Article first published online: 9 AUG 2011
© 2011 Blackwell Publishing Ltd
Journal of Advanced Nursing
Volume 67, Issue 9, page 1857, September 2011
How to Cite
Parahoo, K. (2011), Editor's Choice. Journal of Advanced Nursing, 67: 1857. doi: 10.1111/j.1365-2648.2011.05806.x
- Issue published online: 9 AUG 2011
- Article first published online: 9 AUG 2011
Health promotion: the way forward for diabetic control
Diabetes has been described as a 21st Century ‘scourge’, an ‘epidemic’ and a ‘time bomb’. However, it is not a new disease; the first reference to diabetes came from an Egyptian papyrus dated 1550 BC (Diabetes.co.uk, 2011). Recent figures paint an alarming and frightening picture. In 2010, it was estimated that 285 million people worldwide lived with Diabetes, and this figure is expected to rise to 438 million by 2038, accounting for 7·8% of the adult population (International Diabetes Federation, 2010).
The personal, social and economic implications of diabetes are well understood. Health professionals worldwide are faced with the enormous challenge of preventing and treating people with diabetes. However, given the enormity of the problems and the strong association between lifestyle and the disease, health promotion is central to any strategy to meet this challenge. According to Benhalima and Mathieu (2010), ‘in all people with type 2 diabetes, lifestyle advice on nutritional habits and exercise should be part of the therapy’ and that ‘the main focus should be on healthy, balanced diets aimed at maintaining normal weight and avoiding overweight’ (p. 2). Increasing the knowledge and skills of people with diabetes, and empowering them to make appropriate changes to their lives, is therefore the way forward. This is why the study by Chen et al. (2011) on ‘effectiveness of a health promotion programme for farmers and fisherman with type-2 diabetes’ in this issue of JAN, is important. These researchers provide an example of how nurses can work in a multi-disciplinary team to implement a simple health promotion intervention aimed at helping some people in Taiwan to control their diabetes and to acquire the skills and knowledge necessary to prevent foot complications that may result from diabetes.
This article has a number of key positive aspects that are worth highlighting. First, it shows that diabetes care requires a multi-disciplinary approach. In this case, nurses (diabetic educators and public health nurses) and doctors (metabolic physicians and plastic surgeons) worked together to develop, implement and evaluate the intervention. Secondly, it shows nurses and doctors reaching out to people (from rural areas) who would normally have little access to health services. In this study, the target population were farmers and fishermen who would frequently walk barefeet and, therefore, be at risk of foot infection. Finally, it illustrates the desire, willingness and ability of nurses to seek evidence about the effectiveness of their practice. They used robust measures to evaluate this intervention. The intervention was delivered by means of group health promotion education and individually tailored home counselling (Chen et al. 2011). The results of this single, pre-and post test study were encouraging; they showed that there was poor diabetic control among rural elders, significant improvement in major physiological indicators and foot care capability and ‘reversed peripheral neuropathy and peripheral vasculopathy’ (Chen et al. 2011, p. 2064). Despite these positive findings, these researchers also recognized the limitations of not including a control group.
Interventions such as this can be costly in term of resources, in particular, the amount of time spent by health professionals in delivering and assessing it impact. However, this should be counter-balanced with the cost of treating diabetes complications and the implications of poor health and the prospect of amputations for people with diabetes.
- 2010) Challenges in the management of hyperglycaemia in type 2 diabetes. In The Diabetes Atlas, 4th edn (International Diabetes Federation (2010), IDF, Brussels, pp. 1–7. & (
- 2011) Effectiveness of a health promotion programme for farmers and fisherman with type-2 diabetes in Taiwan. Journal of Advanced Nursing 67, 2060–2067. , , , , , & (
- Diabetes.co.uk (2011) Diabetes History. Retrieved from http://www.diabetes.co.uk/diabetes-history.html on 26 June 2011
- International Diabetes Federation (2010) The Diabetes Atlas, 4th edn. IDF, Brussels.