Diabetes Self Management Curriculum

Teaching Objectives:

1. Participants will verbalize their feelings about the diagnosis of diabetes.
Teaching points:

  • Discuss feelings and recognize the impact they might have on control of diabetes.Dispel myths that surround the reasons for contracting diabetes; i.e., the participants did something bad, or they ate too much sugar.
  • Ask participants what they feel is the hardest part of their diagnosis to manage and what life style changes are most difficult to incorporate into their lives.

This discussion should lead into teaching objective #2.

2. Participants will be able to define diabetes and its pathophysiology.
Teaching points for the questions, „what causes diabetes?” and “what is diabetes?”

  • Describe normal glucose metabolism in simple terms. Explain that most foods contain sugar (glucose) and that the body needs this sugar or glucose for energy. Explain that the brain, muscles and internal organs all use sugar (glucose) for fuel.
  • Emphasize that eating too much sugar did not cause participant‟s diabetes. Genetics, weight, family history and ethnicity all contribute to diabetes.
  • In diabetics, the body can‟t use the insulin that is produced or the pancreas doesn‟t produce enough insulin. Familiarize participants with the term, “insulin resistance.”
  • Without insulin, glucose can‟t move from the bloodstream into body cells.
  • Without insulin, sugar or glucose builds up in the bloodstream.
  • The body can also make glucose from storage supplies in places like the liver. Therefore, many participants with diabetes have a high glucose level in the morning even though they haven‟t eaten since dinner. Their bodies have been “making” sugar while they were asleep.
  • Because some people don‟t produce enough insulin and other people can‟t use what is produced, different people take different types of medication.

Key Teaching Point: diabetes is the inability of the body to take sugar out of the bloodstream and put it where it needs to go.

3. Participants will understand normal glucose ranges, the importance of blood glucose self-monitoring and the significance of A1c laboratory monitoring.

Teaching points:

  • Blood glucose levels reflect the amount of glucose in the blood at that moment. Because most foods have sugar, blood glucose levels increase after eating.
  • Target blood sugar levels are 80-120. Two hours after eating, a blood sugar level of 180 or less is ok.
  • Identify test times. Stress the need to check blood sugars at different times of the day. Stress the importance of recording the results and time of day that the reading was taken even if the meter has memory.
  • Describe A1C as a three month report card that shows how much sugar has built up on the cells in a three month period. Stress that this is the most accurate way of determining how well controlled diabetes is.
  • Define an A1C of below 7.0 as a goal.
  • Discuss complications of diabetes. Explain why a lower A1C is important.
    Readings above 8 mean higher risk for problems.
    Participants with an A1C of 7.0 or less have much less risk for heart disease, stroke, kidney disease, eye problems, foot problems and nerve damage.

Key Teaching Point: it is essential to check blood glucose levels daily and to strive for levels of 80-120 (and no more than 180 after eating)

4. Participants will understand that diabetes is a lifelong disease. Participants will also understand that they can self-manage their diabetes with proper nutrition, exercise and sometimes medication. This is an overview: specific points will be discussed in more detail in later sessions.
Teaching points:

  • Diet is crucial to diabetes management
  • Maintaining a healthy body weight is one of the keys to managing diabetes. Being overweight makes insulin less able to do its job (keeping glucose levels normal in the blood). Losing even a small amount of weight helps lower the blood glucose levels.
  • Physical activity helps to decrease blood glucose levels and other aspects of health. Stress need for MD approval before beginning any exercise regimen.
  • Discuss the role of taking medications, oral or injected, as prescribed.
  • Discuss that diabetes is a progressive disease and they should not blame themselves if they need to go on insulin.

Key Teaching Point: diabetes is a lifelong disease in which self-management is crucial.

5. Hand out self-management goal sheets. Discuss the concept of self-management and have participants develop one self management goal related to today‟s session. Let participants know that these will be reviewed in future sessions and with their PCP‟s. Ask participants to work on their goals in the next week and to bring the sheets back to the next session