Subject(s)
Diabetes Mellitus, Type 2/drug therapy , Diabetes Mellitus, Type 2/psychology , Hypoglycemic Agents/administration & dosage , Insulin/administration & dosage , Nurse Practitioners , Self Administration , Aged , Blood Glucose Self-Monitoring/methods , Blood Glucose Self-Monitoring/psychology , Diabetes Mellitus, Type 2/metabolism , Humans , Infusion Pumps, Implantable/psychology , Infusion Pumps, Implantable/supply & distribution , Injections, Subcutaneous/instrumentation , Insulin Infusion Systems/psychology , Insulin Infusion Systems/supply & distribution , Male , Medication Adherence/psychology , Nurse Practitioners/organization & administration , Nurse's Role , Patient Education as Topic , Primary Health Care/methods , Self Administration/instrumentation , Self Administration/methods , Self Administration/psychology , Self Efficacy , Social SupportABSTRACT
Diabetes education has been an integral part of diabetes care since insulin was discovered in the 1920's. Education over time has kept pace with our clinical knowledge of diabetes care as well as medical technology. In the 1970s both diabetes care and education entered a new era with the development of self-monitoring of blood glucose. In keeping pace with assuring quality education in the 1980s, educational programmes and standards began to emerge. In 1993 the Diabetes Control and Complications Trial (DCCT) announced its findings which confirmed the value of a multi-disciplinary team approach. The investigators of the DCCT reported that as the study progressed it was necessary for the dietitians and nurses to increase their involvement in the managment and education of the research volunteers in order to achieve the goals of the study. In the 29 centers the educators provided most of the on-going education and diabetes management for the volunteers. Programmes included all aspects of diabetes education and intensive diabetes managment to achieve the target HgbA1c. The challenge before us is to take the findings of the DCCT and to put them to practice. We know with certainity that improving blood glucose control will descrease the rate of complications related to diabetes mellitus. The team approached with the patient as a team member, trained in self-care managment skills, is a vital ingredient in improving blood glucose control. Education, phone triage, follow-up care, are all central components for improving blood glucose control. The educator is a key member of the health care team who can provide the care, education, and support vital to the patients' success in accomplishing their goals. (au)
