An expanded model of diabetes care based in an analysis and critique of current approaches.
OBJECTIVE
To examine and critique various models guiding the care and education of people with diabetes, to develop more helpful and effective approaches to care. The focus is on relationships and communication between patients and healthcare providers.


BACKGROUND
Many patients are not adhering to the recommended treatments, hence it seems that effective diabetes care is difficult to achieve, particularly for patients of lower socio-economic status, who are disproportionately afflicted. The results are usually devastating, and lead to serious health complications that incisively diminish quality of life for patients with diabetes, frustrate healthcare providers and increase healthcare costs.


METHODS
Critical review.


METHODS
This paper represents a critical review of various approaches to diabetes care and education. A CINAHL search with relevant key words was carried out and selected exemplary research studies and articles describing and/or evaluating the various approaches to diabetes care and management were examined. Particular attention was paid to how the paradigmatic underpinnings of these approaches construct patient - healthcare provider relationships.


CONCLUSIONS
The literature revealed that the traditional top-down approaches to care were largely ineffective, while collaborative approaches, based in respect and taking the whole persons and their unique situations into account, were found to be central to good care. Further, an integration of the different kinds of knowledge contained in the various approaches can complement and extend one another.


CONCLUSIONS
Avoiding devastating complications by improving the management of diabetes and overall quality of life of patients is a worthwhile goal. Therefore expanding diabetes care beyond the traditional bio-medical model to develop more effective approaches to care is of interest to all healthcare professionals working in this area.
Associate Professor, School of Nursing, York University, Toronto, Canada.
Isolde
I
Daiski
D003142:Communication; D003920:Diabetes Mellitus / Q000628:therapy*; D006801:Humans; D010353:Patient Education as Topic; D010817:Physician-Patient Relations; D011788:Quality of Life
bio‐medical model; collaborative care; diabetes care; diabetes management; empowerment model; human science perspective