Diabetes Education: A Right for All
January 2004

Diabetes is increasing at an alarming rate globally. It is a complex, chronic condition that affects all areas of a person’s life and that requires high quality care. To this end, diabetes education is of critical importance and should be considered an integral part of diabetes prevention and care. Unfortunately this is not the case in many countries of the world where diabetes education is, at best, in its infancy or non–existent. The combination of lack of access to quality medical management and diabetes education leads to poor clinical outcomes, reduced quality of life and high health–related costs due to service utilization and the costs of treatment.

IDF’s position is that

• All people with diabetes, no matter where they live, have the right to learn about their disease.
• Healthcare professionals must be educated to be responsible for prevention and provision of diabetes care.
• People at risk and the wider public must know the risk and learn about prevention.
• Health ministries have to ensure they have a comprehensive diabetes education strategic plan integrated into their National Diabetes Programme.

Education is a key component in the prevention and treatment of diabetes and should be directed to three audiences: the individual and those affected by the disease, healthcare providers and the community at–large. Today, although many people are aware of the value of education, findings of a survey with IDF member associations reported similar barriers in the provision of education: financial, limited access, lack of knowledge and education resources.

As the world incidence of diabetes grows efforts to promote self–management education, training for providers and public awareness are critical in reducing the humanistic and economic burden caused by the disease. For people affected by diabetes, self–management education training is important since people with diabetes and their families provide 95% of their care themselves. Without appropriate education people cannot make the complex daily medical decisions required for good health, quality of life and survival. The goal of diabetes self–management training is to support the efforts of people with diabetes to:

• Understand the nature of their illness and its treatment.
• Identify emerging health problems in early, reversible stages.
• Adhere to self–care practices.
• Make needed changes in their health habits.

Diabetes self–management training assists people in dealing with the emotional and physical demands of their disease, given their unique socio–economic and cultural circumstances.


Healthcare providers must be active participants in facilitating quality diabetes self–management education and care and to motivate their patients to undertake the demanding daily regimen associated with diabetes care. It is also considered best practice for diabetes education and care to be provided by an integrated multi–disciplinary team including, at a minimum, the person with diabetes, a nurse, a dietitian and physician who are skilled in diabetes management, and possibly a pharmacist and a behavioural scientist. All of them need to be educated on the provision of quality care and prevention methods. IDF recognises that in many countries healthcare providers are facing numerous barriers, such as:

• Too many patients for the number of healthcare professionals who have specific training.
• A lack of access to and availability of education programmes for health professionals and their patients.
• A wide variation in standards for diabetes education within and between countries.

It is the goal of the IDF, through the work of its Consultative Section on Diabetes Education to address these and other issues by developing and implementing strategies that facilitate equitable access to high quality diabetes education services.

More broadly, the public must be made aware of the serious health consequences of diabetes. Educating the public in the provision and support of prevention strategies and quality care are key in the spirit of improving community health.

IDF recommends that for the prevention and treatment of diabetes to be successful through education initiatives, governments, and local, national and international health associations must organize efforts to promote the training, exploration of technological methods to enhance education, financial support, access and public awareness of diabetes education. IDF recommends that governments in particular address the burden of diabetes needs on three levels:

• Central governmental level where the burden of the disease needs to be recognised and the importance of diabetes education acknowledged, promulgated, funded and delivered according to the IDF Standards for Diabetes Education.
• Health professional training directed at medical and non–medical health professionals. Diabetes education should be included in medical schools and postgraduate curricula. It should also be directed at non–medical health professionals and be implemented based on the IDF International Curriculum for Health Professional Education.
• Local policies and procedures developed to support the delivery of evidence–based diabetes education.

References:
1. International Curriculum for Diabetes Health Professional Education, IDF, 2002.
2. Diabetes Control and Complications Research Group. The effect of intensive treatment of diabetes on the development and progression of long–term complications in insulin–dependent diabetes mellitus. N Engl J Med 1993; 329:977–998.
3. Expanded role of the dietitian in the Diabetes Control and Complications Trial: Implications for Clinical Practice. Journal of the American Dietetic Association, 1993.
4. The Diabetes Control and Complications Trial: The Trial Coordinator Perspective. Diabetes Educator, 1993.
5. Diabetes Atlas 2nd edition; International Diabetes Federation, 2003.
6. Gagliardino JJ, Etchegoyen G, and the PEDNID–LA Research Group. A model educational program for people with type 2 diabetes: A cooperative Latin American implementation study (PEDNID–LA). Diabetes Care 2001; 24:1001–1007.
7. Piette JD, Glasgow R. Strategies for improving behavioral and health outcomes among patients with diabetes: self–management education. In: Gerstein HC, Haynes RB, eds. Evidence–Based Diabetes Care. Ontario, Canada: BC Decker Publishers 2001, 207–251.
8. Brown SA. Interventions to promote diabetes self–management: state of the science. Diabetes Educator. 1999; 25 (6 Suppl):52–61.
9. Norris SL, Engelgau MM, Narayan KMV. Effectiveness of self–management training in type 2 diabetes. A systematic review of randomized controlled trials. Diabetes Care 2001; 24:561–587.

Source: www.idf.org