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Why do I need to work with a diabetes educator and what help is it anyway?
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Virginia Zamudio, R.N., M.S.N., C.D.E., is past president of the American Association of Diabetes Educators (AADE) and a current partner at the Alamo Diabetes Team, LLP, in San Antonio. |
A: A diabetes educator (DE) is a health-care professional whose main focus is helping people with diabetes understand their disease and learn how to adjust their lifestyle and behavior so that they can achieve good diabetes self-management. Diabetes is truly a disease that requires self-management; people with diabetes must make decisions several times a day that will have an impact on how their diabetes affects them in the long run.
A diabetes educator is there to show them several important self-care tools: how to test their blood glucose level, make sense of the numbers, take their diabetes medications properly—in short, how to put it all together so that they can keep their blood sugar under control and avoid the complications of the disease. That’s a tall order, so the DE is also there to provide assistance in making behavioral changes. At the end of the day, behavior change is where the “rubber meets the road,” so to speak.
A: Lifestyle changes are the hardest thing for people to deal with. I always tell my patients that they have to validate that they’re going through some tough times and it’s going to be difficult to change. When adults are diagnosed with diabetes, they must deal with changing a lifetime of habits. Anytime we make a change in our lives, even if it’s only something as minor as rearranging the furniture or moving the trash can to the other side of the room, it may take our brains a couple of weeks to get in the habit of going to the new location. And anytime you want to make an important change in your behavior, whether it’s adding exercise into your daily routine or calculating carbs, you certainly have to give yourself time to make the new behavior a habit. While people are going through the process of change, a DE can help them identify barriers that may be getting in the way and suggest ways to improve coping skills. A DE can also pull in family and friends and let them know how they can help you succeed in changing your behavior.
A: Remember the saying, “Rome was not built in a day.” You have to find out what your priorities are and address one area of change at a time. Once you’ve been successful making one change, you can tackle another area. A DE can help set priorities and define specific goals. If someone said, “I’d like to exercise more,” a DE would ask what kind of exercise. If he said, “I like to walk,” then the DE might ask, “Realistically, how many minutes, and how many times a day or week, can you walk?” That’s how you build a plan you can stick to.
A: We encourage them to bring with them an important person in their life so that there is someone else who hears the information. Many times friends or relatives who want to help the person with diabetes may mean well, but they don’t know how to be helpful. They may come off as the “diabetes police,” and that’s not good. If the person who is part of the support system hears the same information as the person with diabetes, it makes it easier for this helper to communicate constructively.
A: Some people aren’t comfortable asking for help. But people who have support systems do better in the long run with their diabetes management.
For people who are alone, it’s very difficult, but this is where a diabetes educator can really help. We become someone with whom they can talk and to whom they can vent a little bit about how difficult it may be to cope with everything.
And sometimes it’s easier for people to talk to us, as opposed to family or friends, because there’s no emotional baggage. We’re professionals, so we are a little more distant, which works for many people. We can also draw on our experience and tell them that even though they may be alone in dealing with the disease, they’re not alone in how they feel.
A: The first step is to talk to your doctor about a referral to a diabetes educator. Make sure you request a certified diabetes educator, or CDE. Certification means a DE has significant experience in diabetes education. CDEs have to meet certain professional requirements and have at least 1,000 hours of direct diabetes-education experience before they’re even eligible to take the national certification exam.
People can also locate a nearby CDE by visiting the American Association of Diabetes Educators Web site at www.diabeteseducator.org or by calling 1-800-TEAMUP4. To find a local DE program recognized by the American Diabetes Association as having met the national standards for excellence, visit www.diabetes.org/education/edustate2.asp or call 800-DIABETES.
A: These days costs vary from clinic to clinic and program to program. A lot of states do have mandates in their insurance regulations, but it’s not across the board, so be sure to ask about insurance coverage whenever you speak with a prospective CDE.
To get the information you need in order to take charge of your diabetes, visit these Web sites:
• National Institute of Diabetes & Digestive & Kidney Diseases at www.niddk.nih.gov
• American Diabetes Association at www.diabetes.org
• Juvenile Diabetes Research Foundation at www.jdrf.org
• The Centers for Disease Control and Prevention at www.cdc.gov/diabetes/faq/index.htm
• National Diabetes Information Clearinghouse at www.diabetes.niddk.nih.gov/about/contact.htm
• The American Association of Diabetes Educators site can help you find a CDE in your area. Visit www.aadenet.org
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