Building Competency in Diabetes Education THE ESSENTIALS

INTRODUCTION| 1-3

DIABETES MANAGEMENT: THE ESSENTIALS

Diabetes is now considered a world health challenge. In 2017, the International Diabetes Federation estimated that 425 million people were living with diabetes worldwide and projected that, by 2045, there will be 629 million people living with diabetes (1). Canada is contributing to this challenge with an estimated 44% increase expected in the prevalence of diabetes from 2015 to 2025. This translates into an estimated 3.4 million Canadians or 9.3% living with diabetes in 2015 to over 5 million or 12.1% living with diabetes in 2025 (2). The estimated prevalence rate for prediabetes is also expected to increase with 6.4 million Canadians or 23.2% of the population living with prediabetes by 2025 (2). The impact of these statistics on the Canadian population and health-care system cannot be ignored. People with diabetes are three times more likely to be hospitalized with cardiovascular disease, 12 times more likely to be hospitalized with end stage renal disease and over 20 times more likely to be hospitalized with non-traumatic lower limb amputation (2). However, as daunting as these statistics are, research continues to inform us that we can make a difference. The Diabetes Control and Complications Trial, the United Kingdom Prospective Diabetes Study and the Diabetes Prevention Program are three landmark studies that demonstrate how lifestyle changes and blood glucose in target range can prevent or delay the progression of diabetes and its complications (3-5). Recently, we are particularly encouraged with the results of several cardiovascular outcome trials showing a clear benefit of some newer oral diabetes medications in preventing cardiovascular death and all-cause mortality in patients with type 2 diabetes (6-8). With these promising research results, one wonders why the prevalence of diabetes continues to increase. The answer lies in the chronic nature of diabetes and the essential elements for treatment. When we realize that the patient with diabetes spends less than 5% of their time with a health-care professional, we begin to understand that a key element necessary for successful diabetes treatment lies in the informed practice of self-management (9). Working with a collaborative, interdisciplinary, patient-centred approach, diabetes educators have the responsibility to teach their patients the knowledge and skills necessary to engage in self management (10,11). We also have the responsibility to support the patient as they engage in their care. The ultimate goal is to effectively facilitate each patient’s informed decision making process resulting in the best possible management of their diabetes. The educator is required to translate research findings, use effective communication strategies and use appropriate educational tools to educate and support the patient in their individualized care.