Education

One reason for poor diabetes outcomes – the development of disabling, potentially life-threatening complications – is the lack of effective participation by people with diabetes in the management of their own condition. This participation is the key to successfully achieving therapeutic goals. To be able to follow a difficult and complex life-long regimen requires high levels of motivation and knowledge. Yet although extensive evidence supports this concept, only a minority of people receive appropriate diabetes education.

The goals of diabetes education are to optimize blood glucose control, prevent chronic and potentially life-threatening complications, and optimize quality of life, while keeping costs within acceptable limits. Research has shown that with appropriate education lower-extremity amputation rates, medication costs, emergency room visits and hospitalizations are reduced. Nowadays, diabetes self- management education is an integral and critical part of any treatment plan.

Since the National Certification Board for Diabetes Educators (the organization responsible for certification of diabetes educators in the USA) was established in 1986, the importance and prevalence of professional certification have increased dramatically. New certification programmes are increasingly being developed for more and more occupations and professional specialties, while existing certification organizations are expanding their certification offerings.

Nowadays, few people would question the role of a person with diabetes as the central figure in his or her diabetes care team. But ‘patient’ empowerment extends well beyond the concept of self-determination. Diabetes does not occur in a vacuum, but interacts with a variety of emotional states and exists within many cultural and social boundaries. People with diabetes hold the power to manage their condition – not their healthcare providers or their family members.

Diabetes educators are professional healthcare providers who are qualified to work with people in the management of their diabetes. The role of diabetes educators is dynamic and shaped by the environment in which they practise and by developments in research and technology. Core components are clinical care, education, counselling, research, and management.

Diabetes is mostly managed by people with the condition. In order to do so effectively, people with diabetes need to acquire and develop a broad base of knowledge and skills, and incorporate lifestyle choices into daily living which facilitate and enhance self-care. Diabetes education is an active process that supports people in building self-management skills, and provides for shared decision making about how best to fit diabetes treatment into daily life.

Guest Editor-in-Chief's editorial

President's editorial

During a meeting halfway through a 24-month project for the UK National Institute for Health and Clinical Excellence (NICE), surrounded by well-known health professionals, Barbara Elster was asked her opinion on one of the subjects under discussion. Having expressed her views, she contemplated how she, a person with no formal medical training, had come to be in such esteemed medical company, involved in producing national guidelines on diabetes for the UK Government.

Breastfeeding has numerous advantages for mothers with diabetes and their babies. Nursing mothers have lower insulin requirements and better control of their blood glucose; breastfed babies may have a lower risk of developing diabetes themselves. Alison Stuebe describes these potential benefits and highlights the special needs of breastfeeding mothers with diabetes.