Caring for the Border Communities

Few would argue that the behavioral regimen required for diabetes management is for many a drastic and challenging change in lifestyle. As we have seen in this book, the demands upon diet, physical activity, medication regimen, and clinical attendance require that patients obtain and practice multiple skills. Individual self-management is the focus for controlling diabetes complications, however, the larger environmental context will either support or hinder the ability of people with diabetes to adopt and maintain self-management behaviors (Jack et al., 1999). This chapter will describe the specific challenges to those living with diabetes in border communities and will recommend some core elements of diabetes outreach and education programs that have proven successful in this environment. In addition, the chapter will explore strategies for addressing broader environmental influences on diabetes prevention and self-management.