Health Care and Nursing Policy Critique, Coursework Example

Introduction

Type 2 diabetes in the United States is an epidemic that has a significant impact on the health and wellbeing of millions of people. With this disease, the quality of life for many children and adults is reduced, and these individuals face critical challenges that require healthcare knowledge and expertise to improve health. The chronic nature of the disease and its severity requires an ongoing effort from healthcare experts, public officials, community leaders, and clinicians in order to address its impact on many population groups. Policymaking individuals play a significant role in establishing a precedent to improve diabetes prevention, care, and management for individuals across a variety of population groups. Therefore,  it is necessary to evaluate the impact of widespread diabetes policy on the development of new perspectives to address the disease and to demonstrate its overall impact on individual health. The scope of type 2 diabetes is far-reaching throughout society; therefore, additional measures must be taken that will accomplish the objectives sought through comprehensive healthcare reform and strategic support in order to accommodate the needs of patients with the disease. The following discussion will address policies, frameworks, and strategies associated with type 2 diabetes and will consider the impact of these issues on the health and wellbeing of individuals. Furthermore, ethical concerns regarding type 2 diabetes prevention, care, and treatment will also be considered as part of a larger reform strategy that is designed to improve outcomes related to the disease and its lasting impact on the general population.

Analysis

In the United States alone, diabetes impacts almost 26 million people, including 18.8 million diagnosed cases and 7 million people who have yet to be diagnosed (Centers for Disease Control & Prevention, 2011). Almost 11 million individuals over the age of 65 had diabetes in 2010, which is approximately 27 percent of this population, while 35 percent of adults over the age of 20 had prediabetes as determined by hemoglobin A1c and fasting glucose levels (Centers for Disease Control & Prevention, 2011). Diabetes-related complications include cardiovascular disease, blindness, hypertension, stroke, kidney complications, neurological symptoms, pregnancy complications, dental concerns, and amputations throughout this population (Centers for Disease Control & Prevention, 2011). It is anticipated that diabetes will continue to increase in the younger population for the foreseeable future and expand the diabetes burden for patients, and this requires an ongoing effort to determine this impact and to promote prevention through lifestyle changes for many Americans (Imperatore et.al, 2012). On a global scale, diabetes will impact 439 million adults by the year 2030 at current growth levels, and this requires a substantial effort from a variety of policymakers, knowledge experts, and clinicians in order to accomplish the desired objectives to promote improvements in lifestyle to promote greater prevention of the disease (Shaw et.al, 2010).

Policies and strategies related to type 2 diabetes require an ongoing level of support and expert knowledge from a variety of groups in order to accomplish effective outcomes. First and foremost, recognizing the scope and severity of the disease are primary steps towards improved prevention and management, including the cost burden of the disease for millions of people (Tapp et.al, 2012). The introduction of the Affordable Care Act places an increased emphasis on the development of collaborative approaches that involve multiple disciplines to address the expansive nature of type 2 diabetes and its influence on health status (Tapp et.al, 2012). The physical complications related to the disease are significant, but the social and psychological complications also wreak havoc on the health and wellbeing of many people (Tapp et.al, 2012). As a result, a multidisciplinary approach must be considered that will favorably impact individuals and provide a basis for exploring new insights into type 2 diabetes that support collaborative approaches to manage the disease (Tapp et.al, 2012). One of the key areas of consideration is diabetes education, which requires those with the disease to be able to self-manage their condition effectively through proven strategies (Burke et.al, 2014).There is a significant emphasis on this process in many healthcare communities, but self-management remains a significant challenge (Burke et.al, 2014). One primary objective is diabetes empowerment, which enables individuals to take control of their health and to apply proven techniques in order to improve their health in a positive manner (Burke et.al, 2014). It is necessary to determine the methods that are required to manage type 2 diabetes by using an educational platform in order to accomplish these objectives and to recognize the value of shaping outcomes through expert knowledge and guidance that is used to improve health and outcomes for patients with the disease (Burke et.al, 2014). Furthermore, it is necessary to use education as a means of diabetes prevention for those persons who are at risk and possess poor habits and/or behaviors that pose a threat to their overall health (Burke et.al, 2014). This process is critical to the expansion of education to accommodate those who require advanced diabetes education to meet their health need (Burke et.al, 2014).

Nurses working with diabetic patients require a high level of knowledge and support in order to establish a valuable educational strategy and treatment plan. Nurses working with diabetic patients should provide adequate knowledge of the disease, the self-care that is required, and the development of tools to follow up with patients as necessary as part of the treatment plan (Zolfaghari et.al, 2012). With respect to self-management, it is important to identify the standards that are in place to address evidence-based solutions (Funnell et.al, 2012). Diabetes-related care requires an ongoing effort to demonstrate the importance of nursing as a key contributor to prevention, care, and treatment for patients (Funnell et.al, 2012). Education related to diabetes requires a variety of best practice approaches because there are a number of different options available, and these must demonstrate a commitment to establishing goals and objectives that will contribute to effective outcomes for patients (Funnell et.al, 2012). Similarly, self-management requires an educational program that is conducive to the promotion of standards that have been deemed effective in supporting diabetes patients across the spectrum, whereby these standards support a widespread approach to education that meets the required standards (Funnell et.al, 2012).

The prevention of diabetes requires an effective approach that is grounded in lifestyle behaviors and the ability to overcome specific challenges that impact health status (Nathan, 2010). To be specific, “addressing the underlying lifestyle behaviors — overeating and inactivity — that result in obesity, the primary cause of the epidemic, has had a major and consistent effect in reducing the cumulative incidence of diabetes. In addition, lifestyle interventions have reduced the cardiovascular risk factors that typically accompany the prediabetic and diabetic states” (Nathan, 2010, p. 1). These factors support an effective strategy to ensure that patient care outcomes are addressed in a timely manner and that there are sufficient actions in place to support the growth of diabetes prevention efforts for patients (Nathan, 2010). The prevention of diabetes-related complications must be considered in a timely manner because these reflect the importance of lifestyle interventions that impact quality of care for patients who are at the highest level of risk (Nathan, 2010).

The prevention of diabetes requires a policymaking agenda that encompasses the development of new strategies that encompass the expansion of guidelines to alleviate the disease through lifestyle behaviors and other activities (Dunkley et.al, 2014). From this perspective, it is evident that diabetes prevention supports lifestyle interventions that include efforts to promote weight loss, such as improved nutrition and increased physical activity (Dunkley et.al, 2014). These efforts have been measured through a meta-analysis approach in order to accomplish the desired treatment objectives, while also considering other factors that influence improvements in lifestyle behaviors and other factors that impact specific behaviors which support prevention on a widespread basis (Dunkley et.al, 2014).

There are many possible interventions associated with diabetes prevention that are available; however, some are more cost effective than others and require further investigation in order to determine how to best move forward and promote a positive agenda towards preventing the condition on a comprehensive basis (Li et.al, 2010). From this perspective, diabetes-related interventions for persons with the disease are instrumental in addressing long-term outcomes for patients, including the use of different pharmacological therapies to alleviate the disease and to provide a basis for exploring the different insights regarding care and treatment that impact outcomes for patients (Li et.al, 2010). There are significant factors that must be considered that must be considered beyond pharmacological therapies that include screening tools for diabetic retinopathy and treatment for smoking cessation, among others (Li et.al, 2010). From this perspective, it is evident that organizations must effectively understand the impact of specific interventions on diabetes care and how they influence patient outcomes, while also considering the impact of the disease burden over the long term (Li et.al, 2010).

The prevention of diabetes for those at risk of developing the disease requires a high level of support and understanding for improvements across communities that will positively influence patient care (Green et.al, 2012). From the primary care perspective, it is known that “primary care medicine needs the support of public health or community interventions for primary prevention. Public health also needs the support of the medical care system. Assessing risk status, discussing risk and referring to a proven community-based prevention program is a critical role for the primary care practitioner. For many people, specific encouragement by their health care practitioner is a key factor in taking action to improve their health” (Green et.al, 2012, p. i13). This perspective requires an ongoing effort to demonstrate the importance of diabetes-related interventions that will capture the true nature of the disease and its scope as it impacts patient care across a variety of settings (Green et.al, 2012). This process will also encourage community-based knowledge experts to provide their input and guidance regarding policies that will reach the affected parties and work towards practical solutions to improve their health (Green et.al, 2012). These efforts require an opportunity to examine the different areas that require widespread attention and focus so that patients are provided with the tools that are required to facilitate change and progress for those affected by the disease in one way or another (Green et.al, 2012).

Patients who have type 2 diabetes who possess extreme obesity and other high risk factors must be considered for strategies that will evaluate their potential effectiveness for patients who experience significant reductions in quality of life as a result of the disease (Rejeski et.al, 2012). This process requires a high level of attention and focus that will support and encourage the growth of research and related practice methods to address lifestyle interventions that may be effective in alleviating some of the burden of diabetes and to reduce functional decline in some patients (Rejeski et.al, 2012). Furthermore, lifestyle interventions must be considered as a means of expanding knowledge and frameworks to address specific factors that influence lifestyle behaviors and the ability to overcome the diabetes burden over time (Rejeski et.al, 2012). This process requires an opportunity to examine the different constructs of care and treatment that influence diabetes and how it contributes to the decline in health status for many patients (Rejeski et.al, 2012).

Many patients with diabetes struggle with understanding the importance of self-care for the disease and how it impacts their quality of life (Bains & Egade, 2011). For patients from low income environments, there is an even greater burden associated with the disease in many cases due to lack of adequate knowledge regarding the disease and its influence on long-term outcomes (Bains & Egade, 2011). As a result, health literacy has emerged as a significant factor in the development of new perspectives to accommodate patient care outcomes and to reflect upon the nature of self-care and how it influences health status on a daily basis (Bains & Egade, 2011). A number of important opportunities exist to develop strategies to alleviate some of this burden and to recognize the importance of improving health literacy and education for those in low income areas (Bains & Egade, 2011). It is likely that enhancing education for patients with diabetes must reflect the importance of self-care and its impact on the life span through the provision of specific information to accommodate behavioral changes for this patient population that will lead to favorable outcomes (Bains & Egade, 2011).

The burden of diabetes for patients is extremely high in the United States; therefore, it is important to identity those who are affected by socioeconomic status (SES), as this plays an important role in health behaviors and access to healthcare (Lee et.al, 2011). It is believed that “SES which although not traditionally thought of as modifiable risk factor for disease after a certain age is arguably a potentially modifiable via early implementation of targeted public health strategies for vulnerable populations such as provision of safe, clean space for physical activity as well as educational and job opportunities aimed at improving SES disparities” (Lee et.al, 2011). From this perspective, it may be argued that there are significant issues that require further attention and focus in regards to the needs of individuals with lower socioeconomic status in order to determine how this status affects diabetes risk and outcomes (Lee et.al, 2011). It is the responsibility of local residents and knowledge experts across different communities to recognize this potential burden for persons with lower incomes and to determine how to best move forward with diabetes prevention, care, and treatment (Lee et.al, 2011). It is likely that those from lower income communities will face a greater burden but not necessarily a greater risk than other members of the population; therefore, it is important to identify the resources that are required to enable communities to recognize these disparities and to take the steps that are required to support an expanded approach to manage diabetes effectively in order to minimize complications and symptoms (Lee et.al, 2011).

From the perspective of managing a chronic disease such as diabetes, it is necessary to improve collaborations and partnerships between different community-based organizations and healthcare teams in order to accomplish the objectives required to expand care in this area (Stellefson et.al, 2013). One model to consider is the Chronic Care Model, which is supported by a framework that influences chronic disease management and its burden (Stellefson et.al, 2013). This model reflects the importance of several criteria which include the system of health care, self-management, decision support to address evidence-based practice solutions, delivery and the design of the system that is in place, the adoption of clinical information system capabilities, and the use of community-based resources (Stellefson et.al, 2013). These issues are relevant because they provide a framework for adapting to change and progress and in supporting the development of new strategies to ensure that diabetes is addressed and supported by new perspectives to ensure that patients are able to manage the disease effectively and overcome some of the most important challenges that the disease presents throughout their lives (Stellefson et.al, 2013). As part of this process, it is necessary to consider the issues that are associated with nurse-led interventions in primary care organizations as a means of improving care for the disease and in preventing some of the more severe complications and symptoms that might occur in some patients (Arts et.al, 2012). These factors support a greater understanding of the different areas that require a significant and concentrated focus on patient care delivery and quality of care as a means of expanding knowledge regarding the disease and its influence on quality of life for affected patients (Arts et.al, 2012). Nurse-led interventions are likely to contribute in a positive manner and provide a framework for improving the intervention itself to encourage positive outcomes for patients in need of care and treatment (Arts et.al, 2012).

The prevalence of diabetes in the United States continues to pose a serious threat to many communities; therefore, it is necessary to continue to expand its relationship to socioeconomic status (Agardh et.al, 2011). It is known that “Although the causal pathways between SEP and disease are not yet fully understood, SEP may contribute to the development of type 2 diabetes through complex processes involving access to health-care services and information, available healthy foods and places to exercise, economic and occupational opportunities as well as individual life-style choices” (Agardh et.al, 2011, p. 805). From this perspective, it may be argued that type 2 diabetes is associated with socioeconomic status from the perspective that it influences how individuals obtain access to healthcare services and education that is essential in alleviating some of the burden associated with the disease through routine monitoring (Agardh et.al, 2011). These factors support and require a greater understanding of diabetes as a disease with a significant burden on the population that requires ongoing attention and support in order to prevent long-term complications and other factors that impact outcomes for many patients who require care and treatment (Agardh et.al, 2011).

Persons with diabetes are identified across many different generations; therefore, these factors must be considered when addressing the requirements of an effective lifestyle intervention and treatment plan (Nolan et.al, 2011). The extensive burden of diabetes cannot be undermined, and statistics demonstrate its widespread impact on many patients; therefore, these factors must be considered as part of the treatment plan and must provide a basis for exploring different insights regarding the influence of diabetes on patients across different communities (Nolan et.al, 2011). For example, pregnant women may develop gestational diabetes, and this reflects the importance of addressing the high level of risk that the disease presents for these women and their unborn children (Nolan et.al, 2011). In this capacity, it is evident that there must be a greater focus on alleviating the burden of the disease across many affected populations in order to accomplish the required objectives and to provide a framework for change that will support the growth of individual efforts to minimize symptoms and to have a positive influence on quality of life (Nolan et.al, 2011).

The burden of diabetes is widely felt in communities where there are ethnic and racial disparities to consider, as these have a significant impact on outcomes and in promoting effective disease management (Wilkes et.al, 2011). This perspective requires a greater understanding of diabetes and its widespread impact on patients, along with other factors that support the need to examine quality of care and the availability of education in communities with a high presence of minorities (Wilkes et.al, 2011). In this context, policies must reflect the ability to improve quality of care and to address the issues that are most important to patients who face these disparities, along with a means of expanding knowledge that will be effective in expressing support for improving healthcare access and the type of care that is received in local communities (Wilkes et.al, 2011). A number of factors have a significant impact on an organization and its ability to be effective in treating patients with diabetes; therefore, in communities where some of these needs are unmet must be addressed on a comprehensive basis to address those factors that contribute to the highest level of risk for patients (Wilkes et.al, 2011).

Diabetes treatment and management requires an ongoing effort that supports the development of new strategies to improve patient outcomes and to reflect upon the needs of patients who require care and treatment in a timely manner (Nyenwe et.al, 2011). This is achieved through an expansion of support and the acknowledgement of the burden of diabetes and also prediabetes, both of which impact healthcare outcomes in many different ways (Nyenwe et.al, 2011). It is recognized that “Although the pathogenesis and long-term complications of type 2 diabetes are fairly well known, its treatment has remained challenging, with only half of the patients achieving the recommended hemoglobin A_1c target” (Nyenwe et.al, 2011, p. 1). Therefore, this condition continues to increase in scope and significance and requires greater attention and recognition from community-based experts and clinicians (Nyenwe et.al, 2011). From this perspective, it is likely that organizations will increase their knowledge of diabetes and how it impacts quality of care, along with the opportunities that are available to support the expansion of efforts to alleviate diabetes in patients through comprehensive efforts to minimize these risks (Nyenwe et.al, 2011). Preventative car in the form of new perspectives regarding care and treatment must also be addressed, along with the factors that are associated with achieving greater quality of care and treatment for patients who require it on a regular basis, which may or may not include insulin dependence (Nyenwe et.al, 2011). Regardless of the condition, it is important to recognize the issues that must be addressed in order to accomplish the desired treatment objectives and to provide a framework to support change and progress for patients to improve quality of life (Nyenwe et.al, 2011).

For patients with diabetes, there is a significant need to evaluate and self-monitor blood glucose levels on a continuous basis, and this reflects the importance of recognizing when glucose levels are too high or too low and require further attention (Malanda et.al, 2012). From this perspective, it is necessary to evaluate the conditions under which blood glucose levels might be impacted by lifestyle behaviors that include food intake (Malanda et.al, 2012). Therefore, it is important to identify the resources that are required to address these concerns and to consider how blood glucose levels are impacted by patient behaviors and whether or not they are adhering to all medication requirements, particularly those persons who are not dependent on insulin (Malanda et.al, 2012). These factors must be considered as part of a larger focus on recommendations that support positive lifestyle behaviors and activities that will positively impact patient care outcomes (Malanda et.al, 2012).

In a similar context, individuals must also consider the consumption of different types of foods and beverages as possible indicators of a higher risk of diabetes throughout their lives, and this includes the use of sugar-sweetened beverages on a regular basis (Malik et.al, 2010). From this perspective, it may be argued that there must be a greater level of focus and attention in this area so that patients are provided with an opportunity to refrain from consuming these beverages, as they may pose a higher threat to the risk of diabetes or the condition if it has already been diagnosed (Malik et.al, 2010). These factors require a greater understanding of food and beverage consumption patterns and how they contribute to obesity and a higher risk of diabetes in many patients (Malik et.al, 2010). At the same time, other factors must be also be considered that influence lifestyle behaviors for patients with diabetes, thereby creating a high level of attention towards foods and beverages that contribute to this risk (Malik et.al, 2010).

The risk of diabetes is very high in many individuals for a variety of reasons; therefore, assessing this risk and the factors that contribute to these levels must be considered in the formation of new policies that will impact outcomes for these patients across a variety of population groups (Buijsse et.al, 2011).This process requires an ongoing effort that will support the development of factors that influence outcomes and that demonstrate the types of behaviors that contribute to a higher risk of diabetes in many patients, along with other issues that impact outcomes for these individuals (Buijsse et.al, 2011). Through the development of a comprehensive framework to assess risk, it is likely that organizations will establish a greater understanding of the different perspectives that influence patient outcomes and that impact how community members support the continued growth and expansion of diabetes prevention and education programs (Buijsse et.al, 2011). Through the assessment of diabetes-related risk in a comprehensive manner, these issues are likely to be considered more closely and will provide an opportunity to examine the different constructs of care and treatment that influence patient outcomes over time (Buijsse et.al, 2011).

Diabetes has created a significant economic burden that requires further investigation. To be specific, patients with diagnosed diabetes incur approximately $9,975 per case, $2,684 for those who are undiagnosed, and $443 for prediabetes on an annual basis (Dall et.al, 2010). It is known that “the annual medical and indirect costs associated with all of these conditions is approximately $218 billion. Estimates of the national cost of diabetes—often reported as “staggering” and “astounding”—bring attention to diabetes and highlight its economic burden with respect to spending on other national priorities” (Dall et.al, 2010, p. 297). Therefore, it is important to demonstrate an effective set of approaches that are designed to specifically target the needs of patients across a variety of spectrums in order to alleviate some of this cost burden and to invoke policies that will be effective in promoting diabetes prevention so that patients are provided with the tools and resources that are required to support their own efforts to prevent the disease effectively (Dall et.al, 2010). The factors that are associated with effective prevention strategy for diabetes must demonstrate an ability to alleviate some of the cost burden that threatens the American healthcare economy and to provide a basis for exploring new insights to ensure that diabetes cases are reduced through effective prevention strategies and lifestyle interventions, both now and in the future (Dall et.al, 2010). These issues must remain a national priority for healthcare experts and provide a basis for exploring new opportunities to improve the health and wellbeing of millions of Americans (Dall et.al, 2010).

The expansion of services to support diabetes prevention requires an effective understanding of its costs and how it impacts healthcare across many spectrums. It is believed that “Estimates of the current and future economic burden on the health care system can assist decision-makers understand the magnitude of the problem, prioritize research efforts, and plan resource allocation to properly manage the condition. Disease cost estimates also help prioritize interventions, which must be done in the face of limited health care resources” (Zhang et.al, 2010, p. 294). From this perspective, it is evident that organizations making policy-related decisions must be effective in their efforts to capture the importance of the diabetes burden and how to reduce some of the costs related to the disease through these efforts (Zhang et.al, 2010). Furthermore, disparities related to diabetes diagnoses and its impact on different populations requires an effective understanding of its impact on these groups and how these factors influence outcomes for individuals across these groups (Zhang et.al, 2010).

Conclusion

The number of type 2 diabetes cases in the United States continues to rise and contributes to a significant cost burden for many Americans and the healthcare system as a whole. A number of guidelines and policies have been enacted that require further consideration in order to promote greater prevention, care, treatment, and management of the disease. This process will enable organizations to be effective communicators in their efforts to alleviate the burden of type 2 diabetes in communities throughout the United States. Clinicians and policy makers must be key contributors in advancing the agenda regarding type 2 diabetes in order to promote greater prevention, particularly for those who are high risk. This process requires an ongoing effort to educate the general public and to recognize the importance of developing new strategies to support advanced knowledge regarding type 2 diabetes and its impact on the lives of those affected. The creation of a strategy to accommodate patients who face the risk of diabetes requires an ethically responsible approach that is designed to facilitate positive behaviors in individuals that will be associated with improved diet and increased exercise potential. Furthermore, policies must be able to frame an agenda that focuses on prevention, while also considering the impact of the disease on those who have been diagnosed and who experience symptoms on a regular basis. There is considerable effort required from many experts in order to provide a basis for advancing the diabetes agenda to promote greater awareness and prevention of the disease, along with an opportunity to examine the different perspectives that support improvements in education in this area. Most importantly, collaborative efforts are necessary in order to improve the outlook regarding type 2 diabetes and to recognize the significance of strategies to expand education and treatment of the disease and its grasp on millions of Americans across a variety of population groups.

References

Agardh, E., Allebeck, P., Hallqvist, J., Moradi, T., & Sidorchuk, A. (2011). Type 2 diabetes incidence and socio-economic position: a systematic review and meta-analysis. International journal of epidemiology, 40(3), 804-818.

Arts, E. E., Landewe?Cleuren, S. A., Schaper, N. C., & Vrijhoef, H. J. (2012). The cost?effectiveness of substituting physicians with diabetes nurse specialists: a randomized controlled trial with 2?year follow?up. Journal of advanced nursing, 68(6), 1224-1234.

Bains, S. S., & Egede, L. E. (2011). Associations between health literacy, diabetes knowledge, self-care behaviors, and glycemic control in a low income population with type 2 diabetes. Diabetes technology & therapeutics, 13(3), 335-341.

Buijsse, B., Simmons, R. K., Griffin, S. J., & Schulze, M. B. (2011). Risk assessment tools for identifying individuals at risk of developing type 2 diabetes.Epidemiologic reviews, 33(1), 46-62.

Burke, S. D., Sherr, D., & Lipman, R. D. (2014). Partnering with diabetes educators to improve patient outcomes. Diabetes, metabolic syndrome and obesity: targets and therapy, 7, 45.

Centers for Disease Control and Prevention (CDC), & Centers for Disease Control and Prevention (CDC). (2011). National diabetes fact sheet: national estimates and general information on diabetes and prediabetes in the United States, 2011. Atlanta, GA: US Department of Health and Human Services, Centers for Disease Control and Prevention, 201.

Dall, T. M., Zhang, Y., Chen, Y. J., Quick, W. W., Yang, W. G., & Fogli, J. (2010). The economic burden of diabetes. Health Affairs, 29(2), 297-303.

Dunkley, A. J., Bodicoat, D. H., Greaves, C. J., Russell, C., Yates, T., Davies, M. J., & Khunti, (2014). Diabetes Prevention in the Real World: Effectiveness of Pragmatic Lifestyle Interventions for the Prevention of Type 2 Diabetes and of the Impact of Adherence to Guideline Recommendations A Systematic Review and Meta-analysis.Diabetes care,37(4), 922-933.

Funnell, M. M., Brown, T. L., Childs, B. P., Haas, L. B., Hosey, G. M., Jensen, B., … & Weiss, A. (2012). National standards for diabetes self-management education.Diabetes care,35(Supplement 1), S101-S108.

Green, L. W., Brancati, F. L., & Albright, A. (2012). Primary prevention of type 2 diabetes: integrative public health and primary care opportunities, challenges and strategies. Family practice, 29(suppl 1), i13-i23.

Haas, L., Maryniuk, M., Beck, J., Cox, C. E., Duker, P., Edwards, L., … & Youssef, G. (2013). National standards for diabetes self-management education and support. Diabetes Care, 36(Supplement 1), S100-S108.

Imperatore, G., Boyle, J. P., Thompson, T. J., Case, D., Dabelea, D., Hamman, R. F., … & Standiford, D. (2012). Projections of Type 1 and Type 2 Diabetes Burden in the US Population Aged< 20 Years Through 2050 Dynamic modeling of incidence, mortality, and population growth. Diabetes Care, 35(12), 2515-2520.

Khattab, M., Khader, Y. S., Al-Khawaldeh, A., & Ajlouni, K. (2010). Factors associated with poor glycemic control among patients with type 2 diabetes.Journal of diabetes and its complications, 24(2), 84-89.

Lee, T. C., Glynn, R. J., Peña, J. M., Paynter, N. P., Conen, D., Ridker, P. M., … & Albert, M. A.(2011). Socioeconomic status and incident type 2 diabetes mellitus: data from the Women’s Health Study. PloS one, 6(12), e27670.

Li, R., Zhang, P., Barker, L. E., Chowdhury, F. M., & Zhang, X. (2010). Cost-effectiveness of interventions to prevent and control diabetes mellitus: a systematic review. Diabetes care, 33(8), 1872-1894.

Malanda, U. L., Welschen, L. M. C., Riphagen, I. I., Dekker, J. M., Nijpels, G., & Bot, S. D. (2012). Self-monitoring of blood glucose in patients with type 2 diabetes mellitus who are not using insulin. Cochrane Database Syst Rev, 1.

Malik, V. S., Popkin, B. M., Bray, G. A., Després, J. P., & Hu, F. B. (2010). Sugar-sweetened beverages, obesity, type 2 diabetes mellitus, and cardiovascular disease risk. Circulation, 121(11), 1356-1364.

Nathan, D. M. (2010). Navigating the choices for diabetes prevention. N Engl J Med, 362(16), 1533-1535.

Nolan, C. J., Damm, P., & Prentki, M. (2011). Type 2 diabetes across generations: from pathophysiology to prevention and management. The Lancet,378(9786), 169-181.

Nyenwe, E. A., Jerkins, T. W., Umpierrez, G. E., & Kitabchi, A. E. (2011). Management of type 2 diabetes: evolving strategies for the treatment of patients with type 2            diabetes. Metabolism, 60(1), 1-23.

Rejeski, W. J., Ip, E. H., Bertoni, A. G., Bray, G. A., Evans, G., Gregg, E. W., & Zhang, Q. (2012). Lifestyle change and mobility in obese adults with type 2 diabetes. New England Journal of Medicine, 366(13), 1209-1217.

Shaw, J. E., Sicree, R. A., & Zimmet, P. Z. (2010). Global estimates of the prevalence of diabetes for 2010 and 2030. Diabetes research and clinical practice, 87(1), 4-14.

Stellefson, M., Dipnarine, K., & Stopka, C. (2013). Peer Reviewed: The Chronic Care Model and Diabetes Management in US Primary Care Settings: A Systematic Review. Preventing chronic disease, 10.

Tapp, H., Phillips, S. E., Waxman, D., Alexander, M., Brown, R., & Hall, M. (2012). Multidisciplinary team approach to improved chronic care management for diabetic patients in an urban safety net ambulatory care clinic. The Journal of the American Board of Family Medicine, 25(2), 245-246.

Wilkes, A. E., Bordenave, K., Vinci, L., & Peek, M. E. (2011). Addressing diabetes racial and ethnic disparities: lessons learned from quality improvement collaboratives. Diabetes Management, 1(6), 653-660.

Zhang, P., Zhang, X., Brown, J., Vistisen, D., Sicree, R., Shaw, J., & Nichols, G. (2010). Global healthcare expenditure on diabetes for 2010 and 2030.Diabetes research and clinical practice, 87(3), 293-301.

Zolfaghari, M., Mousavifar, S. A., Pedram, S., & Haghani, H. (2012). The impact of nurse short message services and telephone follow?ups on diabetic adherence: which one is more effective?. Journal of clinical nursing, 21(13?14), 1922-1931.