Canadian Diabetes Association Clinical Practice Guidelines Expert Committee
Helen Jones RN, MSN, CDE Lori D. Berard RN, CDE Gail MacNeill BNSc, RN, MEd, CDE Dana Whitham RD, MS, CDE Catherine Yu MD, FRCPC, MHSc
- Offer collaborative and interactive self-management education (SME) interventions as they are more effective than didactic SME.
- Incorporate problem-solving skills for ongoing self-management of medical, social and emotional aspects of care into the traditional knowledge and technical skills content of educational interventions.
- Design patient-centred learning to empower individuals to make informed decisions toward achievement of patient-chosen goals.
- Individualize SME interventions according to type of diabetes and recommended therapy, the patient's ability and motivation for learning and change, and his or her culture and literacy level.
- Provide ongoing SME and comprehensive healthcare collaboratively to make SME most effective.
- People with diabetes should be offered timely diabetes education that is tailored to enhance self-care practices and behaviours [Grade A, Level 1A (1-3)].
- All people with diabetes who are able should be taught how to self-manage their diabetes [Grade A, Level 1A (3)].
- SME that incorporates cognitive-behavioural educational interventions, such as problem solving, goal setting, and self-monitoring of health parameters, should be implemented for all individuals with diabetes [Grade B, Level 2 (2,4-6)].
Interventions that increase patient participation and collaboration in healthcare decision making should be used by providers [Grade B, Level 2 (3)].
- For people with type 2 diabetes, SME interventions should be offered in small group and/or one-on-one settings, since both may be effective [Grade A, Level 1A (7,8)].
- In both type 1 and 2 diabetes, interventions that target families' ability to cope with stress or diabetes-related conflict should be included in educational interventions when indicated [Grade B, Level 2 (9)].
- Technologically based home blood glucose monitoring systems may be integrated into SME interventions in order to improve glycemic control [Grade C, Level 3 (10,11)].
- Culturally appropriate SME, which may include peer or lay educators, may be used to increase diabetes-related knowledge and self-care behaviours and to decrease A1C [Grade B, Level 2 (12,13,14)].
- Adding literacy- and numeracy-sensitive materials to a comprehensive diabetes management and education program may be used to improve knowledge, self-efficacy and A1C outcomes for patients with low literacy [Grade C, Level 3 (15)].
Highlights of Revisions
Less focus on didactic teaching and greater focus on patient-centred learning.
Recognition of the need for culturally appropriate, literacy- and numeracysensitive materials and education.
Acknowledgement of the role of technologically based home monitoring systems.
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Reproduced with permission from Canadian Journal of Diabetes
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