Reflective accounts

Self-managed diabetes

Diabetes is a common long-term condition resulting from a deficiency of insulin secretion or resistance to insulin. It can affect all aspects of an individual’s life, and it is a significant public health issue.

Picture credit: Alamy

Healthcare professionals require appropriate knowledge and skills to help individuals to manage their condition. If diabetes is not well managed, it can lead to complications such as retinopathy, neuropathy, nephropathy and alterations in the circadian rhythm.

Management of diabetes should take into consideration the person’s circumstances and lifestyle. It can be challenging, and may involve monitoring blood glucose levels and carbohydrate intake, adjusting insulin doses and activities, and awareness of the signs and symptoms of hypoglycaemia. Increased stress at work, the presence of a cold or infection, and generally feeling unwell can affect blood glucose control.

Individuals with diabetes are expected to self-manage their condition. On diagnosis, they should be educated about the condition and the importance of monitoring blood glucose levels, ensuring the correct insulin doses are administered and monitoring food choices and portion sizes, depending on their personal requirements and activities.

Blood circulation and sensation can be impaired in individuals with type 1 diabetes, meaning that their feet are vulnerable to injury, and healing can be delayed. They require education on appropriate foot care to prevent ulceration.

A lack of understanding of the condition, treatment regimens and psychosocial issues such as stress, anxiety and depression may complicate the management of diabetes. People with type 1 and type 2 diabetes are responsible for controlling their blood glucose levels on a daily basis and should be encouraged to engage in active decision making and problem solving. It is also important to ensure that they understand their treatment instructions and care plans.


Involving relatives can help to avoid information overload and unnecessary hospital admissions. Empowering individuals to be in control of their condition improves self-efficiency and adherence to management regimens.

Healthcare professionals should ask individuals with diabetes what support and advice they need to enable them to manage their condition successfully. There is a link between diabetes and depression and it is important to ensure that the treatment of both is prioritised.

To support individuals to self-manage their diabetes, I ensure that they have a good understanding of their condition. I encourage self-care through monitoring blood glucose levels before meals and at bedtime, and the self-administration of insulin. I also arrange reviews and ensure the individual has access to treatment when required.

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