Keywords
diabetes education - certification - National Diabetes Education Program
Introduction
Diabetes mellitus (DM), an overgrowing disease, is affecting 72.9 million of people
worldwide. The number of patients keeps on increasing and so does the pressure on
the health care professionals. An emerging field came into being called certified diabetes educator (CDE).[1]
Physician-to-patient ratio in India is 1:1,800. The government has recommended at
least 1:1,000 ratio. Owing to the inadequate workforce, it becomes difficult to manage
patients or even give them a preventive or behavior changing session. It is where
CDE plays a very important role in educating such patients and helping them manage
the condition.
Currently, there are 780 members in the Association of Diabetes Educator (ADE), and
most of them are CDE except for physicians. One of their eligibility criteria is that
a person should be a CDE with adequate experience. The most common barrier stands
the lack of time, collaboration, and motivation.[2]
[3]
History
DM is a chronic lifestyle ailment, and lifestyle modification remains the cornerstone
of DM management. DM management also involves educating patients about the disease
itself, treatment targets, monitoring and follow-ups, hypoglycemia, and footcare and
sensitization to complications. Elliott P. Joslin[4] believed that patient education is important. Dr. Joslin was a true and devoted
teacher as he educated patients and their family members. He also taught it to the
health care professionals.
In 1957, Dr. Joslin realized of creating a model of diabetes treatment and education
center. He opened the Diabetes Treatment Unit (DTU). It had classrooms, kitchen, and
gymnasium. Patients used to stay for 1 week to learn as much as possible on how to
live with diabetes. He had physicians who took classes, but he himself also took lectures
sometimes.[4]
[5]
CDE is a health care professional who is specialized in managing and preventing diabetes
as he/she are trained well into developing comprehensive knowledge and skills. They
form a link between physicians and patients. They modify patients’ behavior and teach
them self-management. They promote behavior changes by
Eligibility
To become a CDE in the Unites States, it is necessary to meet the eligibility requirements
set by the National Certification Board for Diabetes Educators (NCBDE).
NCBDE has set two eligibility requirements:
-
Eligible health care professional, that is, nurse, dietitian, pharmacist, occupational
or physical therapist, etc.
-
Professional practice experience with a minimum of 1,000 hours of diabetes self-management
education experience, with 40% of those hours accrued in the most recent year preceding
application.[6]
In India there is no regulatory body defining standards for CDE.
National Diabetes Educator Program
National Diabetes Educator Program
The National Diabetes Educator Program (NDEP) is a program that was developed with
an objective of creating CDE. CDEs are specialized and certified to educate patients
about aspects of DM management. This program is backed by Dr. Mohan Diabetes Education
Academy (DMDEA), a unit of Dr. Mohan Diabetes Specialties Centre and the Indian Association
of Diabetes Educators (IADE).
Program Structure
-
This course is being conducted in 140 pre-selected cities/centers.
-
Each center enrolls more than 10 candidates.
-
The entire course is for 40 hours (on a Sunday once in a month for 10 consecutive
months).
-
Candidates will be assessed on the basis of MCQs, role-plays, and practical assignments.
-
At the end of the course, each candidate will be awarded a certificate.
Eligibility for Program
-
Science graduate (B.Pharm, BSc/Associate of Science in Nursing or BSN, BA in Nutrition,
or similar)
-
Candidates must be working with a practicing or a diabetologist.
-
Participants will be required to fill in the registration form and submit it at the
center. The candidate selection is subject to fulfillment of the aforementioned criteria.
Program modules: There are 10 modules.
Participants are not to be charged any fees for the same. Founded in: 1997; member
of IDF since: 2011; number of members: 190.[7]
Other programs include VIVO diabetes educator program and 3-month online diabetes
educators course.
Association of Diabetes Educators
Association of Diabetes Educators
ADE is a nonprofit organization comprising a team of trained diabetes nurse educators
who are dedicated to provide teaching and counseling on diabetes management to health
care professionals, people with diabetes, their family members, and any individual
interested in understanding diabetes.
Vision
The vision is to improve life of people with diabetes through education.
Mission
The mission is to promote optimal health and well being for people with diabetes through
effective education and counseling.
Main Focus
-
To provide diabetes education and skills training
-
To act as a consultant for diabetes education and training
-
To provide a platform for diabetes health care professionals to network and seek peer
support
-
To facilitate opportunities for diabetes educators to participate in community outreach
Activities
Accreditation and Certification Board for Certified Diabetes Educators:
ADE through Journal of Diabetes Education as well as NDEP through Indian Diabetes Educators Journal are continuously doing the work of updating diabetes educators.[8]
International Diabetes Federation
International Diabetes Federation
The International Diabetes Federation (IDF) is an umbrella organization of more than
230 national diabetes associations in 170 countries and territories. It represents
interests of the growing number of people with diabetes and those at risk. IDF has
been leading the global diabetes community since 1950. The mission of the Association
of Diabetes Educator Singapore (ADES) is to set the standard of excellence in the
profession of diabetes education.
Objectives of Certification
-
Providing a mechanism to demonstrate professional accomplishment and growth as a validation
to self and working organization
-
Providing formal recognition of specialty practice and knowledge
-
Promoting continuing commitment to best practices, current standards, and knowledge
in diabetes education
Educational Seminars/Workshops
-
The aim is to create platforms for shared learning from various health care professionals
and keep abreast of latest updates on diabetes treatment and management.
-
Managing diabetes requires a concerted effort on the part of the patient. Knowledge
alone is not sufficient to promote behavior change, and if the symptoms are absent,
the motivation level goes down.
-
This can be done by appointing a CDE in a diabetes clinic setup to ensure that the
patient is well motivated till the next follow-up visit.[9]
Technology Replacement
Technology replacement focuses mainly on motivating patients through artificial intelligence
that basically works as a diabetes educator and helps in self-management.
Pros
-
Apps contain Storing data option where you can store your readings and Food log for
better understanding and can help the physician prescribe medications.
-
Artificial intelligence or nutritional coaches to monitor your progress and encourage
you throughout.
-
Individualized goal, meal plans.
Cons
Conclusion
Health care is now focused on patient and public involvement to get better outcomes;
thus, there needs to be proper involvement of both the patient and CDE. It therefore
makes it a patient-centric method. Diabetes educators need to collaborate well with
other health care professionals. Health care providers may fall short of time, and
so with the help of a diabetes educator, patient self-management knowledge and personalized
individual plans can be given, which will benefit the patient in a long run. Thus,
a CDE will help improve patient outcomes.
