Building Competency in Diabetes Education THE ESSENTIALS

TREATMENT MODALITIES: PHARMACOLOGICAL THERAPIES I 6-19

PHARMACOLOGICAL MANAGEMENT WITH ANTIHYPERGLYCEMIC AGENTS

Advanced self-management for people with type 2 diabetes

Type 2 diabetes is a chronic and progressive disease requiring engaged and timely management in order to prevent or minimize the risk of complications. The natural history for most people with type 2 diabetes is that BG and A1C levels rise over time, reinforcing the importance of ongoing support of the person in order to assist the person in achieving their health-care goals and optimizing their health outcomes. The role of the healthcare team is to assist and support people with diabetes and their caregiver teams in making informed treatment choices.

Education and training

Diabetes requires individuals to acquire new knowledge and skills, and make sustainable lifestyle changes. On-going education and training of the individual with diabetes is fundamental to achieving success in diabetes care. Education using principles such as empowerment theory, motivational interviewing, coping-skills training and the Transtheoretical Model of Change (TTM) have been shown to be beneficial in promoting behaviour change and assisting people in managing their diabetes. Chapter 2: Foundations of Diabetes Self-Management Education and Support and Chapter 11: Self-Management Education and Support, provide an in-depth discussion of educational principles and strategies. Education should begin with a comprehensive assessment to gain an understanding of the impact of diabetes on the individual’s life and that of their family and/or social support team, and to uncover any potential concerns or fears about the condition, necessary lifestyle interventions, or recommended pharmacological therapy. The financial burden of diabetes can be a huge obstacle to treatment options and adherence. Therefore, it is important to assess the individual’s insurance coverage (private/public) or ability to self-pay. Insurance plans can place limitations on the type or amount of diabetes supplies and medications covered. The Diabetes Canada website provides information on provincial and territorial drug plans. Alternatively, educators can inform people with diabetes about other insurance plans or programs available (i.e. Monitoring for Health Program, pharmaceutical compassionate programs (if available), or price reduction programs, such as InnoviCares (https://www.innovicares.ca/en) or assist them in determining their best treatment option given their financial situation. Individuals can claim a portion