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Diabetes Education Skills for Low Grade Literacy Patients

Case Study: “Chronic complications of diabetes are primarily those of end-organ disease from damage to blood vessels as a result of chronic hyperglycemia. The hyperglycemia causes changes to the blood vessels resulting commonly in eye and kidney abnormalities as well as peripheral vascular atherosclerosis.”

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Studies indicate that about 285 million people in the world were diabetic in 2010 and the figure is estimated to reach 440 million by the year 2030 (Shaw, Sicree & Zimmet, 2010). With several ongoing investigations and research related to the disease, health literacy is an important issue associated with diabetes (Cavanaugh et. al, 2009). Health literacy is defined as “The degree to which individuals can obtain, process, understand and communicate about health-related information needed to make informed health decisions” (Berkman, Davis & Mccormack, 2010).

Effective communication is vital for disease prevention and control for diabetic patients to understand measures to control the disease. Low levels of literacy are apparent among diabetics who do not have sufficient knowledge about the disease resulting in the inability to adopt suitable control measures (Cavanaugh et. al, 2009). Research confirms that patients with low literacy skills could have difficulty in understanding, following, and applying the complex terminology used in health information (Cavanaugh et. al, 2009).

To explain the nature of the disease to a patient with low literacy skills, the nurse should use simple language. Technical jargon should be avoided and sentences should be short and clear.

What is diabetes?

Diabetes is a chronic lifelong condition; there is no cure for it.

What are the side effects and complications of diabetes?

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Diabetes causes severe injury and damage to several body organs, such as the kidneys and eyes. Diabetes is an end-organ disease means that it damages the organs completely. The organs are damaged and the damage is irreparable.

What happens when a person gets diabetes?

When a person gets diabetes, the body produces low levels of insulin or no insulin at all. Insulin is necessary for breaking down the sugar and glucose in the body.

What happens when sugar is not broken down?

When sugar and glucose are not broken down, the level of sugar in the blood rises. When there is too much sugar in the blood it causes a condition called chronic hyperglycemia.

What happens due to chronic hyperglycemia?

When blood sugar levels in the body are high, organs of the body are affected, mainly the eyes and the kidneys. Due to high blood levels, nerves in the back of the eye (the area called the retina) are damaged. In severe cases, high diabetes can also lead to permanent blindness. Research indicates that retinopathy is the number one cause of blindness among diabetic patients.

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High blood levels damage the kidneys in the same manner. The main function of the kidneys is to filter blood. When blood with high sugar levels is filtered by the kidneys, the blood vessels and nerves of the kidneys get damaged. The affected nerves are those which tell you when your bladder is full – that is you want to pass urine. When the nerves are not able to give you this information, the bladder remains full and damages the kidneys. Also, when urine remains in the body for a long time, there is a risk of infection which can spread to the whole kidney. This can cause permanent kidney damage.

Another notable side effect of diabetes is peripheral vascular atherosclerosis. This is a disease that affects the arteries. High blood sugar levels damage blood vessels by making them narrow and weak. Over time, fats collect in and around the arteries causing them to block. This results in weak blood circulation. Total loss of circulation to the feet can cause gangrene and loss of a limb. When a coronary (heart) artery is blocked, it can lead to a heart attack. Blockages can cause damage to limbs, the heart, and the brain due to an insufficient supply of blood.


Berkman, N. D., Davis, T. C. & Mccormack, L. (2010). Health literacy: what is it? J Health Commun, 15(2), 9–19.

Cavanaugh, K., Wallston, K. A., Gebretsadik, T. et al. (2009). Addressing literacy and numeracy to improve diabetes care: two randomized controlled trials. Diabetes Care, 32(12), 2149–2155.

Shaw, J. E., Sicree, R. A. & Zimmet, P. Z. (2010). Global estimates of the prevalence of diabetes for 2010 and 2030. Diabetes Res Clin Pract, 87(1), 4–14.

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