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Diabetes education
Content of education program
The content and pace of education are determined by the model of care utilized (e.g. ambulatory care compared with inpatient management). Therefore the following guidelines on survival skills and continuing education can only act as a template on which to develop an appropriate curriculum
A practical, simplified, written summary of most of the sections in these ISPAD Guidelines should provide the basis of an educational curriculum
At diagnosis: survival skills
- Explanation of how the diagnosis has been made and reasons for symptoms
- Simple explanation of the uncertain cause of diabetes. No cause for blame
- The need for immediate insulin and how it will work
- What is glucose? — normal BG levels and glucose targets
- Practical skills: insulin injections, blood and/or urine testing and reasons for monitoring
- Basic dietetic advice
- Simple explanation of hypoglycemia. Glucose/sucrose always available
- Diabetes during illnesses. Not to omit insulin
- Diabetes at home or at school, including the effects of exercise
- Identity cards, necklets, bracelets, etc
- Membership of a diabetes association and other available support services
- Psychological adjustment to the diagnosis
- Details of emergency telephone contacts
Continuing educational curriculum
- Continuing education will take place most often in an ambulatory (clinic, community, domiciliary) setting. Where staffing levels, expertise and local circumstances do not permit this, educational programs may be carried out in the hospital environment, either by individual teaching or in groups
- The educational program should utilize appropriate patient-centered, interactive teaching methods for all people involved in the management of diabetes, particularly the affected child or adolescent
Continuing curriculum
- Pathophysiology, epidemiology, classification and metabolism
- Insulin secretion, action and physiology
- Insulin injections, types, absorption, action profiles, variability and adjustments
- Nutrition: meal planning; local systems of regulation of carbohydrate, fat, proteins and fiber; coping with special events and eating out; growth and weight gain; ‘diabetic foods’; sweeteners; drinks; exercise and food
- Monitoring, including glycated hemoglobin and the targets of control
- Hypoglycemia and its prevention, recognition and management, including glucagon
- Intercurrent illness, hyperglycemia, ketosis and prevention of ketoacidosis
- Micro- and macrovascular complications and their prevention. The need for regular assessment
- Exercise, holiday planning and travel, including educational holidays and camps
- Problem-solving and adjustments to treatment (matching insulin, food and exercise)
- Smoking, alcohol and drugs
- School, college, employment and driving vehicles
- Sexuality, pregnancy, childbirth and contraception
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