1. Diabetes Structured Patient Education Diabetes Specialist Nurse
Linda Burns
Diabetes Specialist Nurse
Linda Burns Diabetes Specialist Nurse June 2016

2. Principles of Adult Education
Process of learning brings together cognitive, emotional, and environmental influences for acquiring knowledge, skills, and values¹
Adults learn most effectively when the teaching
environment allows individuals to internalise and
express their understanding of the content and its
interpretations.
It is not enough to just provide content - learners must be allowed to experience it through a lens that accounts for their personal experience and environment.
Illeris, K. “Adult education as experienced by the learners”, International Journal of Lifelong Education. 2003; Vol. 22

3. Key criteria of a structured education programme
A clear underlying philosophy on which the programme is based
A structured written curriculum
Trained educators familiar with the programme and its delivery
A quality assurance system applied to the structure, process, content, and delivery of the programme
A process of audit of programme outcomes including biomedical, psychosocial, and patient experience
Linda Burns Diabetes Specialist Nurse March 2016

4. Ongoing Diabetes Education Work in GGC
Diabetes MCN developed patient pathways for Type 1 and Type 2 education with a move towards quality assurance for all courses now being provided.
Multi-disciplinary working groups are reviewing current provision and developing action plans to improve provision of Type 1 & Type 2 patient education.
New Continuing education programme developed by dietician Valerie Laszlo called “Mastering Type 2 DM”
Expected restart after April 2016.
Linda Burns Diabetes Specialist Nurse March 2016

5. Type 2 Patient Education
Linda Burns Diabetes Specialist Nurse March 2016

6. Conversation Maps Good to talk
Linda Burns Diabetes Specialist Nurse March 2016

7. Diabetes Conversation Maps
A comprehensive and unique set of educational tools known as Conversation Maps
Designed to engage patients in the learning process and help them become better self managers through group sessions
Developed in accordance with Clinical Practice Guidelines
Linda Burns Diabetes Specialist Nurse March 2016

8. Diabetes self-management education and ongoing self-management support are crucial components of effective diabetes care and significant contributors to the metabolic and psychological outcomes of people with type 2 diabetes
Linda Burns Diabetes Specialist Nurse March 2016

9. Conversation Map™ (CM) education tools are a series of tools for facilitated group education that were developed by Healthy Interactions in collaboration with the International Diabetes Federation (IDF) and are sponsored by Lilly Diabetes. Different CM versions have been developed for specific regions or countries (United States, Canada, Europe, Asia, Australia, Latin America, and Africa) in cooperation with national and international diabetes associations (IDF and the Canadian, American, and U.K. diabetes associations) to reflect differences in culture and background.
CM-based education guides people with diabetes through a process with the aim of helping them understand and internalise information about their disease and generate insightful conclusions, which may then result in improved self-management decisions and actions
Linda Burns Diabetes Specialist Nurse March 2016

10. Linda Burns Diabetes Specialist Nurse March 2016

11. Linda Burns Diabetes Specialist Nurse March 2016

12. Linda Burns Diabetes Specialist Nurse March 2016

13. How does it work?
It hopes to promote understanding of type 2 diabetes, allowing patients to be more knowledgeable about what will positively benefit their long-term health as they live with the condition.
The course aims to dispel any myths about the condition, and any illness beliefs that are false or potentially damaging.
It should help patients to see their illness in a biomedical model, as well as the personal functional and social model that most use as their initial conceptual framework for understanding the impact of the illness.
It should enable patients to monitor their type 2 diabetes effectively, realise when their control is inadequate, and enable them to self-manage their lifestyle, nutrition and medication to bring about improvement in diabetic control, or know when to seek professional help.
It should enable them to be an active partner in the management of their type 2 diabetes, along with healthcare professionals.
Linda Burns Diabetes Specialist Nurse March 2016

14. Patient share if they wish through pier conversation their ....
Thoughts and feelings of the participants around diabetes.
Discussion helps them understand their diabetes and glucose: what happens in the body.
Gives them insight and understanding about the risk factors and complications associated with diabetes.
More understanding about monitoring and medication.
Encouraging patients on how to take control discussing
Food Choices
Physical Activity.
Planning for the future.
Setting goals.
Knowing their numbers
Linda Burns Diabetes Specialist Nurse March 2016

15. Training Educators
After completing the Conversation Map training, facilitators are able to incorporate new education techniques into their practice, which can help drive greater information retention and help positively affect behaviour.
The training can expand the skill set of healthcare professionals by enhancing group-session facilitation skills.
A new role for educators – that of a facilitator rather than just a dispenser of facts. Educators are there to ensure that information shared within the group is correct.
Training workshops – 4 hours arranged through Lilly representative
Linda Burns Diabetes Specialist Nurse March 2016

16. Do you know how to refer patients locally to diabetes structured education classes ?
Type 2: Paper referral to local CHP Diabetes Education co-ordinator for Conversation Map or one to one
Linda Burns Diabetes Specialist Nurse March 2016

17. Cost of diabetes treatment in the UK in 2012
Area of expenditure
Type 1 diabetes
Type 2 diabetes
Total cost
Percentage of costs
Diabetes drugs
£0.344 billion
£0.712 billion
£1.056 billion
7.8%
Non-diabetes drugs
£0.281 billion
£1.810 billion
£2.091 billion
15.2%
Inpatient
£1.007 billion
£8.038 billion
£9.045 billion
65.8%
Outpatient (excluding drugs)
£0.170 billion
£1.158 billion
£1,328 billion
9.7%
Other (including social service) -
£0.230 billion
1.7%
Total
£1.802 billion
£ billion
£ billion
100%
Source: Kanavos, van den Aardweg and Schurer: Diabetes expenditure, burden of disease and management in 5 EU countries, LSE (Jan 2012)
Linda Burns Diabetes Specialist Nurse March 2016

18. The prevalence of diabetes is estimated to rise to 4 million by 2025.
Diabetes costs the NHS £1.5m an hour
The cost of diabetes to the NHS is over £1.5m an hour or 10% of the NHS budget for England and Wales. This equates to over £25,000 being spent on diabetes every minute. This equates to £ every second.
In total, an estimated £14 billion pounds is spent a year on treating diabetes and its complications, with the cost of treating complications representing the much higher cost.
The prevalence of diabetes is estimated to rise to 4 million by 2025.
Linda Burns Diabetes Specialist Nurse March 2016

19. Although knowledge alone is likely insufficient to achieve changes in A1C, it is evident from prior research that behaviour and ultimately clinical outcomes are unlikely to change unless there is knowledge together with an understanding of the need to change, what to change, and how to change it.
Knowledge is necessary for diabetes self-management behavior, physical and psychological well-being, glycemic control (A1C), body weight, attainment of personal therapeutic goals
Linda Burns Diabetes Specialist Nurse March 2016

20. Thank you Any questions?
Linda Burns Diabetes Specialist Nurse March 2016