Assessment 3 | Task 2: High risk populations (Discussion)

CALD and Refugees and Gestational Diabetes

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Assessment 3 | Task 2: High risk populations (Discussion)

CALD refugee group

Language and health literacy has been one of the major setback facing the CALD and

refugees community globally. Most of the CALD communities have limited access to diabetes

health services (Health, 2019). Reluctance is observed among CALD population in accessing

both well diabetes health services. Stigma and Lack of appropriate information about diabetes,

cultural differences and poor communication have been reported as major challenges in

accessing health services on time (Alzubaidi et al., 2015). Continuity of care in the CALD

community has been limited due to inability access of healthcare services. For instance, most of

the CALD community members have been relocated to remote areas with limited health

facilities. Physical inactivity has been presented as a barrier for patients with diabetes from

CALD community in managing diabetes condition. The physical inability of these patients is

inhibited by sociocultural factors. Decision making on the diabetes has become a challenge from

CALD population. People form this group have a hurdle in understanding what they are going

through at the onset of diabetes. Sociocultural and religious beliefs of some CALD group

especially the refugee’s holds them back from accessing health services after their migration

(Smythe et al., 2019). In some communities fear has overshadowed their self-management due to

perceived negative labeling as a result of being diagnosed with diabetes thus making it a

challenge in seeking consultation with health practitioners in their host country.

Strategies of diabetes management encompasses lifestyle modification, ongoing patient

engagement as well as pharmacotherapy enhanced by a holistic patient –practitioner relationship.

General practitioners plays a vital role through engaging patients and are in a critical position.

Provision of appropriate education and required resources is proven to be an effective strategy in

meeting CALD group needs. Incapacitation of culturally sensitive features in patient consultation
Assessment 3 | Task 2: High risk populations (Discussion)

is critical in fostering quality healthcare for CLD patients. Supporting of their traditional diet

while observing healthy nutrition elements with appropriate proportions is vital. The general

practitioners should be versatile and flexible in learning by engaging the patients from CALD

community. This can be done by opening up to them through implementing open ended

questions solely on their cultural beliefs, foods, religious beliefs, traditional medications as well

as their perceptions about health practitioners (Black, 2012). This strategy will enhance building

of strong patient-practitioner relationship and trust. By understanding the patient’s values,

confidence is built in working with individual patients from CALD group effectively (Parajuli &

Horey, 2019). Significantly, the use of medical jargon should be avoided to avoid more

complication while communicating with CALD patients. The incorporation of multicultural

health practitioners, social workers, religious leaders as well as pharmacists is vital (Shahin,

Stupans , & Kennedy, 2018). The aforementioned professions can be used as role models` in

targeting CALD group complimented by storytelling in CALD group native dialects.

The incorporation of professional interpreters has been proven to bring effective clinical

outcomes in line with patient satisfaction during care (Health, 2019) National Diabetes Strategy

includes this strategy of translation of consumer resources on management and prevention into

various CALD languages. The improvement of health literacy has been incorporated in the

National Australian Diabetes strategy through tailoring culturally appropriate information as well

as effective programmes in management of diabetes in CALD and refugees communities.

Assessment 3 | Task 2: High risk populations (Discussion)

Gestational diabetes

Fear and emotional disturbance inhibits the GDM patients. Upon being informed on the

dire consequences of GDM, most of the patients are careful in meeting their dietary needs as

well as their health. However they disregard the importance of medicine based on the ethical

backgrounds (Morrison, Lowe, & Collins, 2014). They fear altering their nutrition due to their

cultural beliefs on their native foods. The cost associated with the management of GDM is a

major need for pregnant women. This varies with the geographical location of the women.

Nevertheless, some of the expectant mothers have the fear of asking clarifications about GDM

due to poor patient practitioner relationship (Morrison, Lowe, & Collins, 2014). These perceived

barriers renders a big number of expectant women victims of sedentary during pregnancy (Martis

et al., 2018) Some women are not able to cover their costs due to poverty especially among the

indigenous community. Associated resources and equipments such as glucometers, diet

modifications, medications, causes financial burden due to low income. Lack of adequate

knowledge on dietary intake and GDM management leads to malnutrition to the expectant

mother and the fetus due to insufficient glucose management (McMillan et al., 2018).

GDM screening should be compulsory to all expectant mothers due to its high

prevalence. GDM status should be incorporated in the routine assessment of the physician

whether for pregnancy or parity. This will help in detecting early signs of impaired glucose

intolerance as well as progenies of diabetes. Counselling is vital in the management of GDM

from the initial diagnosis of the condition. The health education should incorporate indulgence

in regular exercises, self-care, treatment as well as monitoring. National Diabetes Strategy

supports the need to teach them efficiently utilize monitoring equipment is essential Expectant

women with diabetes should have an access to a certified diabetes educator to be equipped with a
Assessment 3 | Task 2: High risk populations (Discussion)

comprehensive advice on appropriate diet as well as physical activity (Di Biase et al.,2019).

Additionally the patient’s family should be taught on emotional and psychological support,

associated needs with GDM as well as the general pregnancy care (AIHW, 2019). It is critical to

articulate the significance of antenatal care supported by holistic support system. Medical

nutrition therapy is important in controlling blood glucose (Stojanovska, Naemiratch, &

Apostolopoulos, 2017). Insulin therapy should be implemented if the patient response to oral

anti-diabetic agents fails. Initial choice of insulin should be human insulin (Campbell et al.,

2017). The dosage varies with the patients’ glucose level, BMI and lifestyle. Further affirms that

pregnant women prescribed with insulin are advised to be hospitalized to achieve treatment

adherence in regulating glucose level effectively with close monitoring. Foetal surveillance is

preferred to be essential in managing GDM. UDG is the preferred tool in detecting the

development complications that may be present in the foetus. High risk GDM pregnant mothers

should have antepartum foetal surveillance through untrasonogram each and every trimester. And

most importantly, biophysical profile is advisable two times per week if the foetus is at high risk.

Australian National Diabetes Strategy (2019) emphasizes providing accessible

programmes to women with risk of gestational diabetes. Emphasis on pre-pregnancy advice and

programmes should be provided to all women at risk and those with previous history. It

advocates that all women should be tested and counselling to be provided appropriately. Also

pediatric follow-up for children at risk of developing diabetes (Health, 2019). Most importantly

reminder is put in place for those registered with National Gestational register for future

reference.
Assessment 3 | Task 2: High risk populations (Discussion)

References

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Black, S. (2012). Diabetes literacy: health and adult literacy practitioners in partnership.

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Campbell, S., Roux, N., Preece, C., Rafter, E., Davis, B., Mein, J., Boyle, J., Fredericks, B., &

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Assessment 3 | Task 2: High risk populations (Discussion)

https://www.health.gov.au/resources/publications/australian-national-diabetes-strategy-

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Martis, R., Brown, J., McAra-Couper, J., & Crowther, C. A. (2018). Enablers and barriers for

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Morrison, M. K., Lowe, J. M., & Collins, C. E. (2014). Australian women’s experiences of living

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Parajuli, J., & Horey, D. (2019). How can healthcare professionals address poor health service

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Shahin, W., Stupans, I., & Kennedy, G. (2018). Health beliefs and chronic illnesses of refugees:

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Smythe, K., Sidhu, B., Simmons, D., Flack, J., & Wong, V. (2019). Challenges associated with

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Assessment 3 | Task 2: High risk populations (Discussion)

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