An individual's ability to manage symptoms, treatment and consequences of diabetes and in doing so improve quality of life and outcomes
Self-management is described as ‘the individual’s ability to manage the symptoms, treatment, physical and psychological consequences and lifestyle changes inherent in living with a chronic condition’ 1. The majority of people with diabetes want to live full, healthy and active lives and their ability to self-care is critical in this ambition.
A review of the evidence into whether it is worthwhile to support patient self-management by the Health Foundation 2 concluded that there is good evidence that helping people to better care for themselves can improve outcomes and quality of life. What is less clear is how this can best be achieved, especially in order to support changes in an individual’s behaviour.
Ongoing support to enable self-management
Self-management is a cornerstone in the care of people who have diabetes 3 and according to Funnell ongoing support is needed to sustain the changes made during the educational process. That is because the nature of the condition is that it requires daily attention and management. People may have contact periodically with health care professionals (HCPs) but during much of their life they need to have the skills, attitude and support to manage their condition independently (Diabetes UK 2009).
Skills for self-management
Complex long term conditions require the individual to be able to master and sustain a range of lifestyle and clinical interventions independently of the HCP. Living with diabetes is challenging and the skills required range in complexity, for example some patients may simply be required to eat a particular range of foods while others have to manage complex data and equipment such as insulin pumps (eg. DAFNE Programme or ThinkGlucose). People with diabetes also need to be able to make sense of results and make appropriate treatment and lifestyle decisions.
Self-management can also apply in inpatient settings, where people with diabetes may be best placed to manage their own condition. If patients are well enough to manage their own care arrangements should be put in place for them to do this safely. Group based training in self-management has been shown to be effective.
Self-management includes the following topics:
- patient education
- peer support
- the use of social media
- self management in hospital
- Barlow J, Wright C, Sheasby J, Turner A, and Hainsworth J. Self Management approaches for people with chronic conditions: a review. Patient Education and Counselling. 2002;48(2);77-187.
- The Health Foundation (2011). Evidence: Helping people help themselves. London: The Health Foundation.
- Funnell M, (2009) Peer-based Behavioural strategies to improve chronic disease self-management and clinical outcomes: evidence, logistics, evaluation considerations and needs for future research. Family Practice. 27;i17-i22