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Diabetes Education Connection
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To Teach, To Learn, To Live:
The Complete Diabetes Education Guide
for Health Care Professionals
"This has been an excellent resource for our staff. I often refer to it for program development and give it to all new staff."
Cindy Gekiere, H-N Diabetes Program Coordinator
We have an epidemic on our hands! According to the most recent data from Health Canada's National Diabetes Surveillance Strategy, the physician-diagnosed prevalence of this disease in adults is 4.8% 1. However, many people with diabetes do not visit the doctor until complications have set in, and some population-based studies2-4 have identified the incidence as greater than 7%—almost double the physician-diagnosed rate! Our whole nation is at risk—and not just for diabetes, but for complications leading to heart attack, stroke, kidney failure, blindness and amputation.
The risk is greatest for the over 14 million Canadians over the age of 40, people of Aboriginal, Metis, Asian, African and Hispanic descent, the 30% of Canadian children who are overweight, and the six million adult Canadians who are overweight and underactive. Individuals who are in more than one of these groups naturally face an even greater degree of risk.
Yet diabetes isn’t inevitable! By learning to eat better, reduce stress and increase their level of physical activity, people with pre-diabetes can reduce their risk of developing the disease. And early diagnosis and aggressive treatment can prevent or delay complications in those who already have it.
" It was easy to read and understand and then translate back to patients."
Tracey Nelson, Family Nurse Practitioner
There is a desperate need for many more health care professionals, in all work settings, to take on the role of diabetes educator. We need to work together to provide increasing numbers of people with the education and support that they need and deserve to live well with diabetes. Too many are “falling through the cracks” . . . and suffering the consequences by developing preventable complications.
Despite the valiant efforts of caring professionals, traditional hospital-based diabetes education programs are experiencing increasing difficulty responding to this epidemic. With funding cuts and inadequate space causing longer and longer waitlists for diabetes education, these programs should no longer be expected to educate all clients singlehandedly, in a timely fashion and with routine follow-up.
If you are a health care professional with clients who have diabetes or are at risk for it, this Guide was written for you. It contains current metabolic targets, and diabetes management and education strategies that have helped my own clients in their quest for optimal glycemic control. I have also included information on meeting the needs of certain groups, e.g. children/adolescents, seniors, and Aboriginal people.
The trust most people have in their health care providers will give you the authority, in their eyes, to deliver this lifesaving, health-enhancing information. Using this Guide, you will be able to design effective programs at your workplace to help your clients learn to prevent or delay complications. (Because much of the information is at a “basic” level, it may be too elementary for experts in the field of diabetes education.)
The writing of this, my second book, was inspired by those who purchased the 1997 edition. Users of the first Guide were generous in their encouragement and appreciation, and also in their suggestions. I’ve now added more material on prevention of diabetes and emergency care of the person with acute complications. I’ve also added new sections on insulin pump therapy, pediatrics and care of the elderly.
" The teaching tips are phenomenal!"
Eileen Schmidt, RN, Home Care Nurse (Nursing Program Supervisor)
The Second Edition is based on the new, evidence-based 2003 Clinical Practice Guidelines for the Prevention and Management of Diabetes in Canada. These Guidelines have tighter blood glucose, lipid, and blood pressure targets than the 1998 Guidelines referred to in the first edition. One thing hasn’t changed—the Teaching Tips. I’ve added more, of course, but the use of everyday objects and events to explain complex concepts remains a core feature.
Since the publication of the first edition of the Guide, my career path has taken me to a formal multidisciplinary diabetes education program. I have now seen diabetes education from “both sides,” first as a community care nurse and now as a diabetes educator in a hospital setting. This additional experience has served to broaden my approach in the Second Edition. The Guidelines will be updated again in 2008, after which I plan to publish a third edition. Hence a continual work in progress!
Designed for convenient use in the field, this Guide provides easy access to current information about diabetes and proven instructional techniques. It can be utilized in the following ways:
- a reference for developing individualized education plans
- a basis for curriculum development and standardization of a diabetes education
program
- a study guide for the diabetes educator certification exam
- an awareness tool for health care policy-makers and the public
- a supplement to professional development related to diabetes education
- justification for an interdisciplinary team approach to diabetes education and
management.
The Learning Outcomes at the beginning of each chapter are for you, the educator. They are the most important concepts that you will need to know in order to effectively educate your clients. The Client Learning Outcomes at the end of each chapter list the facts, skills and behaviours to be learned and adopted by your clients. Designed to help you in program planning and evaluation, the Client Learning Outcomes, along with client checklists and informational updates, will be posted at www.diabeteseducationconnection.com.
The Challenge
Research is rapidly expanding our knowledge of diabetes. With this knowledge comes new technology, new medications, and an ever-increasing ability to manage the disease and minimize, delay or prevent complications. Both the burgeoning worldwide epidemic of diabetes and our growing knowledge make it incumbent upon us to remain current in this ever-changing, exciting and rewarding field.
With the aim of this Guide in view, let’s continue to work together To Teach, To Learn, To Live!
To Teach, To Learn, To Live: The Complete Diabetes Education Guide for Health Care Professionals is based on the Canadian Diabetes
Association 2003 Clinical Practice Guidelines for the Prevention
and Management of Diabetes in Canada. American readers are encouraged to use this Guide for general principles of diabetes care and education, but to refer to the American Diabetes Association Clinical Practice Recommendations.
References:
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Health Canada. Diabetes in Canada. 2nd edition. Ottawa, ON: Centre for Chronic Disease Prevention and Control, Population and Public Health Branch, Health Canada; 2002.
- Leiter LA, Barr A, Belanger A, et al. Diabetes Screening in Canada (DIASCAN) Study: Prevalence of undiagnosed diabetes and glucose intolerance in family physician offices. Diabetes Care. 2001;24:1038-1043.
- Harris MI Flegal KM, Cowie CC, et al. Prevalence of diabetes, impaired fasting glucose, and impaired glucose tolerance in U.S. adults. The Third National Health and Nutrition Examination Survey, 1998-1994. Diabetes Care. 1998;21:518-524.
- Dunstan DW, Zimmet PZ, Welborn TA, et al. The rising prevalence of diabetes and impaired glucose tolerance: the Australian Diabetes, Obesity and Lifestyle Study. Diabetes Care. 2002;25:829-834.
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