-component strategies (cognitive and behavioural).

It will be a good idea to have an alliance that involved community health workers, church-based education and screening effort, corporate settings, managed care and pharmaceutical company partners, a health policy and services research group and in-patient and out-patient clinical care sites. Such alliance will illustrate that treatment of diabetes and hypertension required a multi-faceted approach that encourages cultural as well as medical considerations.

Preventable complications and death from the hypertensive diabetics are common in our society. The management poses special problems for the medical community. However, gradual, continual improvement is realistic and obtainable and provides positive reinforcement that may promote long-term compliance. Reductions of morbidity and mortality are achievable goals but aggressive treatment and improved adherence are necessary they are to be achieved.

For more interesting and very important health related and medical articles, click on the links below
1. General Considerations, Clinical And Medical Classifications Of Anemia
2. Heart Failure: Definition, Detailed Causes And Precipitating Factors Of Cardiac Failure
3. Special Investigations In Cardiology II: The Significance Of Echocardiography
4. Clinical Significance And Health Importance On The Actions Of Adrenocorticotropic Hormone (ACTH) On The Adrenal Cortex

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Comments

author avatar cnwriter..carolina
21st Mar 2014 (#)

another well done page Funom..

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author avatar Funom Makama
22nd Mar 2014 (#)

Thanks a lot cnwriter

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author avatar Funom Makama
22nd Mar 2014 (#)

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author avatar Lambasted
25th Mar 2014 (#)

As usual, one of your excellent stuff you have shown to us.. Keep it up Dr. Funom

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author avatar bronnamdi
9th Apr 2014 (#)

Nice and informative article Funom. Thanks for the information.

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