Diabetes Education

Author: Judy Kohn, RN, BSN, CDE

Last Updated: Friday, September 12, 2008

Q: "In your answers, you often mention discussing things with the diabetes team, or you suggest seeing a diabetes educator and dietitian. I was diagnosed with diabetes 2 months ago and was told to cut out sweets, but I have not been referred to see anyone else. Is it necessary that I see a diabetes educator?"

A: Yes! The National Standards for Diabetes Care state that a diabetes management plan must recognize diabetes self-management as an integral component of care. People with diabetes should receive medical care from a physician-coordinated team which may include, but is not limited to: physicians, nurses, dietitians, pharmacists, and mental health professionals with expertise and a special interest in diabetes.

Take an active role

It is essential that you take an active role in your care. To be able to do this, you need to fully understand your condition, as well as have the strategies and problem-solving skills necessary to manage your diabetes.

Obtain an individualized plan of care

You should have a plan of care that considers your specific needs, taking into account your age, learning style, school or work schedule, physical activity, social situation, personality, cultural factors, and the presence of complications or other medical conditions. You can best accomplish this by seeing a certified diabetes educator.

Obtain diabetes education

There are specific content areas designed to help you understand the disease process and treatment options, make informed choices, practice self-directed behavior change, and reduce your risk of complications. The American Association of Diabetes Educators (AADE) believes that behavior change can be achieved best by using the AADE7™ Self-Care Behaviors framework. The 7 behaviors are described below:

1. Healthy eating: You should see a registered dietitian who would do the following:
   • Assess your height, weight, activity level, and laboratory values --such as glucose, A1C, lipids, and kidney function.
   • Review your eating patterns, and your food likes/dislikes--this is best accomplished after you keep a detailed food record for 3-7 days.
   • Explain the effect of food on blood glucose, and advise you on specific recommended amounts of carbohydrate, protein, and fat for both portion and weight control.
   • Teach you various meal planning tools, such as carbohydrate counting, fat gram counting, the food guide pyramid, food labels, and exchange lists to assist you in making food choices.
2. Being active: Regular activity helps with overall fitness, weight management, and blood glucose control, but you must learn how to balance food and medication with your activity level.
   • If you have pre-diabetes, you can reduce your risk of developing type 2 diabetes.
   • Being active can help improve your body mass index, enhance weight loss, help control your lipids (blood fats) and blood pressure, and reduce stress.
   • Your diabetes educator can help assess any physical, environmental, psychological, or time limitations.
3. Monitoring: Daily self-monitoring of your blood glucose helps you determine how food, activity, and medications affect your blood glucose levels.
   • You should be provided assistance in choosing your equipment, knowing your target goals and when and how often to test, and how to interpret and use the results.
   • Monitoring also includes blood pressure, ketones (if you are pregnant or are using insulin), and weight.
4. Taking medication: Diabetes is a progressive condition, so your treatment may change over the years.
   • You will learn how diabetes pills and insulin work, and how to take them.
   • You will need to know each medication's action, side effects, efficacy, toxicity, prescribed dosage, timing and frequency, effect of missed and delayed doses, and instructions for storage, travel, and safety.
5. Problem solving: You may need to make rapid, informed decisions about your food, activity, and medications, based on whether you have a low glucose, high glucose, or are sick.
   • Life situations change, but with effective coping strategies, you can learn how to address physical, emotional, or financial obstacles.
6. Reducing risks: It is important to understand, seek and regularly obtain preventive services to reduce your risk of diabetes complications and maximize your health and quality of life.
   • You will learn about the standards of care which include: smoking cessation, foot inspections, blood pressure monitoring, self-monitoring of blood glucose, aspirin use, and maintenance of personal care records.
7. Healthy coping: Psychological and social factors can affect your health status and quality of life.
   • You will learn how to identify your motivation to change, and to set achievable behavioral goals.
   • It will be important to learn what you can control along with how to cope with things you cannot control.

So if you haven't already done so, please ask your healthcare provider for a referral for diabetes education. If you are having trouble locating a diabetes education, you can find one in the related link below under the American Association of Diabetes Educators (AADE).

Related Questions

Standards of Care
Q: "How can I be sure I’m getting all the right tests and exams for diabetes?"

The Diabetes Team
Q: "I am newly diagnosed with type 2 diabetes and am scheduled to attend diabetes classes. I am already feeling overwhelmed with all of this and am looking forward to getting some help. In some of your answers, you refer to the diabetes team. What is the team?"

Related Links

American Association of Diabetes Educators (AADE)
http://www.diabeteseducator.org

American Diabetes Association (ADA)
http://www.diabetes.org

American Dietetic Association’s Nationwide Nutrition Network
http://www.eatright.org

Diabetes Self-Management
http://www.diabetesselfmanagement.com

Joslin Diabetes Center
http://www.joslin.org

DOC09524-Rev-B 10/08