Both type 1 and type 2 diabetes are complex conditions requiring a specialised approach and programme of care.
‘Good diabetes care’ is comprised of several key pillars. The principles mentioned here are important components of any good diabetes management programme and assist in reducing sickness, death, hospitalisation and costs due to diabetes.
Each person is unique in their combination of physiological, lifestyle, cultural, emotional and cognitive needs and responses to experiencing diabetes. Never before has the requirement for personalised diabetes care been more accepted and possible.
CDE patients understand that not only their doctor or other healthcare professional is responsible to look after their diabetes. People with diabetes themselves have to make choices and decisions about managing, caring for and coping with their condition daily. These decisions can significantly affect their health and well-being, positively or negatively.
It is thus vital that people with diabetes are equipped to make good choices and decisions. This means that they must also acquire the skills and confidence to perform self-care.
‘Diabetes education’ is often ignored by funders of healthcare. In contrast, we consider diabetes education to be one of the most important aspects of successful diabetes care. Significant focus is placed on providing our patients not only with correct information but also with insight and problem-solving ability. Each of our patients is encouraged to consult with our diabetes educators regularly.
Facilitation of self-care by a passionate Management Team of health care professionals with specialised training and knowledge is essential in the control of diabetes. The members of the Diabetes Team provide diagnosis, counselling, coaching, education, treatment and lifestyle options, support and motivation.
In addition to a doctor, input from a diabetes educator, dietician, podiatrist, ophthalmologist, pharmacist, biokineticist and psychologist (amongst others), is necessary at different times to maximise care and quality of life.
Importantly, the doctor is not the head of this team – it is the person with diabetes and their family.
Community Diabetes Associations are a vital part of the team to provide support where most diabetes care occurs – in the community.
It is essential to ensure that diabetes is ‘Treated to Target’ – a best-practice approach adopted by the CDE.
The treat to target approach ensures that both people with diabetes, as well as their treating healthcare providers, know and understand the individualised health targets to aim for.
Ideally, every person with diabetes would know what their targets are for:
- HbA1c
- Blood glucose readings
- Cholesterol and other lipids
- Blood pressure
- Weight
- Waist circumference
These important parameters need to be measured regularly, and treatment therapies need to be adjusted and fine-tuned by healthcare professionals to help achieve targets.
In addition, kidney function, growth (in children) and eyes and feet need to be checked.
Attention to three cornerstones of diabetes care
- Getting active and exercise
- Healthy, mindful and sustainable eating and
- The appropriate medication at the right dose and at the right times.