БАРИЕРИ ПРЕД ЕФЕКТИВНОСТТА НА УПРАВЛЕНИЕ НА ЗАБОЛЯВАНЕТО ПРИ ХОРА СЪС ЗАХАРЕН ДИАБЕТ (Bulgarian)

Diabetes mellitus (DM) is a global public health problem and the world is facing an epidemic of type 2 diabetes mellitus (T2DM). Diabetes mellitus is a widespread condition, which is associated with significant morbidity and mortality and high costs for health services. Diabetes prevalence is increasing among all age groups in Bulgaria. In our country 9.55% of the total population has diabetes mellitus, with over 90% suffering from a type 2 diabetes mellitus (T2DM). Complications due to diabetes are a major cause of disability, premature death and healthcare expenditures. More than half of the mortality and morbidity large proportion of people with diabetes are related to cardiovascular disease (CVD). Mortality in people with diabetes is most often caused by cardiovascular complications: - adults with diabetes mellitus have a 2- to 4-fold higher lethality from cardiovascular disease compared to those of the same age without diabetes. Diabetes leads to blindness and end stage renal disease. Diabetic neuropathy, which occurs in more than 60% of type 2 diabetes mellitus patients, causes more than half of the lower limbs amputations. Diabetes imposes a large economic burden on patients, their families and national health systems. Treatment of the disease is very expensive, but the real impact of diabetes is in the treatment of its complications. Despite significant advances in the diagnosis and treatment of the disease, patients very often have unsatisfactory metabolic control. Poor results can be attributed to both the lack of proper self-management by the patient and inadequate intervention strategies by clinicians. According to the American Diabetes Association (ADA), self-management is an important part of optimal diabetic care. The main components of self-management include a combination of optimal treatment, diet, physical activity and self-control of blood glucose levels. Effectiveness of disease management depends on complex lifestyle changes that can be achieved through health education of patients. Although self-management education is an essential component of optimal diabetes care, diabetes education programs are greatly underused. Evidences support the claim that educating patients with diabetes mellitus helps to manage the disease properly, improves glycaemic control, reduces complications, increases adherence and reduces health costs. Proper self-management of diabetes mellitus is critical for improving the Quality of Life (QoL) of patients and increasing their life expectancy. The aim of this review is to summarize the existing knowledge about the various barriers in front of optimal management of diabetes. [ABSTRACT FROM AUTHOR]

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