Diabetes is a disease that can be controlled-or greatly exacerbated-by a patient’s overall lifestyle. It’s a disease that calls strongly for healthcare professionals to look at the “whole person,” not just the aspect of the patient’s health they are treating.
How important is it to see that your patients
-no matter what your role is in their treatment-get the information and the follow-up they need? It can literally be a matter of life and death. Diabetes can lead to heart disease and stroke, kidney disease, diabetic neuropathy, skin and foot complications, vascular problems, eye complications, and even blindness. Diabetes is a leading cause of lower-limb amputations. Once you’ve lost one limb, the risk to the other is extremely high, points out Amparo Gonzalez, RN, BSN, CDE, president-elect of the American Association of Diabetes Educators (AADE) and director of the Georgia Latino Diabetes Program affiliated with the Emory University School of Medicine, Atlanta.
Can You Play a Role?
Any professional treating patients with diabetes should be prepared to provide basic education in diabetes self-management regarding diet, exercise, foot care, controlling glucose levels, and other concerns, according to Gonzalez. “Many people with diabetes aren’t connected with a diabetes educator; they are getting their diabetes education in other ways. So it really helps the patient when others on the healthcare team are able to provide basic knowledge… When the patient has a question, such as, ‘Can I eat pineapple?’ etc., he needs to have these questions answered.”
Patients with diabetes may be in denial-not accepting the reality of their disease; others may be dealing with depression, points out Rebecca Sanchez, RN, MPH, director of education at the Texas Diabetes Institute (TDI), San Antonio. “We need to convince them to check themselves. We teach them why it’s important to better manage sugar levels in order to establish a baseline and work toward a level balance in sugar control rather than peaks and lows. We teach them how to use the glucose meter, how to eat more healthfully, and about portion control.”
Healthcare professionals can help by opening the diabetes discussion: “How is your diet going? How are you doing with your sugar?” They can be prepared to help educate and motivate their patients, Gonzalez points out.
Providing Patient Information
As an orthotist, pedorthist, or prosthetist, how can you assume, at least in part, the role of a diabetes educator? Many diabetes care centers, hospitals, and diabetes organizations offer courses and seminars for healthcare professionals to increase your knowledge. Various organizations provide brochures and pamphlets in English and Spanish either free or at a moderate charge that you can give to your patients. Having information available in Spanish can be very helpful, since statistics show that 25 percent of Latinos between the ages of 45 and 74 living in the United States have diabetes-a much higher rate than the general population. Much helpful information is also available online for patients in both languages, as well as information specifically for healthcare professionals.
Another tool for pedorthists and O&P practitioners is monofilament testing, an easy, inexpensive, and effective way to screen for foot neuropathy. Foot neuropathy puts patients at risk for ulcers that can lead to amputation. The foundation of this prevention program is a 5.07 monofilament calibrated to apply ten grams of force when pressed against the foot. You can obtain the monofilaments with use instructions from the Lower Extremity Amputee Prevention (LEAP) program, administered through the U.S. Department of Health & Human Services Health Resources Services Administration (HRSA). You also can teach your patients how to perform this test at home. For more information, visit
How Diabetes Educators Can Help
Should you bring a diabetes educator into the picture? How can a diabetes educator help your patients with diabetes?
Seven Tenets of Diabetes Education
According to the AADE website, diabetes education focuses on seven essential self-care behaviors, called The AADE7™ Self-Care Behaviors: