**8. Why adopt family-centred care in diabetes management**

Lack of adequate knowledge about illness and inadequate social support contribute to poor control of diabetes [25]. The adoption of FCC is aimed at capacitating both family members through the DSME together with patients at the healthcare facility, which capacitate and empower them with knowledge on how to best become healthcare providers at home, where most of the diabetes care takes place. Adequate social support from knowledgeable family members helps in preventing, delaying and minimizing the severity of diabetes complications, as well as reducing the chances of family members from developing diabetes. Family members are informal healthcare providers at home as they primarily provide Diabetes Self-Management Support. The QoL is regarded as "an estimation of well-being as well as the measurement of health and the effects of health care" [28]. In order to achieve better QoL, it is important to adhere to diabetes treatment and adopt

*Lifestyle and Epidemiology - The Double Burden of Poverty and Cardiovascular Diseases...*

Provide required medical interventions Nurses Assess and refer patients and their families to multi-disciplinary team

grants for the care of diabetes patients.

Establish diabetes support groups at the PHC facilities

Social workers Provide services on how best to cope with the disease and also on social relief or

Patients Recipient of family-centred diabetes care and share experiences of living with

Family members Recipient of family-centred diabetes care and advocate for patients by expressing additional health challenges which the patients has omitted. Provides emotional support to the patient, and care at home.

**Diabetes team Responsibility**

General Practitioners Clinically assess the patients

Dietitians Provide dietary care services Physiotherapists Provide exercise care services.

diabetes.

**7. Diabetes self-care, self-care activities and its adherence**

Psychologists Provide psychological and behavioral care services.

the self-care activities into patients' daily routine.

home care to patients.

**Table 1.**

*Diabetes team and their responsibilities.*

Diabetes self-care is explained as "evolutionary process of development of knowledge or awareness by learning to survive with the complex nature of the disease within social context" [20]. Diabetes education is critical and must be practically translated into activities for the achievement of better diabetes outcomes. The self-care activities includes adherence to dietary plan, avoidance of fatty food, regular physical activity and self-glucose monitoring, and foot care, taking of medication (insulin or an oral hypoglycaemic agent), and cessation of smoking [21]. In addition, self-care activities includes good problem-solving skills, healthy coping skills and risk-reduction practices [20]. Integrating self-care activities into patients' daily routine improves diabetes outcomes, minimizes chances of developing complications and diabetes related health problems. Compliance or adherence to diabetes treatment remains a problem, in spite of the advantages of integrating

Diabetes Self-Management Education and Support, and Family as provider of

Diabetes Self-Management Education (DSME) is regarded as "the process of facilitating knowledge, skill, and ability necessary for diabetes self-care" [18], and is provided by healthcare providers. Multi-disciplinary team provides various diabetes care services, therefore, a clear referral system should be developed and implemented. The DSME is provided with the sole purpose of capacitating both patients and family members with skills and knowledge required in self-care practices. Adequate diabetes care knowledge may pursue both patients and their family members to follow healthy lifestyle healthy lifestyle [15], so as to prevent diabetes complications and also reduce new cases, respectively. Sufficient diabetes knowledge also minimizes risk of comorbidity which impact significantly the QoL of patients [22]. However, Ajzen et al. [23] argued that adequate knowledge alone is not sufficient for the adoption of healthy lifestyle, it should be accompanied by positive attitudes. There should be collaboration between the health sector and the

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a healthy lifestyle [3]. Adequate family support also helps in achieving good QoL [29], particularly when the family are knowledgeable with regard to diabetes care.
