Renewing the patient’s commitment to self-care through education

Diabetes educators can be a key link in continuing treatment and care.

Caring for any chronic illness requires long-term, consistent care. As health care professionals, we understand that caring for diabetes is not a sprint but a marathon that requires patience and endurance.

At diagnosis, most patients are eager to learn about their disease and how to manage their own care. With so much information to take in, early education typically focuses on Diabetes 101: blood glucose levels, insulin tests and dietary changes. As our patients become more comfortable with the basics, we can direct them to new tools and resources that can help them move to the next level.

Diabetes educators can be a key link in continuing treatment and care for people with diabetes, which is why it is widely recognized that patients need several hours of education as they’re introduced to self-care. Our patients start the life-long marathon of self-care with constant support and attention from diabetes educators, but after the initial briefings and assistance, many of them are left to continue the race on their own.

After several years, people with diabetes know the basics about diabetes care but need someone to come alongside them and help them continue the journey. During life changes, attitude changes and simply over time, a patient’s involvement and interest in their self-care can waver. The support of diabetes educators and other members of the care team can strengthen the patient’s desire to persevere.

Marcia Draheim

Using websites, books to educate

Although it’s true that the longer someone lives with diabetes the more they know about their body and its hurdles, even experienced patients need to increase their understanding of diabetes and new approaches to living with it. Patients can use time with a diabetes educator throughout their lives to renew their commitment to self-care. As educators, it’s important that we make the most of that time and arm our patients with resources. By bridging the information gap and providing experienced patients with new resources, we can re-invigorate them to continue self-care. To do this, we must become familiar with and stay on top of the latest tools and resources that we can share with patients.

Because your patients all have their own unique story about dealing with diabetes, many of them may enjoy joining the diabetes conversation online. Personal blogs by people with diabetes can form a connection that an educator without diabetes would struggle to make. “Six Until Me,” a blog written by Kerri Morrone, speaks to patients who have felt alone in their battle with diabetes. Morrone started her blog in 2005 with the goal of telling people with diabetes that a vibrant, exciting life is possible. She blogs about personal issues like her childhood with diabetes and also brings up current issues, such as how drinking affects people with diabetes. Your patients can learn from Morrone’s experiences and benefit from her firsthand understanding of their experiences.

Another blogger, Amy Tenderich, writes the blog “Diabetes Mine.” Tenderich uses her blog to pass on her “diabetes smarts,” including tips on carb counting, glucose tabs, insulin pumps and the American health care system. She encourages other patients to share what they have learned as well. Her blog is a sounding board for anyone looking for better, more efficient ways to live with diabetes.

If your patients want to go from reading personal accounts to actually discussing diabetes issues with other people, you can recommend online chat rooms that bring these people together. The diabetes chat room at diabetesdaily.com offers the opportunity to join conversations with people dealing with all aspects of life with diabetes.

Online resources offer a broad range of information but some of the information lacks credibility. Your patients should build a library of trusted print resources that they can turn to for answers.

For a catchall index to all things diabetes, you can recommend American Diabetes Association Complete Guide to Diabetes. This book helps people with diabetes implement diabetes management habits into their normal daily routine. Readers will find tips on how to limit diabetes’ control on their lifestyle. The broad range of issues and topics make this a must-have for people with diabetes.

Some people need to review the basics of diabetes management to make sure they are still on track. Know Your Number, Outlive Your Diabetes: 5 Essential Health Factors You Can Master to Enjoy a Long and Healthy Life by Richard Jackson, MD, and Amy Tenderich (author of the “Diabetes Mine” blog) examines the five tests that are the cornerstones for monitoring your overall health with diabetes and developing a daily management plan. Dr. Jackson explains the importance of the HbA1c, blood pressure, lipids and microalbumin test as well as a yearly eye exam. Patients learn how to use the results of these tests to create a personalized treatment plan.

Other sources of information

Not all patients want to wade through diabetes websites and books. Some would prefer an outlet where they can watch short, direct videos that address self-care. The American Association of Diabetes Educators has identified seven self-care behaviors that influence overall health and has created short videos that address each one. The AADE7 Self-Care videos provide current information on issues ranging from healthy eating to taking medication and can be found at mydiabetespartner.org.

A final way educators can motivate patients to take care of themselves is to point them toward reliable news sources. Try cutting out articles you find helpful so you can share them with your patients or pointing them to WebMD or even the health section of their local newspaper for a resource on keeping up with health news.

It is difficult to change the amount of time a patient spends with a diabetes educator, but we can make the time more meaningful by arming patients with the resources they need to increase their patience and endurance.

Marcia Draheim, RN, CDE, is the President of the AADE.