Empowerment for diabetes management: integrating true self-management into the medical treatment and management of diabetes mellitus.

Approximately 16 million people in the United States have diabetes mellitus, and the number of diagnoses is increasing at an alarming rate. A very costly disease in both human and economic terms, diabetes (currently the seventh leading cause of death) is common in both the old and young, crossing all racial, ethnic, and economic barriers. Diabetes significantly increases the risk of cardiovascular, cerebrovascular, and peripheral vascular disease, retinopathy, neuropathy, and nephropathy. The team approach to treating and managing diabetes provides a foundation of support and education for the patient, while allowing the individual control of his or her health care decisions. A self-management education program is essential for diabetes patients and their support systems to learn optimal strategies for dealing with chronic illness and the associated physical and psychological obstacles. Diabetes education must motivate and empower patients with instruction in self-monitoring techniques, proper nutrition and exercise, pharmacologic options, and psychosocial adjustments to depression and stress brought on by chronic disease, as well as provide resources for continuing education. Ochsner is developing a system-wide diabetes self-management education program as a resource for all of Louisiana and parts of Mississippi to improve the outcomes of diabetic patients. The program has demonstrated significant results since 1998 by providing a comprehensive foundation to patients and their support systems and providing a foundation for the lifelong quest to master the chronic disease process.