Building Competency in Diabetes Education THE ESSENTIALS

3-4 | CHAPTER 3

INTRODUCTION

Diabetes mellitus is defined as “a heterogeneous metabolic disorder characterized by the presence of hyperglycemia due to defective insulin secretion, insulin action or both” (1). It is a group of metabolic disorders characterized by abnormalities in the metabolism of carbohydrate, fat and protein. Different types of diabetes have different underlying causal mechanisms, presentations and treatment; educators need to be aware of the current terminology, diagnostic criteria and treatment recommendations associated with each type and be able to interpret these for people with diabetes. Research findings from the Diabetes Control and Complications Trial (DCCT) (2) and the United Kingdom Prospective Diabetes Study (UKPDS) (3) significantly altered approaches to treatment. Optimizing therapy is now the standard of practice for all persons affected by diabetes, regardless of type. This chapter describes the essentials of glucose homeostasis and its overall regulation; the pathophysiology of type 1 and type 2 diabetes, gestational diabetes mellitus (GDM) and monogenic diabetes, including genetic considerations; and current screening and diagnostic criteria. The goal of this chapter is not to provide an encyclopedia style review of hormones, but rather to prepare diabetes educators with a solid understanding of complex pathophysiologic phenomena in different types of diabetes. Understanding these profound mechanisms will enable professionals to simplify concepts and have meaningful discussion with individuals with diabetes regarding lifestyle changes, new therapies and approaches.