Diabetes patient care is all about passion
With the rise in life expectancy and the nation’s fixation with all things sweet, it is no wonder type 2 diabetes is now one of the country’s biggest health worries. The National Health and Morbidity Survey (NHMS) 2015 places the prevalence of type 2 diabetes at 17.5%. With such a high burden of disease, patient care and education can take its toll on the healthcare system. It falls upon the shoulders of healthcare personnel to ensure complications are minimized and targets are met. Here, the role diabetes educators play in the care of people with diabetes can help stem the tide of type 2 diabetes and its impending outcome on the healthcare system.
MIMS Doctor spoke to Tan Ming Yeong, Doctor of Nursing and Credentialed Diabetes Educator (CDE), a diabetes nurse specialist and one of the pioneer diabetes educators in Malaysia to delve deeper into the topic of care and education for people with diabetes. Diabetes education is also known as diabetes self-management education (DSME)—it is defined as a collaborative process where people with diabetes or at risk of diabetes are taught the knowledge and skills needed to modify behaviour and successfully self-manage the health issue and its related conditions.
Diabetes education is important because a person living with diabetes has many things to do (eg, take medication, inject insulin, and make proper food choices) over the course of a day. “As diabetes educators, we help [empower] the individuals with diabetes to live their lives normally,” said Tan.
The roles of diabetes educators
In Malaysia, the role of diabetes educators is highly dependent on the hospital or healthcare institution’s policy. In general, an educator gets referrals from an inhouse doctor to start providing support to a person with diabetes.
During the initial education session, the person’s existing conditions and health status are determined. From there on, the educator can help the individuals with diabetes to set achievable goals and monitor their condition. With that in mind, the relationship among healthcare professionals, the person with diabetes and the family members must be maintained. Constant communication between the educator and doctor will help to keep the doctor up-to-date on the status of the persons with diabetes, hence, it improves monitoring their conditions. Tan said that patient education and empowerment are not simple tasks and involve other healthcare professionals, including the likes of dietitians. In other words, diabetes education is a multi-specialty task.
Diabetes education can be challenging and is somewhat of an art. “You can tell them many things but they may not follow the advice given” said Tan. “Instead, ask them their problems and get them to tell you what [aspect of their problems] they would like to change.” From there, the educator can begin to teach and empower people with diabetes with the skills required to overcome their problems.
One of the tools used to overcome challenging behaviour is motivational interviewing, where instead of being told what to do, the individual is questioned in a goal-oriented manner, with the focus of the interview being the individuals with diabetes.
Additionally, diabetes management requires input and cooperation from all parties—friends, family and colleagues—of the person with diabetes. Each has a role to play in order to help the person with diabetes achieve his or her goals. Tan said it doesn’t help the situation when family members keep offering food to the invidual. Therefore, diabetes education and support should include the family members and carers too.
Backgrounder on MDES
The Malaysian Diabetes Education Society (MDES) was initiated by Emeritus Prof. Dato’ Dr. Mustaffa Embong with the support of Lifescan Johnson & Johnson Medical Malaysia and was registered in May 2007 as a society. A short while later, in 2009, the society started actively organizing its activities and by 2012, MDES organized their first seminar and conference.
The vision of MDES is to improve the life of people affected by, and at risk of diabetes through optimal health and wellness. Its mission is to lead and advocate best practice of diabetes education by promoting healthy living and diabetes self-management
The society currently has more than 300 members and run regular conferences with participation of around 400 for each event.