Preparing nurses to face the pandemic of diabetes mellitus: a literature review

Abstract

Background: Diabetes constitutes a global public health problem. Today about 135 million people are affected and it is estimated that the number in 2025 will be 300 million. Aims: By reviewing existing literature the aim is to raise awareness among nurses, nurse educators and nursing students of the global epidemic of diabetes mellitus, its multiple underlying causes, especially social ones, and how to fight it. A further aim is to discuss the implications for future curriculum content in nurse education programmes. Findings: The main underlying causes of the disease are genetic and environmental factors, such as urbanization and industrialization, as well as increased longevity and changes in lifestyle from a traditional healthy and active life to a modern, sedentary, stressful life and over-consumption of energy-dense foods. This process, labelled ‘coca-colonization’, is evident all over the world, although more so in developing countries. The prevalence of diabetes mellitus varies among populations due to differences in genetic susceptibility and social risk factors such as change in diet, obesity, physical inactivity and, possibly, factors relating to intrauterine development. Migrants are especially affected. Diabetes mellitus needs to be treated by a holistic approach through dietary adjustment, exercise, medication (if needed), education and self-care measures. Type 2 diabetes mellitus is a preventable disease. The main implication for nurses and nursing curricula is to change the focus from the individual with diabetes mellitus and management to prevent deterioration of health (secondary prevention), to population-based community-intervention programmes. These need to focus on health promoting activities to raise awareness among healthy people of the risk factors for diabetes mellitus. Conclusion: Nurses all over the world have an important role in fighting the diabetic pandemic by health promotion aimed to keep people healthy as long as possible.