Barriers to Self-Management of Diabetes

Barriersto Self-Management of Diabetes

Aquantitative study among low-income minority diabetics

Thisstudy entails the critique on the article “barriers toself-management of diabetes among the low-income minority”(Onwudiwe, Mullins, Winston, Shaya, Pradel, Laird, &amp Saunders,2014). It seeks to examine the strength and weaknesses exhibited inthe article concerning the population, setting and variables for thestudy. An in-depth assessment of hypothesis is done with how itrelates to the relevant studies provided in the literature review ofthe article. Further assessment parameters include the type ofresearch design used, description of three variables in the article,ascertaining whether the study was approved by the InstitutionalReview Board (IRB) (Onwudiwe, Mullins, Winston, Shaya, Pradel, Laird,&amp Saunders, 2014), accessing credibility of the researcher andexamination of confidentiality provisions for the subjects.

Inthe article diabetes self-management highlighted by the authors isdepicted as an important assessment tool in diabetes maintenance. Thestudy focuses on exploring the common barriers to diabetesself-management, termed essential step in the attainment of theoptimal health results. The study utilizes the patient perspectiveconcerning what they understand as the obstacles to diabetesself-management that then offers an explanation as to why poor healthoutcomes experienced by the minority of the patients.

Inthe study, the researchers identified the variables, the patientswith seemingly successful management of diabetes particularly themajority with adequate access to medical literacy and the minoritypatients with poor health outcomes due to many barriers toself-management of diabetes. The perspective of the patients’perceived barriers was used to explain the prevalent of high rates ofdiabetes among the minority population.

Theminority population which is the main target of this study isidentified. Thirty-one African American patients are used as therepresentative of the minority group suffering from diabetes. Thoughthe sample represents minority people, it is not conclusive as it didnot incorporate other minority population living in the UnitedStates. The research was conducted in Baltimore Health system (BSBHS)a partnership study that was funded by the NIH. Theresearch-intensive medical center and the University of MarylandBaltimore were among the partners of the study.

Theassociation was planned to offer an exceptional open door to examinehow an organization between BSBHS and the university upheld by thegroup, can give a stage to enhance patient, doctor and frameworkadherence. The study enlisted primary consideration doctors andpatients of these doctors. Patients were enrolled from both centers.Inside of every facility, they were randomized to either persistenttraining gathering or the control group. In order to underscore thesynergistic organization and the creative learning between the twofoundations, full infection ranges were inspected where BaltimoreUniversity concentrated on hypertension, what`s more, BSBHS centeredon diabetes(Onwudiwe, Mullins, Winston, Shaya, Pradel, Laird, &ampSaunders, 2014). As a portion of this association concentrates on,the popular target of this exploration was to investigate thepatients` discernments about boundaries to self-administration ofdiabetes from the objective populace (Pyatak et al., 2014).

Thisarticle utilized relevant studies to bring about an explanation ofbarriers to effective management of diabetes in the minoritypopulation. The researchers identified diabetes disease as the fifthcause of death in the United States. The large proportions of thoseaffected are the minority groups, with the African American havingthe highest prevailing rates of about 11% followed by the Caucasianswith 8 %. It approximates that the rate of prevalence of females istwice in African Americans (14%) than those of Caucasian (7%).Inseveral studies conducted researchers agree that diabetes type 2 isusually four times more prevalent in African Americans than fornon-Hispanic Whites. Lifestyle and Genetic factors are prone torepresent the expanded predominance of type 2 diabetes among ethnicminorities. (Onwudiwe, Mullins, Winston, Shaya, Pradel, Laird, &ampSaunders, 2014). The article has cited numerous studies reporting ahigher commonness of insulin resistance in minority population amidthe campaign to control diabetes, lifestyle variables, and obesity.It is provided in the article that financial factors, for example,pay might likewise assume a part in the expanding predominance ofdiabetes also, diabetes-related difficulties.

Economicand social status is a significant parameter of health and aprominent contributor to health variations. Typically, it isconnected with poorer access to medicinal services but on the otherhand health care access and usage among diabetics are high.Regardless of the high rates of medical services access and use amongdiabetics, health status and results found in poor pay minorities isunsuitable. Clarification for the weakness out- comes among patientswith diabetes is poor self-administration hones. Poor adherence tostandard diabetes care suggestions is connected with conflictingresults in clinical practice.

Problematicadherence to standard diabetes care recommendations is as often aspossible saw in patients who have poor correspondence with theirsupplier, absence of comprehension of the infection, polytherapy,imperfect self-checking of blood glucose, what`s more, psychosocialvariables, for example, gloom. Incomplete adherence once saw as apatient issue, is presently regarded as a sign of patients`self-administration of interminable illness inside of the intuitivestructure of suppliers, medicinal services frameworks, families andgroups.

Insideof this system, the element cooperation of patient, medicinalservices suppliers and systemic components can impact the generaladministration of diabetes. The consideration of patients withdiabetes has generally enveloped new and more viable diabeticmedicines and enhanced prescription conveyance systems, but writinghighlights the significance of coordinating self-administrationinstruction (Onwudiwe, Mullins, Winston, Shaya, Pradel, Laird, &ampSaunders, 2014). To enough deliver hindrances to diabetesself-administration and distinguish techniques to overcome them, itis vital to analyze whether extra boundaries still exist. This inessence offers a concise background for the assessment of theprevalent diabetes cases in the minority groups (Pyatak et al.,2014).

Thearticle clearly identified its hypothesis, the examination of thepossible barriers of self-management of diabetes among the minoritypatients that has resulted to poor health results among these groupsof patients.

Theresearch design for the study employed the use of four categories ofAfrican American diabetic patients who were exclusively thirty-one innumber. This represents a quantitative study. These patients wereenrolled in Bon Secours Baltimore Health System (BSBHS). Researcherssource information from these patients through the use of open-endedquestions. These entails a series of questions that required thepatients to provide their understanding about the medication usedcurrent health status, nutrition, blood glucose level and continuityof care.

Itis an effective approach to utilize four samples groups, theresearchers obtained alternative variables which they used to makecomparison and in the process incorporate diverse perspective of thepatients concerning the possible barriers. But on the other hand,the sample group is not proper representation of the minority groupsresiding in the United States. The researchers needed to havefactored out other minority groups such as the Caucasians andnon-Hispanics Whites among others in this study. Using only AfricanAmerican minority group may bring about bias perspective on theexpected barriers to an effective diabetes management by the minoritypopulation. It is therefore required that a more inclusive study,factoring all the minority population, need to be conducted to obtainbalanced perspective on these subject.

Variablesutilized for this study involved the examination of the barriers toeffective self-management programs of the diabetic patients,assessment of the minority population and the prevalent diabeticdisease among them when compared with the majority of the patientssuffering from the same disease. To measure the prevailing barriers,the researchers interviewed the patients in order to obtain therelevant challenges. African American population was identified tobe the minority population, with the others just mentioned also toexhibit a higher prevalent of diabetic conditions.

Inthis study informed consent was obtained before undertaking theresearch. The subjects tasked to provide answers to open endedquestions were given adequate prior information. After which theparticipants completed an informed consent document to warrantrecording of these information by the researchers.

Thestudy was not approved by the Institutional Review Board (IRB) thistherefore may become a major issue to challenge the credibility ofthe research results. However the qualifications of the researcherswere beyond any doubt, all the five researchers had reputableacademic credentials all being PhD holders. To a great extent theymaintain confidentiality of their subjects which is proven when theywithhold the exact names of their subjects.


Onwudiwe,N. C., Mullins, C. D., Winston, R. A., Shaya, A. T., Pradel, F. G.,Laird, A., &amp Saunders, E. (June 01, 2014). Barriers toself-management of diabetes : a qualitative study among low-incomeminority diabetics : research article. SouthAfrican Journal of Diabetes and Vascular Disease, 11,2, 61-65.

Pyatak,E. A., Sequeira, P. A., Whittemore, R., Vigen, C. P., Peters, A. L.,&amp Weigensberg, M. J. (December 01, 2014). Challenges contributingto disrupted transition from paediatric to adult diabetes care inyoung adults with Type 1 diabetes. DiabeticMedicine, 31, 12,1615-1624.