Diabetes Self-Management Education Needs

I have a difficult time understanding the logic behind not educating people with diabetes the basics of Diabetes Self-Management (DSME). If the people responsible for this education are not equipped for this, then they need to teach the basics of Self-Monitoring of Blood Glucose (SMBG).

My cousin that is a nutritionist has asked me quite a few questions lately because she has been working with several other communities needing nutritional assistance. In one community, they had her there for a program with a certified diabetes educator and people were up in arms after the CDE left. She had been present for most of her program and wondered how someone with that much education could not teach, but only offer mandates and dogma.

In the question and answer part after the CDE talk, several had asked questions about sleep apnea and were told that she did not feel qualified to answer any questions about sleep apnea. The questions then turned to questions about what the different blood glucose readings were telling them about the food they were eating and my cousin said she could not believe that she evaded those questions and answered with mandates.

The last question the CDE was asked was about how to avoid depression and diabetes burnout. She started gathering her papers together while telling the people to talk about this with a psychologist. Then she promptly left.

My cousin said that many were hostile at that point, but she waited until she was introduced and said that if the group were interested, she would contact some people and ask if they would be willing to talk to the group about sleep apnea and depression and diabetes burnout. She said she would try to answer some of the questions about blood glucose testing during her presentation. She told the group that she knew of another group that could probably answer a lot of questions, but they would not be trained, as the CDE should have been.

She said her presentation should have been for 45 minutes, but lasted for about an hour and thirty minutes. They had many questions and asked some that she could not answer, but did give her a round of applause when she opened it up for questions and answers. She said nutrition was her specialty and that she was aware of diabetes only because a cousin had it and she had worked with most of our group on their daily nutrition.

The doctor advising that group had stated that he could find someone to talk about sleep apnea and depression, but the group needed more on diabetes management and equipment use. She warned me that she had given out my blog and several had pulled it up and may be sending emails with questions. I told her the doctor had already contacted me and asked for several of our group to speak at their November meeting. I said Tim had also received a call with the same request.

I asked her if she would be available to introduce us and answer more questions. Then I asked her if she was familiar with ketone meters. My cousin laughed and said she could guess why as people on low-carb/high-fat diets should use one if they are interested in maintaining a ketogenic diet. She said she has two of the three meters recommended by most of the medical insurance companies in our state. I said I would be asking for the medical insurance companies served by most of the group she had met.

I said this will be difficult, as most insurance companies will hesitate to reimburse for these, but will for some cases. She agreed and said she would talk directly to the doctor. Tim arrive then and we talked for another hour planning what we could talk about and who would be best for each part. We have more emails to send to the doctor asking questions. We agreed that as things came together for an outline that this should be sent to all the members of this group. Now the work begins.