December 25, 2014
Diabetes Self-management Education Not being Utilized
I am not surprised that diabetes self-management education is underused or not utilized at the level many educators think it is. To begin with; there are too few certified diabetes educators (CDEs). As explained in my blog here, most are located in or near large populations and in the Washington DC to Boston corridor (Northeast Corridor). Out here in the hinterland, we occasionally have a CDE, but most are not reliable.
Our diabetes support group has discussed this among ourselves and now with the new members, we are getting many questions asking if they should make use of the classes. We are trying not to be negative, but one of the new members, Rose, did attend a class this week and is scheduled for one more class next week. She called Brenda and started asking questions and wondering if she should even go to the next class.
Brenda called Tim and me to come to her place and when we were there, she had Rose explain what had happened. Rose put the business card on the table where we could look at it. Both Tim and I noticed that the title was RD (registered dietitian) and CDE. I brought this to Rose's attention and Brenda agreed this could be the reason why Rose was not pleased. Tim asked her if most of the class was on food and Rose said that was why she was unhappy as very little was taught about self-management of diabetes. Rose said that was why she had asked for the class – to learn more about managing her diabetes since she was on insulin.
Tim asked if there were others in her class and how many. Rose said there were three others and all were not happy about the amount of time spent on food and the number of carbohydrates they were told to eat and the heavy promotion of whole grains. She said that two of those present people with type 1 diabetes and could not eat gluten. Rose said the person ignored that and emphasized that they would be missing a lot of nutrients by leaving whole grains out of their meal plans.
Tim asked Rose to think about returning to the class and she said she would not stay unless the person stuck to teaching about managing diabetes. She would go, but would leave if it was all about food. Tim thanked her, and then asked if Brenda would be opposed to adding this to our meeting on the tenth of January. Brenda said that was a good idea in case the class was about food. I told Tim that I knew a nurse that was knowledgeable about diabetes and she could present something. Rose said anything would be better than the class she had. Tim said to call her and see what was possible.
Then Tim said he would talk to Allen and Jason and see if they would like to do a presentation on this topic. Brenda spoke up and said she would like to work with Jason for the topic. Tim said for her to go ahead and we would not need the nurse then. He said that the evening could be long and Rose said that with the topic of testing and self-managing of diabetes, it would be interesting for her.
Tim thanked Brenda for asking to do the presentation. Brenda said it was time she started to give back and she would like this topic. She asked Rose to be available and think about questions she had and then write them down. Tim said that once he knew Jason was willing, he would send an email to everyone for questions they might have on the topic. He would ask them to send the questions to him for forwarding to Brenda and Jason.
Tim and I left then and Tim asked how well I knew the nurse. I said she is a second cousin and on the surgery staff of a nearby hospital. Tim said we would probably have her and the cousin that is a nutritionist for the February meeting. Tim asked me to call them and find out what they thought. Then give him their phone numbers so he could talk to them. Tim said we need to avoid Valentines day so that left the seventh or the twenty-first. I said either one should be okay and would say the first one so we have a second or third available if we have bad weather. Tim said good and we wished each other happy holidays and left.