Clients should be monitored regularly for changes in blood pressure, weight and foot problems. If problems are identified earlier, the doctor and/or nurse can be alerted sooner, and problems can be dealt with sooner before they get worse.
Measuring weight is important because it helps determine whether or not a client is overweight or obese. Obesity can lead to diabetes, and reducing obesity can help improve diabetes. However, you need to know the height as well as the weight to determine if someone is obese. Someone who is 160lbs and 5 feet is obese, but someone of the same weight and 6 feet is not; the extra weight is due to more muscle and bone, not fat.
Height is used to calculate the Body Mass Index (BMI) according to a special formula. “Ideal” is from 18 to 25; “overweight” is from 25 to 29; and “obese” is 30 or higher. (You don’t need to know this formula; you just have to enter weight and height in the registry, and BMI will be automatically calculated.)
Checking the feet is important because people with diabetes lose their sensation and may not notice small cuts or tears in the skin. These problems can quickly get worse if not identified early and treated. Complications of cuts or ulcers include infections, which if not treated early enough can lead to severe infections, and even amputation.
The CHW’s role is to do physical assessments on clients deemed at “high-risk”, those who have very poor control of their diabetes and require more support. See section I below on how these clients will be identified. CHWs will use the CHW Diabetes Clinical Assessment Log Sheet paper form to record visit information.
1. Tell client you will measure their height.
“I’d like to take your height now. Do you have any questions?”
2. Ask client to remove shoes, bulky clothing, and hair ornaments, and unbraid hair that interferes with the measurement.
“Please remove your shoes, hat, anything that can add height. Stand up straight here so we can measure your height, and please face away from the wall.”
3. Take the height measurement on flooring that is not carpeted and against a flat surface such as a wall with no molding.
4. Ensure client stands with feet flat, together, and against the wall. Make sure legs are straight, arms are at sides, and shoulders are level.
5. Ask the person to look straight ahead and that their line of sight is parallel with the floor.
6. Take the measurement while the person is standing tall and straight upright.
7. Use a flat headpiece to form a right angle (90 degrees) with the wall and lower the headpiece until it firmly touches the crown of the head.
8. Make sure your eyes are at the same level as the headpiece.
9. Lightly mark where the bottom of the headpiece meets the wall.
10. Measure from the floor to the marked measurement.
11. Accurately record the height in the Log sheet, to the nearest 0.5 centimeter.
Download or use this online CHW sample form to practice the contents of this module.
Please note that these training modules are to be used for the purposes of CHW training in diabetes management. CHWConnect does not provide medical advice or specific diagnostic or treatment information.