www.diabeticretinopathy.org.uk

General

Diabetes education

David Kinshuck

 

What is diabetes education?

Diabetes is a big challenge if you want to achieve good control. The NHS and experts around the world recommend that everyone in diabetes understands their condition, and understands how to prevent complications. They need to know what to do is something goes wrong, and how to adjust their insulin is they use it.

Diabetes education courses

These courses teach people how to achieve food control and how to adjust insulin in their everyday life, see.

For patients with type 1 diabetes, the DAFNE or BERTIE or in the the Heart of England, SEDRIC.

'SEDRIC' :  Support & Education for type 1 Diabetes Requiring Insulin adjustment & Carb counting'.

For patients with type 2 diabetes there are several 'structured diabetes education programs. Formerly, these included DESMOND for newly diagnosed patients, or for long-standing type 2 patients, the XPERT program was very helpful.

The programs help

What is DAFNE?

diabetes education group: cbhec.tamhsc.edu/diabetes/

Diabetes education courses can be very helpful

 

 

DAFNE stands for Dose Adjustment For Normal Eating. It is described in detail here DAFNE in detail   Here is advice about adjusting insulin dose.

DAFNE is a way of managing Type 1 diabetes and provides people with the skills necessary to estimate the carbohydrate in each meal and to inject the right dose of insulin.

improvement in HbA1c after attending a DAFNE program

improvement in HbA1c after attending a DAFNE program

 

DAFNE is based on:

DAFNE involves attending a 5-day training course (9am to 5pm Monday to Friday) plus a follow-up session around 8 weeks after the course and yearly half-day top-up sessions. The structured teaching program is delivered to groups of 6-8 participants and covers topics including carbohydrate estimation, blood glucose monitoring, insulin regimens, hypos, illness and exercise.

The DAFNE course is about learning from experience. During the week you practice the skills of carbohydrate estimation and insulin adjustment under the supervision of DAFNE-trained nurses and dietitians.

Most of the training is built around group work, sharing and comparing experiences with other people with Type 1 diabetes. However, there are opportunities for each person to speak to a doctor, nurse or dietitian individually.
DAFNE allows people to fit diabetes into their lifestyle, rather than changing their lifestyle to fit in with their diabetes.
The aim of DAFNE is to help you lead as normal a life as possible, while controlling your blood glucose levels, hence reducing the risk of long-term complications related to diabetes.  

It is described in detail DAFNE. If you use insulin and want good diabetic control, insist you can attend such a course. This site teaches you to count your carbohydrates, so you can work out your insulin dose (you need to register and log in).

Many people have benefitted tremendously, see "The DAFNE course absolutely blew me away".

 

Structured diabetes education programs for patients with type 2 diabetes

If you are diabetic and want good diabetic control, insist you can attend one of these education programs. Find a course and ask if your GP if you can attend.

 

A buddy

This is available in parts of the UK. "The Buddy Service is a group of trained volunteers in Lothian who have personal experience of the life changes required to live with diabetes successfully. They all have diabetes or are looking after partners, parents or children with diabetes and come from different backgrounds.

A buddy's job is to listen to and talk with others in the same situation and to give help whenever possible. Buddies don’t give any medical advice, that is provided by experienced doctors and nurses. Buddies can share the practical problems of living with diabetes, day in, day out." See.

 

Telephone support

 

For professionals

the '5 A's

5 As in diabetes 'education'

From here  the 5 As in diabetes education

Advice has to list to patients problems, and tailor the goals accordingly. There are many strategies, (p115) , including the Care Ambassador program  & here.  Such strategies should be used. (P126) as below, describes an office based intervention.

 

A Primary care plan (p126)

 

  • prior to visit
  • mailed reminder
  • goals, self-monitoring records, blood tests

  • waiting room
  • patient completes self management form
  • surrounded by diabetes information.. pamphlets, leaflets, posters

  • examination room
  • nurse gives feedback on changes
  • nurse checks self management form and finds areas of most concern

  • doctor examination
  • check self-management form and discuss areas of most concern TO PATIENT
  • reinforce willingness to change behaviour, refer to nurse for specific plan

  • nurse follow-up
  • review and clarify goals in one area of self-care
  • develop a realistic specific & measurable plan
  • have patient identify barriers & assist problem solving
  • plan continues support...diabetes support group, education, community, phone call between  visits
  • record goal and plan for follow-up at next visits

 

Diabetes and Culture

See BMJ 2008. The central role of a healthy diet and lifestyle is recognised by many religions and religious leaders. There is no cultural 'fatalism', that is leaving everything to God. The individual should adopt a healthy diet and should exercise.