Diabetes management

Diabetes management

Situation: need for customized care for diabetics in a residential care center

The number of diabetes patients in Belgium is rising. Timely diagnosis and proper treatment possibly avoid long-term consequences such as blindness or kidney failure. This is different among the very old or elderly with health issues. Blood sugar levels that are too high or too low due to diabetes has a determinative effect on their lives. Additional, avoidable complications such as urinary infections due to excessive sugar levels or hospitalization due to hypoglycemia also arise. An older diabetic often depends on caregivers.

When a diabetes patient enters a residential care center (RCC), this requires adjustment to a new structure with fixed times for eating. This creates a difficult balance between the desires of the patient, the therapeutic requirements and the attainability and meaningfulness of the care required. How does one deal with extremely intensive therapies with minimal results for very old people with a limited life expectancy? Or interventions to change a diet that paradoxically lead to malnutrition and lowering the quality of life? Furthermore, in a residential care center, not only the nurses but also the nursing assistants determine the care for a patient under the guidance of various general practitioners. This leads to confusion and a dilution of the expertise of these caregivers and nurses. The use of different therapeutic schemes limits the expertise of the paramedics. For instance, type 1 patients are often approached in the same way as type 2 patients who are treated with insulin. This is problematic.

Project InnovAGE, a care renewal project

The InnovAGE project pursues improvement in the "quantity and quality" of life of diabetes patients in residential care centers.

The project has three pillars:
1. Educating and training paramedics involved in the care of residents with diabetes, the patient and his or her environment
2. Coordinating the medical and paramedical policy
3. Structured communication among the care actors involved

All caregivers are involved in this care renewal initiative. The residential care centers and the general practitioners concerned support the project. Diabetes specialists (diabetes specialists and paramedical diabetes educators) guide and facilitate the project.

Additionally, a higher quality of life automatically leads to a decrease in the number of avoidable hospitalizations. This is manifest in a substantial reduction in the federal healthcare (RIZIV) budget. Furthermore, this project fits perfectly into the Flemish healthcare objectives. Prevention is central. This occurs by shared care and structured information sharing. The introduction of innovative communication tools is unique. Currently, all the platforms concerning sharing files are targeted at shared data among doctors. This project is committed to sharing data among paramedics and doctors on a very rudimentary level (daily glucose profiles and blood pressure). Expansion is possible.