Diabetes Self-Management Education and Credentialled Diabetes Educators
Diabetes self-management education is an ongoing process that supports people with diabetes and pre-diabetes, their family and carers, to achieve self-identified goals through:
- facilitating an understanding of their condition
- facilitating an understanding of the risks and benefits of lifestyle choices and treatment options
- supporting them to make informed choices
- supporting problem solving
- facilitation active collaboration with the health care team to improve clinical outcomes, health status, and quality of life
- supporting implementation, maintenance and change of health behaviours as required.
Diabetes self-management education is client centred and outcomes focused. It integrates client identified needs and goals with clinical targets to achieve a continuum of outcomes. This process incorporates the needs, goals, and life experiences of the person with diabetes or pre-diabetes and is guided by evidence-based standards. Support may be educational, psychosocial, behavioural or clinical.
Diabetes self-management education is a structured, comprehensive, collaborative and ongoing process between the credentialled diabetes educator (CDE) and the person with diabetes or pre-diabetes and their support network, and includes:
- an individualised psychosocial, clinical and cognitive assessment of the person with diabetes or pre-diabetes and/or their care givers
- formulation of an education plan including collaboratively identified behavioural goals based on a core body of knowledge in diabetes management and self-care behaviours and agreed clinical targets
- implementation of the plan based on evidence based principles of teaching-learning theory and behaviour change theory
- evaluation to assess the person’s attainment of self-management goals and progress toward attainment of clinical targets
- documentation of all encounters in a permanent client record and communication with referring practitioners.
Structured education is a process of education that ensures particular information is covered in education sessions that has been deemed essential for the self-management of diabetes and pre-diabetes. Structured education is important to ensure national standards of diabetes education are being met in accordance with the ADEA National Standards of Practice for Credentialled Diabetes Educators and ADEA National Standards of Practice for Diabetes Education Programs and other relevant documented guidelines for diabetes education such as International Diabetes Federation Clinical Practice Guidelines. Structured education allows for correct processes being followed, evidence-based best practice being implemented and reviews being made through continuous quality improvement.
CDEs utilise the following eight (8) key areas of education to facilitate and guide structured diabetes self-management education, while individualising education and providing person centred care:
1- Understanding of the diabetes disease process and treatment options in order to make informed health and lifestyle choices
2- Making appropriate food choices
3- Incorporating physical activity into daily life
4- Monitoring blood glucose and using results to improve diabetes management
5- Using medications for therapeutic effectiveness
6- Problem solving for high and low blood glucose levels and for sick days
7- Adapting to work, family and social roles
8- Reducing the risks of chronic complications.
CDEs current role and scope of practice is likely to include:
- community education and health promotion programs that aim to prevent diabetes and diabetes complications
- provision of healthy lifestyle advice including basic nutrition and physical activity
- consideration of psychosocial factors, their impact on self-management and how to address these factors to enhance diabetes education and care
- education of people with diabetes and their carers on the relationship between diabetes and other health conditions and how to prevent, recognise and treat short term and long term complications
- education regarding individualised structured blood glucose monitoring regimens to assist people with diabetes, their carers and their health professionals to assess the effectiveness of lifestyle/medication interventions
- education of people with diabetes and their carers in the role, options, safe use, side effects and storage of diabetes medications
- education regarding how to prevent, identify and treat hypoglycaemia (low blood glucose levels)
- education regarding how to prevent, identify and treat hyperglycaemia (high blood glucose levels), which includes developing a sick day care plan and managing sick days
- initiation of referrals to a medical practitioners or nurse practitioners to optimise medication regimens if required
- education and evaluation of the knowledge and skills of people with diabetes, their carers and health professionals to inject glucose lowering medicines
- regular re-evaluation of the person with diabetes and/or their carers self-management knowledge, skills and strategies over the continuum of diabetes care
- input into policy and procedures relating to all aspects of diabetes education, management and care.