Patient Education

It is the responsibility of the diabetes team to ensure that the person with diabetes can follow the life-style of their educated choice, achieved through the three elements of empowerment: knowledge, behavioural skills, and self-responsibility

Patient education - Taking resposinbility

Assess whether the person with diabetes :

		has the knowledge and behavioural skills necessary for optimum self-care
		makes early and effective responses to everyday problems
		has the confidence to obtain the best input from the diabetes health-care team

Ensure that empowerment is :

		a primary objective of your consultations and education programme
		supported by availability of diabetes publications and other information sources
		the active policy of your diabetes service

Provide :

		positive encouraging responses to requests for information and understanding
		a copy of the European Patients' Charter or a similar national or local statement of rights and roles
		a copy of the person's diabetes health-care record
		information on the results and meaning of all investigations

Consider :

need for assisted self-care for those with cognitive or physical impairment

Patient education - Assessment

Use :

		review of diabetes skills ( self-monitoring, food identification )
		biomedical measures ( changes in body weight, glycated haemoglobin )
		evidence of appropriate behaviours ( footwear, physical activity, smoking cessation, membership of diabetes associations )
		assessment of life-style, emotional adjustment, and perceptions of barriers to life-style activities and self-care
		perceptions of desired short-term goals ( glucose control, weight ), and long-term vulnerability ( to arterial disease )
		knowledge ( as a basic measure )
		diabetes-specific well-being and health profile assessments ( as global measures )

Perform assessment :

		as part of routine care visits, by direct enquiry
		more formally, as part of Annual Review, or on first contact

Patient education - Goals

Aim to optimize :

		knowledge of diabetes, its progressive nature, and the aims of its management
		ability to define personal health-care targets
		motivation and attitudes to self-care
		behaviours which interact with diabetes management
		empowerment in using the skills of health-care and other professionals

Aim to provide skills to :

		manage nutrition and physical activity
		understand and agree health-care targets, and develop strategies for meeting them
		manage complications of therapy including hypoglycaemia therapies
		use the professional members of the diabetes care team effectively
		respond to new problems in diabetes care

		monitor and use the results of therapy
		avoid self-destructive behaviours and deal adequately with stress
		ensure appropriate use of glucose-lowering
		empower self-management during intercurrent illness
		cope appropriately with the late tissue damage of diabetes

Patient education - Provision

Integrate education into regular clinical care by providing your own curriculum and programme

Ensure that the diabetes team has personnel adequately trained in patient education

Assess special needs of each individual ( see above )

Be aware of needs of special groups ( language problems, physical / mental disabilities )

Provide education within three time frames :

		At and shortly after diagnosis :
		basic information on healthy eating, physical exercise, and smoking cessation supportive information on the nature and outcomes of diabetes the minimum skills to obtain control over the new situation
		In the months following diagnosis :
		a comprehensive coverage topics covered previously, plus targets of therapy, eating at home and away complications of diabetes, arterial risk factors, foot care employment, insurance, driving and travel
		In the long term :
		reinforcement periodically after annual evaluation ( see also : Annual Review )

Include carers and family members as appropriate

Use group education to uncover problems and provide solutions and behavioural change through peer example

Review, evaluate, and improve the impact of your education programmes regularly

Patient education - Life-style issues

Assessment

Ask regularly about diabetes interfering with :

		employment
		social and leisure activities
		travel

Topics

Employment

	Provide:
		individualized advice
		counselling and contacts for those affected by a change to insulin therapy

Insurance and driving licences

	Be aware of where appropriate and up-to-date premiums can be obtained
	Provide:
		advice to patients wishing to enter into insurance contracts
		rapid and appropriate reports on request
		informed comment and advice on legal restrictions on licences

Travelling

	Provide advice :
		on the need for valid travel insurance
		on special health risks in visited countries
		as appropriate for those using insulin ( see also : Guide to Type 1 Diabetes, 1998 )
	Review coping skills for acute illness, especially gastroenteritis, and hypoglycaemia

The aims of patient education and training are to provide information in an acceptable form, in order that people with diabetes develop the knowledge to self-manage their diabetes and to empower them to make informed choices in their lives

Self-monitoring of Blood Glucose Control

Patient Education

-	Taking responsibility
-	Assessment
-	Goals
-	Provision
-	Life-style issues

Self-monitoring of Blood Glucose Control