Legal aspects of the team approach to diabetes treatment

Diabetes Education: A Multidisciplinary Team Approach

Diabetes mellitus is one of the leading causes of mortality and morbidity in the United States, showing an incidence of over 14 million individuals, with the numbers increasing yearly. Current evidence suggests that maintaining normal blood glucose levels will result in preventing or lessening the degree of acute and chronic complications of diabetes. Therefore, because many of the complications of diabetes may be prevented or lessened by strict glycemic control, it is of the utmost importance that the individual with diabetes understand the roles of diet, exercise, and insulin/oral hypoglycemics in the management of his or her diabetes. This is an area in which diabetic education plays an important role. The properly educated individual with diabetes can learn to increase or decrease insulin, to change diet, or to modify exercise regimens based on results of home blood glucose-monitoring to achieve normoglycemia. This article discusses a multidisciplinary team approach to educating the diabetic patient. This involves using the skills of physicians, pharmacists, nurses, dieticians, and other health care professionals, as well as teaching tools such as diabetes patient assessment forms, diabetes education, and teaching documentation records. It should become clear from this discussion the active role that pharmacists can play as an important member of the diabetic education team.

The scope of practice of diabetes educators in a metropolitan area

A survey of 108 members of a local metropolitan AADE chapter was conducted to assess (1) current roles and responsibilities of diabetes educators with respect to medical management and patient education, and (2) the use of behavioral strategy techniques among diabetes educators. Nurses and dietitians specializing in diabetes care performed a range of responsibilities. Approximately 75% of the nurses performed standard patient education roles and 20% performed the majority of roles traditionally considered to be in the medical domain, including insulin adjustment. More than half of the respondents had not received formal training in the use of behavioral strategies. Formal training was positively associated with greater use of behavioral techniques. Training for diabetes educators should include behavioral intervention strategies. Nurses specializing in diabetes care may also need training regarding physical assessment for chronic complications, and knowledge regarding adjustment of insulin and oral hypoglycemic medications.