In Malaysia, where the number of people with type 2 diabetes mellitus is on a sharp upward trajectory, the role of the nursing profession has never been more important. The National Health and Morbidity Survey 2019 found that one in five adults in Malaysia suffers from diabetes. This means that approximately 3.9 million people aged 18 years and above have diabetes.
Diabetes, in turn, leads to a high morbidity and mortality as its complications include cardiovascular diseases i.e. strokes, heart attacks, limb amputations. It is also the leading cause of kidney failure. This causes a great deal of pain, distress and disability, not only to the patients but their families and society at large.
It is essential that those who have diabetes be identified, educated about their condition, and treated. There is another troubling entity, however: pre-diabetes. Pre-diabetes is when one has consistently high blood glucose levels which have not yet reached the diabetes threshold. They can be identified because of their abnormal or impaired fasting blood glucose and impaired glucose tolerance.
Approximately 70% of this group of people will go on to develop diabetes. Many studies have shown that even those with pre-diabetes have already got evidence of early cardiovascular complications because of risk factors like obesity, hypertension and high cholesterol levels. This is worse if they are smokers.
Here, the importance of the nurses’ role cannot be overstated. They are usually the first point of contact for patients who engage with the medical profession. Simple nursing protocols put in place to screen, record and convey a patient’s glucose status make this an effective avenue to pick up and diagnose those with pre-diabetes or diabetes. This is a key step in identifying those who have the condition.
In addition, the nature of this noble profession makes nurses the ideal healthcare professionals to begin and oversee the life-long journey of caring for patients with pre-diabetes and diabetes. Those in the nursing profession, in essence, have an eye for detail and their training in establishing protocols ensures that the multiple aspects of managing a patient with diabetes is addressed in a comprehensive manner. This includes details of diabetes education and awareness, self-care, nutritional needs, healthy lifestyle changes, and compliance and management of oral and injectable therapies.
The role of nurses, specifically the diabetes nurse, is vital from the beginning to the end; starting with screening, identifying and documenting patients; continuing on to patient education, self-care, guidance on modifying lifestyles and managing their medical treatment. They are the key to ensuring a holistic management of patients with pre-diabetes and diabetes.
This year, let us recognise the vital role and the selfless work of our nurses in caring for patients with pre-diabetes and diabetes.
Dr Anuar Zaini Md Zain is a fellow at the Academy of Sciences Malaysia.
The views expressed in this article are those of the author(s) and do not necessarily reflect the position of MalaysiaNow.