Certified Diabetes Educator.
What do we learn when we educated by Certified educator? What Educator do know about Diabetes, and how this Educator able to answer to our questions?
Difference between diabetes type 1 and type 2.
But before Educator start to educate diabetics what are those difference educator must know what types of diabetes in practice.
Type 1;
type 2;
LADA;
Tropical Diabetes;
Diabetes resulted by protein malnutrition;
Idiopatic diabetes;
unknown type of diabetes.
No one Educator know what types of diabetes developed by humanity. Educator do know only type 1, children or those who were diagnosed as children or those who were diagnosed with diabetes before 1980 when a new classification divided diabetics to two not even parts: 95% of type 2 diabetics, Non Insulin Dependent Diabetics (NIDDM), and type 1,and 5% of Insulin Dependent diabetics who treat diabetes with insulin or even without it.
Now any one diabetic type 2, or mother diabetic type 2 child wish to know why and how diagnose of type of diabetes was made? Is there are any Diabetes Educator capable to answer to this very reasonable and very simple question: How type of diabetes diagnosed? Why one is type 1 diabetic with fasting level of sugar around normal and with insulin injections 7 units daily; and another diabetic with fasting sugar 370 mg/dl and level of random sugar over 599 mg/dl, diagnosed as type 2 diabetic insulin independent which treated with diet and work outs?
Do not bother to ask Educator how diagnose type of diabetes was made. The only one standard answer is possible to get: diabetes type 2 diagnosed usually at age of 40+ and people with diabetes type 2 are overweight or obese. To have this answer why do I need to go to education lessons? every one is already do know it. Still, every one of us, diabetic type 2 still wonder to get answer to this question: Why I am diabetic type 2? I was not obese when all symptoms started to surface, and I al ill all my life.
What goals do you have for various health measures such as blood pressure, blood sugar, lipid values and body weight?
To answer to all these questions I wish to say only one, I wish to have all measures as close to normal as it is possible. What is interesting, how many people will say they do have goal to have blood pressure 240/130 ? No one. Do how many people wish to set up goal as blood sugar level such as 599 mg/dl? And how many people wish to have body weight 400 pounds? At least I did not meet one of any of those. So, what does Educator really ask, and what Educator must to say to diabetic with these numbers? Educator must call 911!!!!!!!!!!!! Regardless of amount of pounds diabetic is in critical condition and in severe pain. Better to sent client to hospital before start to teach victim what to do.
How many Educators will do so? No one. Even when diabetic transported to ER in hospital, there is no admission to hospital. Usually diabetic would be sent home after a few hours after admission into ER. It is education to all practitioners, do not admit critically ill people who need urgent care. They may die, and really what Med Pro can do for them? To educate diabetic in coma how to eat and how often do work outs? Does not matter. Victim of that medical care is already out of reach and not every one return home form Emergency Department.
But still on the room of Diabetic's Educator clients are not in such critical condition, and Educator try to educate them to set up goals. OK, client with body 400 pounds said, one wish to be as one was in high school, 120 pounds. Is this realistic goal? Not at all. So, why this question really so important? Well, at least Educator has some topic to discuss. Otherwise what Educator suppose to talk about? The idea to set up goals is simple not reasonable.
It is so difficult to get out of standards and see the obvious absurd in the subject of discussion. There is no such needs as goal to set up. Every one ill person need to be as healthy as it is possible to be, at least to keep own functionality. The question is not the goal but what to do when one is sick or ill. Every one who got flu try own best to get rid of it and be healthy, no headaches, no running nose. We prefer to go to work then call for sick days. What is difference with diabetes? Diabetics are the same as every other ill or sick people. The goal is only one, to get healthy as much as possible, as soon as possible.
Demonstration.
Skills such as blood sugar testing or insulin injection can be learned by demonstration. As Dr. A. Peters educated diabetic one must take off cup from needle before put needle into belly. It is really important to tech diabetic what end of pen to put into stomach. Otherwise insulin will spring into air in stead to go under skin. But what I never encounter, why there is no teaching how to swallow Oral Agents. Really, one can take oral agents by another end, and it will not provide proper effect on blood sugar level.
Diabetes Self Management Education. (DSME) ADA program.
There are a lot to learn in this program. What I tried to find out the answer to twoquestions:
How to see if medicine and any treatement I take work for me or not?
How to count dose of insulin in everyday injections according to my personal needs to keep diabetes under control, and at the same time avoid low blood sugar, which is dangerous and unpleasant?
Try to ask Educator when you are on this program. No answer every will be given. Every educator do know very well what diabetic must eat and how often diabetic must go into fitness club. No one educator will every answer to the question, how to count dose of insulin. They all do know very well how to inject insulin. No one do know how to find dose of insulin injection. Really, what all this Education about?
Orientation.
The person believes that fate, luck or chance determine his or her outcome.
Educator suppose to help to diabetic to recognize importance of self- management in diabetes outcome. I would be positively accept that. But remember, it is MD who made us type 1 or type 2 diabetics, and so, it is MD who determined any outcome we will have in any self management. If one diagnosed as type 2 diabetic with needs in large dose of insulin, and as diabetic type 2 it was determined that diabetic is non insulin dependent and so there is no need in insulin then say me, how to self manage diabetes type 2 control without proper treatment?
In some countries diabetes type 2 diagnosed as 'non sugar type of diabetes' with diagnostic tool of having elevated sugar in blood. Say what is absurd in this definition?
So I stick with luck and chance and fate. I can do my part of job. But it was my luck when I found proper treatment I need, and it was my fate when I met my doctor who took good care for my needs and Rx large dose of insulin. Today I live.
What do we learn when we educated by Certified educator? What Educator do know about Diabetes, and how this Educator able to answer to our questions?
Difference between diabetes type 1 and type 2.
But before Educator start to educate diabetics what are those difference educator must know what types of diabetes in practice.
Type 1;
type 2;
LADA;
Tropical Diabetes;
Diabetes resulted by protein malnutrition;
Idiopatic diabetes;
unknown type of diabetes.
No one Educator know what types of diabetes developed by humanity. Educator do know only type 1, children or those who were diagnosed as children or those who were diagnosed with diabetes before 1980 when a new classification divided diabetics to two not even parts: 95% of type 2 diabetics, Non Insulin Dependent Diabetics (NIDDM), and type 1,and 5% of Insulin Dependent diabetics who treat diabetes with insulin or even without it.
Now any one diabetic type 2, or mother diabetic type 2 child wish to know why and how diagnose of type of diabetes was made? Is there are any Diabetes Educator capable to answer to this very reasonable and very simple question: How type of diabetes diagnosed? Why one is type 1 diabetic with fasting level of sugar around normal and with insulin injections 7 units daily; and another diabetic with fasting sugar 370 mg/dl and level of random sugar over 599 mg/dl, diagnosed as type 2 diabetic insulin independent which treated with diet and work outs?
Do not bother to ask Educator how diagnose type of diabetes was made. The only one standard answer is possible to get: diabetes type 2 diagnosed usually at age of 40+ and people with diabetes type 2 are overweight or obese. To have this answer why do I need to go to education lessons? every one is already do know it. Still, every one of us, diabetic type 2 still wonder to get answer to this question: Why I am diabetic type 2? I was not obese when all symptoms started to surface, and I al ill all my life.
What goals do you have for various health measures such as blood pressure, blood sugar, lipid values and body weight?
To answer to all these questions I wish to say only one, I wish to have all measures as close to normal as it is possible. What is interesting, how many people will say they do have goal to have blood pressure 240/130 ? No one. Do how many people wish to set up goal as blood sugar level such as 599 mg/dl? And how many people wish to have body weight 400 pounds? At least I did not meet one of any of those. So, what does Educator really ask, and what Educator must to say to diabetic with these numbers? Educator must call 911!!!!!!!!!!!! Regardless of amount of pounds diabetic is in critical condition and in severe pain. Better to sent client to hospital before start to teach victim what to do.
How many Educators will do so? No one. Even when diabetic transported to ER in hospital, there is no admission to hospital. Usually diabetic would be sent home after a few hours after admission into ER. It is education to all practitioners, do not admit critically ill people who need urgent care. They may die, and really what Med Pro can do for them? To educate diabetic in coma how to eat and how often do work outs? Does not matter. Victim of that medical care is already out of reach and not every one return home form Emergency Department.
But still on the room of Diabetic's Educator clients are not in such critical condition, and Educator try to educate them to set up goals. OK, client with body 400 pounds said, one wish to be as one was in high school, 120 pounds. Is this realistic goal? Not at all. So, why this question really so important? Well, at least Educator has some topic to discuss. Otherwise what Educator suppose to talk about? The idea to set up goals is simple not reasonable.
It is so difficult to get out of standards and see the obvious absurd in the subject of discussion. There is no such needs as goal to set up. Every one ill person need to be as healthy as it is possible to be, at least to keep own functionality. The question is not the goal but what to do when one is sick or ill. Every one who got flu try own best to get rid of it and be healthy, no headaches, no running nose. We prefer to go to work then call for sick days. What is difference with diabetes? Diabetics are the same as every other ill or sick people. The goal is only one, to get healthy as much as possible, as soon as possible.
Demonstration.
Skills such as blood sugar testing or insulin injection can be learned by demonstration. As Dr. A. Peters educated diabetic one must take off cup from needle before put needle into belly. It is really important to tech diabetic what end of pen to put into stomach. Otherwise insulin will spring into air in stead to go under skin. But what I never encounter, why there is no teaching how to swallow Oral Agents. Really, one can take oral agents by another end, and it will not provide proper effect on blood sugar level.
Diabetes Self Management Education. (DSME) ADA program.
There are a lot to learn in this program. What I tried to find out the answer to twoquestions:
How to see if medicine and any treatement I take work for me or not?
How to count dose of insulin in everyday injections according to my personal needs to keep diabetes under control, and at the same time avoid low blood sugar, which is dangerous and unpleasant?
Try to ask Educator when you are on this program. No answer every will be given. Every educator do know very well what diabetic must eat and how often diabetic must go into fitness club. No one educator will every answer to the question, how to count dose of insulin. They all do know very well how to inject insulin. No one do know how to find dose of insulin injection. Really, what all this Education about?
Orientation.
The person believes that fate, luck or chance determine his or her outcome.
Educator suppose to help to diabetic to recognize importance of self- management in diabetes outcome. I would be positively accept that. But remember, it is MD who made us type 1 or type 2 diabetics, and so, it is MD who determined any outcome we will have in any self management. If one diagnosed as type 2 diabetic with needs in large dose of insulin, and as diabetic type 2 it was determined that diabetic is non insulin dependent and so there is no need in insulin then say me, how to self manage diabetes type 2 control without proper treatment?
In some countries diabetes type 2 diagnosed as 'non sugar type of diabetes' with diagnostic tool of having elevated sugar in blood. Say what is absurd in this definition?
So I stick with luck and chance and fate. I can do my part of job. But it was my luck when I found proper treatment I need, and it was my fate when I met my doctor who took good care for my needs and Rx large dose of insulin. Today I live.
via Ravenvoron
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