by Dr Unnikrishnan A.G
Diabetes educators are a new group of health professionals who are changing the diabetes management scenario in India. Though, in Western countries, they have been around for decades, it is only now that their presence is required urgently in India. This is because the prevalence of diabetes is rapidly increasing in our country and we now need the help of doctors, diabetes educators , nutritionists as well as other allied health professionals to control this epidemic of diabetes.
Who is a diabetes educator?
It is well known that the health of the diabetic subject is in his or her own hands. This is the concept of “Self Management”. Many patients feel that self-management means that they are free to decide and choose what therapy they must take (or must not take!). While this is true to an extent, the actual meaning of self-management is that a diabetic patient becomes informed, and updated about his or her illness, which helps them to take charge of their diabetes. Essentially, this means that patients watch their own nutrition, sugar, exercise, and become compliant with medication. Self-management leads the way for good health and independence in making the right lifestyle choices.
However, this means several hours or even weeks or months of diabetes education to the patient. A single visit and a prescription from a doctor might help in short-term control, but a lifetime of diabetes needs a more rigorous adherence to drugs and lifestyle modifications. This is where a new breed of professionals, called diabetes educators make their mark. The diabetes educators are the interface between the doctor and the patient. They help the patient to understand the disease, adhere to the doctors advice and even in successfully maintaining glucose control by improving the home blood glucose monitoring.
All over the world, diabetes educators are in great demand, as research has shown that they help the patient to understand diabetes, as well as empower him to adhere to medication, lifestyle changes as well as home blood glucose monitoring.
What do diabetes educators do?
Diabetes educators could be trained-graduates, health professionals, nurses, dietitians, pharmacists, exercise specialists, doctors, and social workers. In general diabetes educators are people who have been trained in assisting with the care of diabetic patients. They help diabetic subjects in living a healthier, more fulfilling life with diabetes.
Diabetes educators work in a many places. You could find them in our hospital teaching patients in group classes. Sometimes they could work with patients individually. They also help the doctor, and are found in the diabetologists’ clinics.
One of the most useful roles for a diabetes educator is in helping you cope with the diagnosis of diabetes, when it is first detected. They will impart the necessary knowledge and skills that you require. Most importantly, they help the patient to be independent by teaching them self-management skills throughout their lifetime of living with diabetes. .
How does a diabetes educator go about his or her task?
The first task that the diabetes educator undertakes is to try to know you as an individual. Next the diabetes educator will help you to tailor create a self-management plan that works for you, and is based on your age, work schedule, your daily activities and eating habits, or if you have another coexisting medical illness. All your family members must ideally interact with the diabetes educator and learn more about diabetes management: techniques and timing of injecting insulin or taking diabetes pills. The diabetes educators will also help you to make healthy food choices, and assist you in bringing about a good exercise schedule and also teach you about self-monitoring your blood sugar. Finally, the diabetes educator helps you to decide and understand when you need to call your doctor to report a change in your health status.
Adjusting emotionally to diabetes
It’s all in the mind, said a wise person. Research has now shown that happiness is not linked to fame or money or success or a good family backing, but is linked to how satisfied you are with your present life status. In other words, whatever the problems that you encounter, if you are contented, you’ll still be happy!! This is called the “emotional quotient” as opposed to the “intelligence quotient”. Extensive research has also shown that subjects who are emotionally well-adjusted tend to live longer than dissatisfied sulkers. The diabetes educator plays a crucial role in helping the patient to achieve emotional adjustment with the disease.
The cricket coach concept
In this regard, the role of a diabetes educator is similar to that of a cricket team’s coach. The diabetes educator helps you and your family to win the match against diabetes!! For instance, many a diabetic has fallen prey to the syndrome of “denial”. In the early stages, when a patient has been recently found to have diabetes, in some cases, he or she repeatedly checks sugars several times over several months, till the diagnosis is established without doubt, i.e. when some problem happens. By then, several months of high blood sugars have ensued, and this often sets in an irreparable cascade of damage to organs like eyes, kidneys, heart and nerves. In some patients, this period of denial can last for years, and it is not very uncommon to see patients who have had uncontrolled sugars for 4 or 5 years, coming to a doctor only when they develop life threatening complications. The diabetes educator also helps the patient come to terms with diabetes.
Lifestyle changes
Diabetes educators help your family too. For, in essence, the lifestyle recommended for diabetes is a model lifestyle that is meant for all people. For instance, it has already been well proven in research studies conducted in the United States that diet control and exercise can prevent diabetes. In other words, if our family members were to make healthy food choices, they could prevent diabetes. Our children would grow and develop as they would if they didn't have diabetes!!! With your doctor’s approval, the diabetes educator interacts with the dietician to make a personalized meal plan, and also interacts with the physiotherapist to make a good exercise schedule keeping in mind the lifestyle of the patient.
Taking medication
Many patients have several questions and points to clarify, even after they have left the hospital. For instance, what should you do when you feel that your blood sugars are low ? How is an insulin syringe used? Where can you inject insulin? How do your diabetes pills work and when should you take them? Diabetes educators can teach you about all your diabetes-related medication. In coordination with the doctor, they help you to make the right decisions.
Self-management of blood sugars
As doctors, we do come across the occasional motivated patient who is able to control their diabetes by regularly checking blood sugar and readjusting insulin. With the advent of diabetes educator, assisted by the telephone, these patients can benefit by clearing their doubts and learn about glucose monitoring. A diabetes educator can help you learn about buying and using a glucometer. Also, the diabetes educator helps you to readjust your diet and exercise based on your glucose profile. You can clarify your questions and also find out how individual foodstuffs, stress and medicines affect glucose control.
Counseling
A diabetes educator provides support and encouragement. You can talk to him or her about your fears about diabetes. They often help to reassure you, and make you understand that these emotions are normal. When your diabetes is out of control, the doctor helps you by treating the illness. However, the diabetes educator helps you to cope with the stress of the problems that you encounter. New life events, like taking up of a new job, a new residence or a new school can cause anxiety about the revelation of the disease, and also about healthy choices. The diabetes educator helps you plan and adjust your life for these events.
Conclusion
The diabetes educator tailors your lifestyle and activities to suit your illness. Diabetes educators understand that each patient is different. They for instance will understand the special needs of the older people, of small children and of pregnant mothers. They are able to adjust and get along with people from different cultures, classes and regions. In other words, they are a secular group, who serve the patients irrespective of class, creed, religion or economic status. At our institute, we have started the diabetes educators training course, and have found that they are a group of smart, intelligent and friendly persons, who are ushering in a new era of diabetes management. These health professionals are part of the new changes in diabetes management, and herald a new generation, who will finally make sure that the diabetic patient is empowered to make the right choices for their health-related requirements.
7 comments:
VERY WELL-WRITTEN ARTICLE THAT SUMS UP EVERYTHING ABOUT THE ROLE OF A DIABETES EDUCATOR IN PATIENT CARE. IN A COUNTRY LIKE INDIA, WITH AN EVER INCREASING POPULATION OF DIABETES INDIVIDUALS, THE ROLE OF A DIABETES EDUCATOR SHOULD BE RECOGNISED BY THE HEALTHCARE INDUSTRY AND THE COMMON MAN EQUALLY TO PUT BRAKES TO THIS ACCELERATING HEALTH PROBLEM BY INITIATING DIABETES EDUCATION PROGRAMS.
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With Type2 Diabetes, your body either doesn’t make enough Insulin (a hormone which regulates your blood sugar level) or the Insulin it produces doesn’t work properly, because your body cells are resistant to it. Type 2 is described as lifestyle disease as it occurs in people who have less physical activity, who are obese or overweight. This is the most common form of diabetes. Research has shown that type 2 can be prevented by exercise , proper nutrition and lifestyle changes.
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