Macro Care Model
Community Based Diabetes Prevention and Management Model
A culturally appropriate and holistic model to achieve evidence based outcomes for the prevention and management type 2 of diabetes; a patient focused approach, was developed by DTFS in association with a team of healthcare professionals specialized in diabetes prevention and management, and considerable input from patients and other stakeholders. The model was implemented at a number of First Nations in British Columbia, and has achieved significant results in terms of prevention and management of diabetes and the sustainability and ownership of the disease within the community.
The model consists of six integrated components: Awareness and Motivation, Education, Management and Monitoring, Treatment, Prevention, and Diabetes Management Software. Diabetes Nurse Educators play an integral part in the implementation of the program as the main point of contact for monitoring patients and coordinating treatment activities. This provides intimate motivational access to healthcare which permits alternative and cost-effective approaches to all aspects of diabetes management.