**9. The type of support a family can give to diabetes patients**

Living alone is linked with increasing depression, poor diabetes outcomes and increased mortality [30]. The family support and care for patients, with daily living activities which includes meal preparation and consumption, physical activity, collection of medication, bathing, distribution of household chores, bathing and clothing, and honoring of medical appointments. Families also help patients cope `with the diabetes and also may be required to financially support the patients so as to daily meet the activities of daily living. Quality of life and better glycaemic outcomes have been associated with better income [31].

#### **9.1 Supporting family**

Family communication needs to be improved during DSME, and also empower them with knowledge and skills essential in positively influence patient health behaviors and subsequently diabetes outcomes. Lack of diabetes care knowledge among family members, result in stress of not knowing how best to care for loved one in need of support, hence adoption of family centred diabetes care empowers family and minimizes the negative psychological impact. Exclusion of families during consultations may lead to families having misconceptions that patients know more about diabetes management than actually patients know, relying on the patients to report to them on how to best care for them [24], leading to inappropriate care. Educating families on diabetes care needs and why the changes are necessary can aid in easing the stress brought along by inadequate knowledge. The family may as well need to be educated on the coping skills. The effective family involvement in diabetes care may help the family accept the lifestyle modifications for the patients and family members' health considering that they are already at risk due to family history [29]. Additional information which should be provided to the family during consultation includes information about the disease, possible treatment alternatives and stress management skills, as well as helping them plan for the future [32].

#### **10. The negative ways family can affect diabetes**

Actions of family members in providing support to diabetes patients may be harmful and lead to poor diabetes outcomes [33], particularly when family members who are not trained about care, are not capacitated through DSME on self-care activities. Family culture, way of living and problem-solving skills may additionally contribute in harming the patients and resulting poor diabetes outcomes. The required diabetes self-management activities may be in conflict with the traditional family way of cooking and eating, which may prompt family to not accept the lifestyle modification and new way of doing things [33].

Family members usually support the patients at home through food preparation and may compromise and sabotage patients through cooking and serving unhealthy meals, tempting patients to consume unhealthy food for the sake of peace at home [30]. Additionally, the family members may also discourage patients from regularly taking medications and its adherence, particularly when the patient relies on them for getting and taking medications and meals. Hence the need for family centred diabetes care to minimize the ways family can negatively impact on patients' outcomes for better glycaemic outcomes.

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*Family-Centered Diabetes Care for Better Glycemic Outcomes of Outpatients in Rural Areas*

• **Understanding Family-Centered Care:** Lack of understanding of the concept of family-centered diabetes care by both healthcare providers and patients may negatively impact on its successful implementation. Hence, there is a need for in-service training of healthcare providers on the familycentered diabetes care for better outcomes [25]. Policy makers and legislatures develops and introduces policies, whilst healthcare providers at any setting are the drivers or implementers of the policies. The drivers of policies need to be trained on the pros and cons of FCC in diabetes care and also given guidelines on family centered diabetes care to minimize confusion and for effective

• **Support for Practices**: Loss of income and employment may affect provision of support to patients as required by the FCC. Repeated visits and honoring of medical appointments should be observed, and that the spirit of humanity must at all times prevail so as to enable consistent support and care during the loss of income [24]. The South African Government introduced Old-Aged Grant, of which diabetes patients are among the beneficiaries considering that diabetes affects mostly the elderly. The introduction of old-aged grants in SA helped the elderly persons getting and needed support from the family members. Also, the families must be empowered with diabetes care knowledge and how it could also benefit their health, so as to minimize the presence or absence

• **Research:** Research helps in informing policy developers, healthcare providers, patients and family members on what should be done in the provision of health formal and informally to the patients. Therefore, lack of adequate research on family centered diabetes care for outpatients may negatively impact on the

• **Reduces the diabetes treatment costs:** Diabetes is costly disease to manage, and more costly in the presence of complication. It has been reported that the global diabetes management cost amount to \$1.31 trillion, which accounts to 1.8% of 2015 global gross domestic product [34]. The FCC reduces diabetes associated hospital admissions and readmissions costs [35], as well as esti-

• **Improvement of Hemoglobin:** Hemoglobin A1c (HbA1c) improves by 1% in

• **Reduces/prevent complications:** The FCC prevent, delays and minimizes the severity of diabetes complications, improve quality of life and better glycaemic control through lifestyle behaviors such as healthy eating habits, regular physi-

• **Improves the clinical and psychosocial aspects of diabetes:** The presence of diabetes affect the quality of life of patients and also brings along emotional and psychological burdens resulting in stress and depression, which worsens in

cal activity and adherence to intake of diabetes medication.

the presence of complications such as erectile dysfunction.

of income being motivating factor for provision of support.

**12. Advantages of family-centered diabetes care**

mated lifetime health care costs.

T2DM patients [36].

adoption and implementation of the family centered diabetes care.

*DOI: http://dx.doi.org/10.5772/intechopen.96223*

**11. Barriers to family-centered Care**

implementation.

*Family-Centered Diabetes Care for Better Glycemic Outcomes of Outpatients in Rural Areas DOI: http://dx.doi.org/10.5772/intechopen.96223*
