Engaging diabetic patients in conversation and helping them to establish monitoring, nutrition and exercise goals are the first steps in an education program, explains Janet Wendle, an RN and certified diabetes educator (CDE) who is also system director of the Main Line Health Diabetes Management program. Continuing to tweak its programs to meet the needs of the populations it serves is an ongoing effort, she adds.
Question: How is your diabetes education program structured?
(Janet Wendle:) The program is 10 hours. There are five encounters. The first one is with an RN. They are often newly diagnosed, and they don’t have a clue. They only want the diet because they think that is all the program is about. We give them a brief overview of diabetes. Most of the time we are giving them a glucose monitor. We always have meters available, which are aligned according to their insurance company’s preference. Throughout the entire program, we show them how the glucose monitoring is a motivating factor in helping them to control their diabetes. We review any medications they are on. This is the one time with the nurse.
Then we start them with survival skills. We give them tangible material and information to start looking at some elements of their diet. Because many times that is all they want. They say: “Give me the Cliff notes. Give me the diet. I’ll go and look it up on the Internet.” Our hope is when we engage them in conversation, we establish goals. Depending on the individual, it might be a monitoring goal. It might be a nutrition goal, even things like starting to have breakfast, trying not to go any longer than four hours without having any food or drinking sugar-free beverages instead of regular soda. We try to write the goals down and have the individuals sign that these are things they are going to be working toward. Sometimes there is an exercise goal. For example, they say: “I have a gym membership, I really need to go.” We look into reactivating the gym membership or having them continue walking, and we try to encourage what they are already doing.
At that point, about 85 percent of people say they will participate in the class. We offer them day and evening classes. There are three education group instruction sessions taught by a nurse, not a dietitian. Depending on available staff, an exercise person or a pharmacist may come and address the group.
Source: Patient-Centered Diabetes Management: Driving Outcomes with Education and Behavior Change
Patient-Centered Diabetes Management: Driving Outcomes with Education and Behavior Change takes an in-depth look at three patient-centered programs for diabetes management that are improving clinical outcomes and bending the cost curve for program participants.