Diabetes is one of the chronic diseases that affect
both the young and old in our society. According to World Health Organization
(2006), at least 171 million people worldwide suffer from diabetes and it is
more prevalent in developed countries. According to American Diabetes
Association (2006), there were about 20.8 million people with diabetes in United
States alone, while in developing countries, increase in prevalence is expected
to occur especially in Africa, where most patients will likely be found by
2030. This increase in incidence of diabetes in developing countries follows
the trend of urbanization and lifestyle changes perhaps most importantly a
“Western – Style” diet (World Health Organization, 2006). In Nigeria though no
estimate of the individuals suffering from diabetes has been made, in a recent
screening exercise carried out in Warri and Sapele (south east, Nigeria) where
787 people attended, 65% were diabetic and hyper-tensive (Urhobo National
Association of North America, 2004). Also at University of Nigeria Teaching
Hospital Enugu the number of patients that attend Wednesday diabetic clinic is
Diabetes is characterized by a disorder in metabolism
of carbohydrate and subsequent derangement of fat and protein metabolism.
Disturbance in production and action of insulin, a hormone secreted by the
islets of langerhans in the pancreas is implicated in the disease
(Shafer,2000). In addition to insulin, aging, over weight and several other
hormones affect blood glucose level there-by preventing glucose from entering
the cells (Clavell, 2005).This leads to hyperglycemia, which may result in
acute and chronic complications such as diabetic keto-acidosis, coronary artery
disease, cerebrovascular disease, kidney and eye diseases, disorders of the
nerves and others (Iwueze, 2007).The management of diabetes poses a challenge
to medical and nursing staff as well as to the patients themselves. Since
diabetes is a chronic disease, most diabetic patients need to continue their
treatment for the rest of their lives. The emphasis is usually therefore, on
the control of the condition through a tight schedule of blood glucose and
urine sugar monitoring, medication and adjustment to dietary modification
(American Diabetes Association, 2003; Iwueze, 2007). Such a chronic condition
requires competent self-care, which can be developed from a thorough under-standing
of the disease process and the management challenges by the patient and family
members. This pre-supposes a need for some form of diabetes education and counseling
for the patient and family members. According to Colbert (2007) educating and
supporting diabetic patients in managing their daily lives are important goals
of diabetic patients care today. Unfortunately, about a third of the people
suffering from diabetes may not be aware of it early considering the insidious
onset and development (Iwueze, 2007). Regrettably too, many who are diagnosed
with the condition demonstrate fears about the future and a general distaste
because of the predominant misconceptions about the disease. This is heightened
by the superstitious explanation of causation of diseases dominant in Africa
where most diseases are caused by “poison” and/or “evil spirits”. Some of these
problems highlighted can be taken care of if patients and indeed the general
public are exposed to diabetes education (Iwueze, 2007).
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[10.] John ME (2007). Handbook of Diabetes Self Management
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