What are we doing to address the reality of diabetes?

Wednesday, October 12, 2011 - 1:51pm

Every month, there are approximately 500 Nova Scotians diagnosed with type 2 diabetes. About one-third of patients in our hospitals have diabetes as an underlying health condition. As one of the most obese provinces in the country, these frightening statistics can only be expected to grow. Faced with this reality, what are we doing to address type 2 diabetes at Capital Health?

Vanessa Donnelly and Mary Lou Martin are well versed in the care and prevention of diabetes. As diabetes case management coordinators, they work with teams to develop effective diabetes plans of care for patients. Vanessa and Mary Lou also work with patients to identify challenges and barriers to good diabetes management, and connect them with the resources they need to manage the disease.

Mary Lou says, “When patients come to us, they’re often vulnerable and very regretful. I say, ‘This isn’t about what you could have done. Let’s focus on the future.’”

Recognizing the impact of diabetes on individuals and the health system, Capital Health has set a 2013 milestone to improve metabolic targets for pre-diabetes and diabetes.

“These are good targets,” says Vanessa. “I try to be practical, and it is important to ask ‘How are we going to achieve them?’”

Vanessa and Mary Lou worked with colleagues Dale Clayton, JR Maderville and Barna Tugwell with input from other interprofessionals, to develop pre-printed subcutaneous insulin orders. These orders standardize the way that insulin is prescribed in an inpatient setting to ensure patient safety and optimal outcomes. The Canadian Diabetes Association states that pre-printed orders are best practice.

“It literally is Our Promise in action,” says Vanessa.

Pre-printed insulin orders help us provide better care to those who have diabetes. What is our role in helping to prevent the disease?

Capital Health is headed in the right direction, says Mary Lou. “The changes we are making in our cafeterias to serve healthier foods will help people long term, and programs like Your Way to Wellness are also helping people with chronic illnesses live healthier lives.”

Vanessa says it is important to address the impact of the social determinants of health, such as income and education, on diabetes. What does this look like?

“It has to be a ground-level, citizen-led movement to change things,” she says.

Providing non-judgmental support is important with a disease, or any chronic illness, that has a strong element of self-management.

“When someone develops type 2 diabetes, there may be a judgment from others,” says Vanessa.

Ultimately, when it comes to addressing the diabetes epidemic, Vanessa believes, “The best thing you can do is to live healthfully and prevent diabetes.”

Sharing our learning 

Vanessa spoke about the work we are doing at Capital Health and Our Promise at the Canadian Nurses Association biennial leadership conference in Montreal, QC in February 2011.

“It resonated with people from across the country,” she says. “It made me proud to be from Capital Health. Capital Health is a national leader.”