Development of a self-management package for people with diabetes at risk of chronic kidney disease (CKD)

Kidney disease progression in diabetes can be slowed by strict blood pressure and blood sugar control, prescription of medicines that modify the renin-angiotensin system and lifestyle changes, such as smoking cessation. This paper describes the development of a self-management package for people with diabetes at risk of kidney damage. This multi-method study entailed a literature review, case-finding of all patients with diabetes and microalbuminuria in six family practitioner (FP) surgeries and interviews with 15 patients at high-risk of progressive kidney disease. Results identified 23% of the study population (n = 1946) at risk of kidney damage, within a population with 3.14% incidence of diabetes. The most important finding from the interviews was that although most people had some understanding of the possible risk of kidney disease, they had little idea of exactly how they could control the condition themselves. This study highlights the importance of incorporating self-management tools in the care and management of patients with diabetes in primary care.