Diabetes Educators: Are They Underutilized?

Diabetes educators: are they underutilized?

applet_6All three stages of the diabetes therapy involves behavioral change, goal setting, planning, implementation, evaluation and documentation as the integral part of the therapy. Three stages of diabetes therapy in a layman’s term can be divided into: Stage I, Prediabetes stage, Stage II, Diabetes maintenance and progression control stage, Stage III, Aggressive treatment stage. In each stage diabetes educators are integral in providing individualized education in promoting behavior change using the framework of seven self-care behavior known as the AADE7 self care behaviors developed by the American Association of diabetes educators. Diabetes treatment involving diabetes educators not only will make the therapy “whole”, but in the long run it slows the progression of diabetes and saves medical costs as a result. Family members of the patient and the patient if cognitive must be educated about the benefits of having a diabetes educator by their side. The starting point is when the primary care physician and patient agree on the necessity of involving a diabetes educator. This aspect is often not emphasized enough. The question: are diabetes educators underutilized in the United States. The answer is astonishingly “yes” considering the fact that only 50% of diabetes patients receive regular service from a diabetes educator.

One aspect of a diabetes educator’s positive contribution working with physicians and pharmacist is curtailing instances of polypharmacy. Polypharmacy causes death in elderly patients. Often times diabetes patients are going polypharmacy as result of multiple use of physicians and pharmacies. Patients often are not able to digest all the information given to them on drug usage, compliance and needed life style change and side-effects. The key here is education, education, and education rendered by a diabetes educator. And the whole process starts with the primary doctor’s insistence to ask patients to commit to be followed on a consistent basis by a diabetes educator. As far as health insurance companies are concerned the involvement of a diabetes educators in the treatment of diabetes would reduce institutional payments in the long run. Thus, a seamless and reasonable reimbursement program to diabetes educators is paramount. “Diabetes is an ongoing disease involving, life changes, treatment changes and management changes. Patients should be able to receive ongoing education as it is needed,” said Virginia Zamudio Lange, RN, MSN, CDE, American Association of Diabetes Educator’s former president.

What is the main reason why diabetes educators services are not applied broadly. Part of blame is the patient, who is not interested in a diabetes educators help, cited earlier in a cover story. Patients are not educated about the importance of a diabetes educators help, could be another reason and this must be communicated strongly by the primary physician at the time of first service. Believe it or not, patients still trust and rely on their physicians more than anyone else. The hospitals and diabetes clinics must not cut the number of diabetes educators on staff but instead need to find ways to increase the numbers of educators and then negotiate with health insurance companies for a reasonable reimbursement for the services rendered by a diabetes educator. This needs to be a group effort involving physicians, hospitals, insurance carriers and diabetes organizations so the program is sustained and grows stronger. The bottom line is if more diabetes educators are involved on a regular basis it will result in an optimum therapeutic outcome and reduced costs.

Written by Charles Liu, Clinical Pharmacist, MBA
Beaumont Health System

Charles H. Liu, R. Ph, MBA

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