Monitoring in diabetes self-management: issues and recommendations for improvement.

The American Association of Diabetes Educators hosted a Monitoring Symposium during which 18 invited participants considered pre-set questions regarding how diabetes education can more effectively address barriers to monitoring for people with diabetes and related conditions. This report provides a summary of the moderated discussion and highlights the key points that apply to diabetes educators and other providers involved with diabetes care. The participating thought leaders reviewed findings from published literature and participated in a moderated discussion with the aim of providing practical advice for health care practitioners regarding monitoring for people with diabetes so that the overall health of this population can be enhanced. The discussants also defined monitoring for diabetes as including that done by the clinician or laboratory, as well as self-monitoring. The discussion was distilled into key points that apply to diabetes educators and other providers involved with diabetes care. Participants developed specific recommendations for a self-monitoring behavior and monitoring framework. People with diabetes benefit from instruction and guidance about self-monitoring and decision making that is based on monitored results and informed interactions with providers. Importantly, collaboration among the entire diabetes care community is needed to ensure that monitoring is performed and utilized to its fullest advantage. Going forward, it will be critical to mitigate barriers to diabetes self-management and training and to identify linkages and partnerships to address barriers to self-monitoring.

Toward describing practice: the AADE National Diabetes Education Practice Survey: diabetes education in the United States--who, what, where, and how.

This article describes the first comprehensive survey of diabetes self-management education programs and practice in the United States. The American Association of Diabetes Educators (AADE), through environmental scanning of members and the external health care environment, identified significant changes in the practice of diabetes education in 2004. In an effort to more completely understand the current state of practice, the association administered the National Diabetes Education Practice Survey (NPS) to the membership in 2005 and 2006. The survey was structured to elicit information about the structure, process, and outcomes of diabetes education practice from both program managers and diabetes educators. Through this baseline description of diabetes education practice and program design, opportunities were identified for broadening the patient referral base, enhancing cost-effectiveness and educator productivity activities, improving program access to all populations, developing innovative delivery methods, improving patient outcomes, and striving for sustainable funding sources. The association will continue to administer the survey annually and report on changes and trends in diabetes education programs and practice.

Diabetes educators: partners in diabetes care and management.

OBJECTIVE: To promote the role of the diabetes educator as an important team member in conjunction with the patient and other clinicians in optimizing diabetes management. METHODS: The goal of the diabetes educator in facilitating changes in patient behavior is reviewed, and current trends and strategies for improvement of outcomes by means of diabetes education are outlined. RESULTS: The American Association of Diabetes Educators (AADE) is a multidisciplinary group of healthcare professionals dedicated to the professional growth and development of personnel who are responsible for diabetes education. Diabetes management is best addressed by using a team approach in a patient-centered care environment. Diabetes education encompasses more than the dissemination of information; the goal is to facilitate changes in specific behaviors relating to both therapy and lifestyle that support good diabetes management and improved clinical outcomes. Diabetes educators currently frame their intervention on the basis of the AADE 7 Self-Care Behaviors: (1) healthful eating, (2) being active, (3) monitoring, (4) taking medication, (5) problem-solving, (6) healthful coping, and (7) reducing risks. Diabetes education is underutilized; approximately 60% to 70% of patients with diabetes have not received training in diabetes self-management. Diabetes educators are trained to identify and help overcome barriers to optimal diabetes care. CONCLUSION: Individual patients and the overall health-care system will benefit when physicians and other health-care providers collaborate with diabetes educators to ensure that patients receive the information, training, and support needed to facilitate effective diabetes self-management.