Receiving a diabetes diagnosis is life-changing. Understanding the steadfast discipline required to keep the disease under control, not to mention the exhaustive list of serious complications that can result from mismanaging the disease, can be overwhelming.
The prevalence of diagnosed diabetes in the U.S. increased by 382 percent from 1988 to 2014, indicating that more and more of us are going to have to learn how to live with and properly self-manage what is a very complex chronic disease.
The good news? Patients don’t have to face the journey alone. And here begins the role of one of the most important people in a patient with diabetes life—the Certified Diabetes Educator (CDE).
An Advocate for Patient Health
Patients with diabetes have a tremendous responsibility in managing their disease beyond simply taking medication. A CDE advocates every day on behalf of their patients to ensure they have the tools and knowledge they need to meet that responsibility and self-manage successfully.
The role CDEs play in the lives of their patients, in educating them about their illness and helping them to develop goals and plans to maintain health for the long-term, is invaluable.
Research shows that diabetes self-management education has a positive effect in reducing A1C, minimizing complications, improving diet and has shown to reduce the costs associated with hospital admissions.
CDE, Lorena Drago, MS RD CDN CE, Hispanic Foodways, LLC, believes there is enormous value in educating patients about their disease.
“Sometimes patients just need to know what questions to ask,” explains Lorena who runs a support group for patients with diabetes at the hospital where she works.
“I work closely with my patients and their caregivers—whether that’s a friend, grandparent, neighbor, or significant other—to make sure they are armed with as much knowledge as possible about their diabetes. I’m always encouraging patients to continue to learn about their illness. The more knowledge they have, the more empowered they will be.”
Diabetes is a complicated disease which is what can make the initial diagnosis so overbearing for patients. Diabetes Health and Lifestyle Coach and CDE, Ann Kennefick, approaches her patients’ diabetes care plans in small, doable pieces.
“We build on patient successes so that diabetes is not so overwhelming. When you really think about it, diabetes is complex, involving every internal system in the body—cardiovascular, endocrine, neurological…it’s a lot to consider. Also, a patient has to think about their diabetes several times throughout the day, every time they eat. That’s difficult. They never get a break. We work together to make it manageable.”
Unfortunately, quick-fix solutions to diabetes do not exist. But for patients working under the guidance of a CDE, confidence in managing diabetes begins to build once they develop a deeper understanding of their disease.
“After working with patients over a period of time, they begin to feel comfortable making their own decisions about their health, and they become more and more independent,” explains Ann. “Ideally, the interactions become less frequent.”
However, Ann likes to extend her relationships with patients. She sometimes hears from them even five years down the road.
“Like with anything, occasionally life takes over, people get busy and something can cause a patient to slip up. That’s when I want to hear from patients. Let’s work together, do some troubleshooting and figure out how to get back on track.”
What ultimately makes the relationship between CDE and patient so unique and effective is that it’s centered around ongoing communication and engagement. Patients can reach out at any time with questions and concerns about their health—not just at a scheduled appointment. This level of patient engagement can be a rarity in healthcare.
Helping Patients to Stay the Course
Managing diabetes requires dedication and perseverance. An individual with diabetes is expected to make numerous decisions on a daily basis in regards to their food intake, be staunch in monitoring blood glucose levels, while staying physically active and closely adhering to medication doses. Many questions can come up in the course of a week, even a day. The three months between a visit with their physician can seem like an eternity and prove problematic for patients expected to remember so many minute details of care.
CDEs are critical in closing the gap between physician office visits, giving patients a lifeline when they need it most—even if it’s just to hear words of encouragement or to ask if they can eat a piece of cake at a friend’s birthday party.
Lorena, who has a nutritionist background, finds that many of her patients are afraid to enjoy meals. “I love food! I want my patients to enjoy food. But I’ve found that many are scared to because of the many dietary restrictions associated with diabetes.” But, Lorena explains, “There are many ways that patients can enjoy good food and also manage their diabetes. It’s rewarding for me to be able to teach them how and reassure them that having diabetes doesn’t mean they have to miss out on life’s simple pleasures.”
CDEs are instrumental in helping patients with diabetes gain the knowledge and confidence they need to learn disease self-management skills, leading to better, long-term outcomes for those living with diabetes.
Every Patient Tells A Unique Story
Patients are affected by their diabetes in different ways. A care plan that works for one person may not work for another. Factoring in individual lifestyles and setting realistic goals that patients are able to meet can be hugely impactful.
“Each client’s story is unique as is my role as a coach,” Ann explains. “I walk beside them and assist them in their goals to make living with diabetes easier. I learn what is important to them…what makes them tick and want to live and enjoy life. Is it their grandchildren? Their work? We play to that passion, working together to create goals that will help them meet the criteria that is important to them, while managing their diabetes more effectively.”
Ann works closely with patients to review their nutrition and physical activity, as well as identify any barriers and challenges that would make it difficult for a patient to manage their diabetes effectively. Ann notes, “there may be psychosocial, economic, or physical barriers impacting an individual patient’s outcome.”
Patients with diabetes have the ability to communicate with their CDE as much as needed to meet their goals—whether that is monthly, weekly or daily. Very few chronic illnesses afford patients this level of interaction. Technological advancements in diabetes care have certainly helped leverage communication with patients. Many patients can easily reach their CDE through text, email, phone call, through an app, or by video.
Speaking with CDEs about their work, it’s clear they hold a vast knowledge about diabetes. Even more remarkable is the passion and energy they emanate for what they do. That level of enthusiasm is contagious.
One can only imagine the reassurance and motivation a diabetes patient feels knowing they have this vigilant and skilled advocate in their corner for the fight ahead.