Effect of Diabetes on Healthcare and Nursing

Effect of Diabetes on Healthcare and Nursing

It can be argued that there is no greater health concern in the world, and in particular, the United States than the rapidly increasing number of people diagnosed with diabetes. Relatively recent changes to the diet and lifestyle of the general public have created a "perfect storm" of conditions that seem to perpetuate the onset of diabetes in an increasing number of people on a daily basis.

According to the American Diabetes Association, the annual economic cost directly related to diabetes in 2002, including costs of diabetic care and chronic diabetes-related complications was $92 billion. According to the same survey, indirect costs of diabetes, including lost workdays, restricted activity, deaths, and disability related to diabetes was over $40 billion, bringing the total annual cost of diabetes to approximately $132 billion. Diabetes alone represents 11% of the annual US healthcare spending, and people who have diabetes spend an average of 2.4 times as much on healthcare as people who don't have diabetes. It is estimated that diabetes causes roughly 88 million disability days every year due to hospitalizations and sick days. It is estimated that diabetes affects 246 million people worldwide; a number that is expected to grow to over 350 million by the year 2025 (IDF 2007). Because type-2 diabetes (also known as adult-onset diabetes) makes up 90-95% of all cases of diabetes in the world, the remainder of the paper will be primarily devoted to discussing this type.

It is the responsibility of the nurses to work with doctors and nutritionists to teach patients and to reinforce to them the importance of factors such as: eating the right types of foods, regularly monitoring their blood sugar, and properly administrating insulin if/when it is needed. Too often patients who are diagnosed with diabetes only hear one quick speech from a doctor that supposedly encompasses what diabetes is, the dangers and potential complications of it, and how it is treated. They will then spend ten to twenty minutes with a nutritionist who will attempt to cover every food that the patient should or shouldn't eat. As if this weren't already too much information for the average layperson to take in all at once, if it is determined that the patient requires exogenous insulin to control their sugar, the nurse will then come in to instruct the patient on the proper administration of insulin injections. Shortly after this the patient will be sent home, usually with a list of websites they are told to visit if they have any questions about their diabetes, which is useless if the patient either doesn't own or is unfamiliar with a computer. With so little real education about their diabetes and what it means for their life it is no wonder that people with diabetes suffer so many complications. Nurses are able to make a difference by virtue of the fact that they spend more time with the patient than anyone else. This availability to the patient allows the nurse to answer any questions that they may have. This demands that nurses be well informed about all aspects of diabetes.

The healthcare industry as a whole needs to begin taking a more proactive approach to dealing with the potential problems of diabetes by using patient education to prevent the complications before they occur, rather than afterwards. Unfortunately, in its current state the healthcare industry in America is geared more towards treating acute symptoms of chronic disease, not the diseases themselves. Insurance companies refuse to cover preventative costs, which they justify by stating that "Customers switch insurance companies an average of once every six years, so why should they try to prevent complications that they probably won't have to pay for anyway?" This problem is further compounded by the fact that hospitals, when presented with a choice, tend to opt for the more expensive treatment options in order to get more reimbursement money from the insurance companies. Large healthcare facilities such as hospitals profit greatly from treating the complications of diabetes. Patients in kidney