Introduction:
Diabetes is one of the leading causes of death and disability in India. India and China together hold the largest number of diabetes with India being known as the diabetes capital of the world. There are now an estimate of more than 62 million patients with diabetes in India. It is the leading cause of adult blindness, kidney failure and amputations of the foot or leg. It also puts people at increased risk of heart disease and stroke. Diabetes is not like a disease, it’s just a metabolic disorder which is preventable and manageable, yet public awareness about the diabetes is very low and many people do not understand how to control their disease and prevent complications. Therefore, in order to manage diabetes properly, diabetic patient need to attend diabetic clinic where diabetic education and diabetic care is available.
Importance of Diabetes Education:
Diabetes education is the cornerstone of diabetes management, because diabetes requires day to day knowledge of nutrition, exercise , monitoring and medication. Diabetic education, increases your knowledge, attitude and perception of the disease and its future consequences, and allows you to better incorporate education into your life and make the necessary changes to improve your lifestyle for a healthy living.
Who are the people that are involve in Diabetic Clinic:
1. Physician
2. Diabetes educator
3. Dietician
4. Physiotherapist /Podiatrist
5. Opthalmologist
Benefits/advantages of diabetes education classes:
Diabetes is a chronic condition that requires you to make multiple decisions throughout the day to successfully manage blood sugars and prevent diabetes related health problems. These problems include:
*What to eat?
*When to eat?
*When to take medicine?
*How to check blood sugar?
*What to do for high or low sugar?
*How to take care of your feet?
Diabetes education classes are the best way for you to learn the answers to these questions. It is an ongoing process that should be repeated either with a diabetes nurse educator or dietician. This allows the patients to keep up to date with their diabetes control. Diabetes education gives you the power to control your diabetes, so it doesn’t end up controlling you. Proper education can lower a person’s average blood sugar and prevent emergencies like hypoglycemia (low blood sugar ) and hyperglycemia (high blood sugar ).
How are the classes structured?
*Classes are made up of small groups and also individual education is provided according to requirement.
*20 to 30 minutes time is required for the first meet.
*From second visit onward, diabetic educator will assess and re-enforce education and, if needed provide as per the requirement.
Main areas covered during diabetes education:
*Pathphysiology(cause) of diabetes and types of diabetes:
Those who attend the class are taught about pathophysiology, types and management of diabetes according to their needs and understanding level.
*Diet: Nutritional assessment is used to determine what the individual with diabetes is able and willing to do. Nurse educator identify the area for dietary intervention and explain the meal pattern, meal plan, food exchanges and lifestyle modification according to the individual’s living standard, diet pattern and sugar level.
*Exercise: Exercise is being increasingly recognized as a part of the treatment of diabetes mellitus. The benefit of exercise, its importance, types of exercise, duration and precautions to be taken are taught in the process of diabetic education.
*Medications: There are different types of medicine to control diabetes mellitus and it is individualized according to the type of diabetes. Medicine dosage, timing and regularity of treatment and complications which can arise due to diabetes are taught by the diabetic educator.
*Insulin therapy: The practical aspect of insulin therapy becomes very important and are discuss and demonstrated well in detail. Insulin storage, insulin syringes, reuse and disposal of syringes, syringe alternatives such as pen like devices and insulin-containing cartridges, sites for insulin administration, factors that affect rate of insulin absorption and complications of insulin therapy are taught to those who are dependent on insulin.
*Self Blood Glucose Monitoring (SBGM): Since regular monitoring of blood glucose is necessary, use of glucometer (a machine use to check sugar) is demonstrated and frequency of its use are taught to the patient so that they can manage such things at home confidently.
*Self care: The education class also cover the importance of eye care and dental care since diabetes is a chronic and progressive condition.
*Diabetic complications: The possible short term complications such as Hypoglycaemia (low blood sugar) and Hyperglycaemia (high blood sugar ) awareness, its remedy and management are taught as well as long term complications such as retinopathy (eye problem), nephropathy (Kidney problem ) and neuropathy (nerve problem).
*Diabetic foot care: High blood glucose in diabetes causes nerve damage and poor blood flow which can result in foot problems that can lead to amputation of leg and foot. For early diagnosis and prevention of such complications, foot examination and nerve function test is done from the first visit .
*Documentation: Detail assessment and documentations are maintain for every individual, so that the disease progress is well recorded and the education team has a clear knowledge about their diabetes patient’s progress and give care as per needed.
*Education Booklet: A small leaflet which contents information regarding diabetes and its management, diet and foot care are provided to the patient. Also diabetic diary is provided to record blood sugar for those who have glucometer (a small handy machine which is use to check blood sugar).
Do I need diabetes education if I see my doctor regularly?
It’s a good idea to see a diabetic educator atleast every 3 months even if it is in good control to be sure you are on track with your diabetes care. The educator works together with your physician to ensure you have the skills and knowledge required to manage diabetes. As a result of research and technology innovations, you may benefit from seeing an educator to learn the latest about nutrition guidelines, new glucometers, new medications, or improved insulin delivery devices.
I’ve had diabetes for 15 years. Can I still benefit from diabetes education classes?
Since diabetes is a chronic and progressive condition, it’s very likely that the strategies used to manage it will need to be adapted overtime. Likewise, other health conditions of lifestyle changes may impact how you care for your diabetes. Attending diabetes education classes will help you to stay current on the best treatments and guidelines available now .
How can I get Diabetic Education?
*Make an appointment where there is diabetic clinic and walk in.
Conclusion:
Diabetes is unlike other diseases such as TB , Malaria, Typhoid etc, where medication along can often times successfully treat it. There are a lot of other components to diabetes such as : The diabetes disease process, nutritional management, physical activity, medications , glucose monitoring and psychosocial adjustment. Thus, diabetes education and self management training should be done with the team.
Diabetes is one of the leading causes of death and disability in India. India and China together hold the largest number of diabetes with India being known as the diabetes capital of the world. There are now an estimate of more than 62 million patients with diabetes in India. It is the leading cause of adult blindness, kidney failure and amputations of the foot or leg. It also puts people at increased risk of heart disease and stroke. Diabetes is not like a disease, it’s just a metabolic disorder which is preventable and manageable, yet public awareness about the diabetes is very low and many people do not understand how to control their disease and prevent complications. Therefore, in order to manage diabetes properly, diabetic patient need to attend diabetic clinic where diabetic education and diabetic care is available.
Importance of Diabetes Education:
Diabetes education is the cornerstone of diabetes management, because diabetes requires day to day knowledge of nutrition, exercise , monitoring and medication. Diabetic education, increases your knowledge, attitude and perception of the disease and its future consequences, and allows you to better incorporate education into your life and make the necessary changes to improve your lifestyle for a healthy living.
Who are the people that are involve in Diabetic Clinic:
1. Physician
2. Diabetes educator
3. Dietician
4. Physiotherapist /Podiatrist
5. Opthalmologist
Benefits/advantages of diabetes education classes:
Diabetes is a chronic condition that requires you to make multiple decisions throughout the day to successfully manage blood sugars and prevent diabetes related health problems. These problems include:
*What to eat?
*When to eat?
*When to take medicine?
*How to check blood sugar?
*What to do for high or low sugar?
*How to take care of your feet?
Diabetes education classes are the best way for you to learn the answers to these questions. It is an ongoing process that should be repeated either with a diabetes nurse educator or dietician. This allows the patients to keep up to date with their diabetes control. Diabetes education gives you the power to control your diabetes, so it doesn’t end up controlling you. Proper education can lower a person’s average blood sugar and prevent emergencies like hypoglycemia (low blood sugar ) and hyperglycemia (high blood sugar ).
How are the classes structured?
*Classes are made up of small groups and also individual education is provided according to requirement.
*20 to 30 minutes time is required for the first meet.
*From second visit onward, diabetic educator will assess and re-enforce education and, if needed provide as per the requirement.
Main areas covered during diabetes education:
*Pathphysiology(cause) of diabetes and types of diabetes:
Those who attend the class are taught about pathophysiology, types and management of diabetes according to their needs and understanding level.
*Diet: Nutritional assessment is used to determine what the individual with diabetes is able and willing to do. Nurse educator identify the area for dietary intervention and explain the meal pattern, meal plan, food exchanges and lifestyle modification according to the individual’s living standard, diet pattern and sugar level.
*Exercise: Exercise is being increasingly recognized as a part of the treatment of diabetes mellitus. The benefit of exercise, its importance, types of exercise, duration and precautions to be taken are taught in the process of diabetic education.
*Medications: There are different types of medicine to control diabetes mellitus and it is individualized according to the type of diabetes. Medicine dosage, timing and regularity of treatment and complications which can arise due to diabetes are taught by the diabetic educator.
*Insulin therapy: The practical aspect of insulin therapy becomes very important and are discuss and demonstrated well in detail. Insulin storage, insulin syringes, reuse and disposal of syringes, syringe alternatives such as pen like devices and insulin-containing cartridges, sites for insulin administration, factors that affect rate of insulin absorption and complications of insulin therapy are taught to those who are dependent on insulin.
*Self Blood Glucose Monitoring (SBGM): Since regular monitoring of blood glucose is necessary, use of glucometer (a machine use to check sugar) is demonstrated and frequency of its use are taught to the patient so that they can manage such things at home confidently.
*Self care: The education class also cover the importance of eye care and dental care since diabetes is a chronic and progressive condition.
*Diabetic complications: The possible short term complications such as Hypoglycaemia (low blood sugar) and Hyperglycaemia (high blood sugar ) awareness, its remedy and management are taught as well as long term complications such as retinopathy (eye problem), nephropathy (Kidney problem ) and neuropathy (nerve problem).
*Diabetic foot care: High blood glucose in diabetes causes nerve damage and poor blood flow which can result in foot problems that can lead to amputation of leg and foot. For early diagnosis and prevention of such complications, foot examination and nerve function test is done from the first visit .
*Documentation: Detail assessment and documentations are maintain for every individual, so that the disease progress is well recorded and the education team has a clear knowledge about their diabetes patient’s progress and give care as per needed.
*Education Booklet: A small leaflet which contents information regarding diabetes and its management, diet and foot care are provided to the patient. Also diabetic diary is provided to record blood sugar for those who have glucometer (a small handy machine which is use to check blood sugar).
Do I need diabetes education if I see my doctor regularly?
It’s a good idea to see a diabetic educator atleast every 3 months even if it is in good control to be sure you are on track with your diabetes care. The educator works together with your physician to ensure you have the skills and knowledge required to manage diabetes. As a result of research and technology innovations, you may benefit from seeing an educator to learn the latest about nutrition guidelines, new glucometers, new medications, or improved insulin delivery devices.
I’ve had diabetes for 15 years. Can I still benefit from diabetes education classes?
Since diabetes is a chronic and progressive condition, it’s very likely that the strategies used to manage it will need to be adapted overtime. Likewise, other health conditions of lifestyle changes may impact how you care for your diabetes. Attending diabetes education classes will help you to stay current on the best treatments and guidelines available now .
How can I get Diabetic Education?
*Make an appointment where there is diabetic clinic and walk in.
Conclusion:
Diabetes is unlike other diseases such as TB , Malaria, Typhoid etc, where medication along can often times successfully treat it. There are a lot of other components to diabetes such as : The diabetes disease process, nutritional management, physical activity, medications , glucose monitoring and psychosocial adjustment. Thus, diabetes education and self management training should be done with the team.