St.

Paul University Philippines

Tuguegarao City, Cagayan 3500

ADVANCED ADULT NURSING III:

DIABETES NURSING

Submitted by:
Arciaga, Mary Grace J.
Macavinta, Joseph Celrin III V.
Mongaya, Meryll L.
Nico, Nelson E.
Submitted to:
Mr. Andr N. Canaria, MSN, RN
Serious Complications of
Diabetes Mellitus
PRESENTED BY:
JOSEPH CELRIN V. MACAVINTA III, RN
Complications of Diabetes Mellitus

A . MACROVASCULAR COMPLICATIONS
complications result from changes in the medium to large blood vessels

3 Main Types of Macrovascular Complications

1. Coronary artery disease

50% - 60% of all deaths among patients with diabetes
Typical ischemic symptoms may be absent that may result for the patient to unable to
experience the early warning signs
a. Myocardial Infarction
Twice as common in men with diabetes and three times as common in women
with diabetes
Complications of Diabetes Mellitus

2. Cerebrovascular disease
Twice the risk for people with diabetes
Transient ischemic attacks
Stroke

3. Peripheral vascular disease

Signs and symptoms may be diminished peripheral pulses, intermittent
claudication (pain in the buttocks, thing or calf during walking)
Increase incidence of gangrene
Amputation in Diabetic patients
 Complications of Diabetes Mellitus

B. MICROVASCULAR COMPLICATIONS
Diabetic Microvascular disease (Microangiopathy) is the thickening of capillary
basement membrane

1. Diabetic Retinopathy
leading cause of blindness
deterioration of the small blood vessels that nourish the retina
Complications of Diabetes Mellitus

3 main stages
a. Nonproliferative (Background)
Early stage, asymptomatic
Blood vessels develop microaneuryms that causes swelling and forming of
exudates
Macular edema causes distorted vision

b. Preproliferative
Increased destruction of retinal blood vessels

c. Proliferative
Abnormal growth of new blood vessels in retina
New vessels rupture causing bleeding into the vitreous and blocking light and
will form scar tissue, which can pull on and detach the retina
Complications of Diabetes Mellitus

Other Eye Disorders

Cataract Opacity of the lens of the eye

Glaucoma Occlusion of the outflow channels by the new blood
vessels
Lens changes swelling in the lens when the blood glucose levels
are elevated
Extraocular muscle palsy result of diabetic neuropathy. Involves
various cranial nerves that are responsible for ocular movement.
Complications of Diabetes Mellitus

2. Diabetic Nephropathy

Account for almost 50% of new cases of end-stage renal disease (ESRD)
About 25% of those requiring dialysis or transplantation
Consistently elevated blood glucose level may cause stress in the kidneys
filtration mechanism allowing blood proteins to leak into the urine that
results to increase pressure in the blood vessels in the kidney.

3. Diabetic Neurophathy
May affect peripheral (sensorimotor), autonomic, and spinal nerves.
Complications of Diabetes Mellitus

2 Common Types of Diabetic Neuropathy

a. Sensorimotor polyneuropathy (Peripheral Neuropathy)

Affects distal portions of the nerves
Paresthesias and burning sensation
Numbness in the feet
Decrease in proprioception (awareness of posture and movement of
the body and of position and weight of objects in relation to the body)
Decreased sensation of light touch may lead to an unsteady gait
Decreased sensation of pain and temperature
Deformities of the foot may also occur; Charcot joints
Complications of Diabetes Mellitus

b. Autonomic Neuropathy
Broad range of dysfunction affecting almost every organ system of the body
3 manifestations are related to cardiac, gastrointestinal and renal systems.
Cardiovascular fixed, slightly tachycardic, orthostatic hypotension
Gastrointestinal - delayed gastric emptying, bloating, nausea, vomiting, and
diabetic constipation or diarrhea
Renal urinary retention, erectile dysfunction
Sudomotor Neuropathy decrease or absence of sweating (anhidrosis) of the
extremities, with a compensatory increase in upper body sweating. Dryness
of the feet increases the risk for development of foot ulcers
Complications of Diabetes Mellitus

Foot and Leg Problems

50% -75% of lower extremity amputation are performed on people

with diabetes
Neuropathy - sensory neuropathy leads to loss of pain and
pressure sensation
Peripheral vascular disease poor circulation of the lower
extremities contributes to poor wound healing and the
development of gangrene
Immunocompromised hyperglycemia impairs the ability of
specialized leukocytes to destroy bacteria.
Complications of Diabetes Mellitus

ACUTE COMPLICATION OF DIABETES

1. Hypoglycemia (Insulin Reactions)

Abnormally low blood glucose level; less than 50-60mg/dL
Caused by too much insulin or oral hypoglycemic agents, too little
food, or excessive physical activity
Complications of Diabetes Mellitus

2. Diabetic Ketoacidosis (DKA)

Absence or markedly inadequate amount of insulin

3 main clinical feature
Hyperglycemia polyuria, polydipsia, blurred vision, weakness and
headache
Dehydration and electrolyte loss hypotension with weak and
rapid pulse
Acidosis acetone breath (fruity odor), hyperventilation (Kussmaul
respirations), anorexia, nausea, vomiting and abdominal pain
Complications of Diabetes Mellitus

3. Hyperglycemic Hyperosmolar Nonketotc Syndrome (HHNS)

Serious condition in which hyperosmolarity and hyperglycemia

predominate, with alterations in sensorium
Lack of effective insulin (insulin resistance)
Persistent hyperglycemia causes osmotic diuresis, which result in
losses of water and electrolytes
Ketosis and acidosis do not occur because of the differences in
insulin levels
Treatment and
Management of Patients
with Diabetes Mellitus
PRESENTED BY:
MARY GRACE J. ARCIAGA, RN
PHILIPPINE GENERAL HOSPITAL NURSE II
Treatment and Management of Complications

Contents:

Basics of Diabetes Treatment and Management

Nutritional Therapy
Exercise
Monitoring Glucose Levels
Pharmacologic Therapy
Basics of Diabetes Treatment and
Management

Major goal of diabetes treatment is CONTROLLING BLOOD SUGAR LEVEL (BGL)

Type 1 Diabetes is managed with INSULIN, nutritional management and exercise
Type 2 Diabetes is managed with non-insulin medications, insulin, dietary change,
weight reduction and exercise
Medications for Type 2 Diabetes are used in combination.
increase insulin sensitivity,
increase glucose excretion,
decrease absorption of carbohydrates from the digestive tract, or
work through other mechanisms.
I. Nutritional Therapy

Goals of Nutritional Therapy:

Control of total caloric intake
Control of blood glucose levels
Normalization of lipids and blood pressure
Weight reduction for Obese DM patients
Meal Plan
Glycemic Index
 Meal Plan

Based on the patients food preferences, lifestyle, activity, usual eating habits
and ethnic and cultural background

Meal timing and timing and amount of insulin administration are

considerations when planning a diet for people with type 1 diabetes.

Diabetes diet must be balanced, nutritious and low in fat, cholesterol and
simple sugars.

The total daily calories are evenly divided into three meals (with snacks for
youth with type 1 diabetes).

< Nutritional Therapy

 Diabetes Diet

American Diabetes Association (ADA) recommends daily calories:

50 60% from carbohydrates
12 20% from proteins
Not more than 30% from fats
Rating your plate is a meal planning system based upon portion size. Imaginary lines
are used to divide a meal plate into two halves, and one half is further divided into
fourths. One-fourth of the plate should contain grains/starches, one-fourth should
contain protein, and the remaining half should contain non-starchy vegetables.
Exchange lists help in planning meals by grouping foods that have similar
carbohydrate, protein, fat and calorie content

< Nutritional Therapy

< Nutritional Therapy
 Glycemic Index

Glycemic Index (GI) is a measurement carried out on carbohydrate-

containing foods and their impact on our blood sugar.
Low-GI diets have been associated with risk of CVD, Type 2 DM, metabolic
syndrome, stroke, depression, CKD, formation of gall stones, neural tube
defects, formation of uterine fibroids, and cancers of the breast, colon,
prostate, and pancreas.
GI is measured by the rise in blood sugar level two hours after eating it. The
food is then ranked on a scale from 0 to 100. The top measure, 100, reflects
the rise in blood sugar following consumption of pure glucose.

< Nutritional Therapy

 Glycemic Index

Combining starchy foods with protein and fat containing foods tends to slow
their absorption and lower the glycemic response.

Raw and whole foods result in lower glycemic response than eating chopped,
pureed or cooked foods.

Eating whole fruits instead of drinking juices glycemic response since fiber in
the fruits slows absorption.

Small amounts of simple sugars are now allowed when consumed with a
complex meal.

< Nutritional Therapy

< Nutritional Therapy
II. Exercise

Lowers BGL by glucose uptake by body muscles and improving insulin utilization

Improves circulation and muscle tone

Reduces weight, eases stress and maintains a feeling of well- being

HDL and total cholesterol and triglyceride levels (DM pt have risk of CVD)

CAUTION on patients with blood glucose levels because exercise release of

glucagon, growth hormone and catecholamines.

Have snacks pre or post-exercise to prevent hypoglycemia. Check BGL!

III. Monitoring Glucose Levels

Self Monitoring of Blood Glucose Levels

Allows for detection and prevention of hypo/hyperglycemia
Enables adjustment to treatment regimen
Reduces risk of long term DM complications

Recommended 2 to 4 times a day (before meals and bedtime)

If with insulin pre-meals, take BGL before meals to determine each dose

Take BGL if suspecting hypo or hyperglycemia

III. Monitoring Glucose Levels

Continuous Glucose Monitoring System

Inserted SQ in the abdomen and connected to a device worn on a belt
After 72 hrs, data from the device is downloaded
Glycosylated Hemoglobin (HgbA1C)
Reflects average blood glucose levels over a period of approx. 2 to 3
months
Normal = 4% to 6%
Urine Glucose Testing *
Testing for Ketones
IV. Pharmacologic Therapy

INSULIN main treatment for Type 1 Diabetes

Also used in Type 2 DM when BGL cannot be controlled by diet, weight

reduction, exercise and oral hypoglycemic agents (OHA).

Animal sources vs. Human insulin (recombinant DNA technology)

Different Types of Insulins

Different methods of delivering insulin

Complications >
Complications >
Complications of Insulin Therapy

Complication Description Management

Redness, swelling, tenderness, induration or a

2- to 4-cm wheal
Local Allergic Antihistamine 1 hr
Appears 1-2 hrs after injection
Reaction before the injection
Appears at the beginning of therapy and
disappear with continued use of insulin

Rare
Systemic Allergic Immediate local skin reaction that gradually Desensitization (small
Reaction spreads into generalized urticaria (hives) amounts of insulin)
Generalized edema or anaphylaxis
Complications of Insulin Therapy

Complication Description Management

Insulin Lipoatrophy loss of fat; dimpling or pitting Rotation of injection sites

Lipodystrophy Lipohypertrophy fibrofatty masses

Weight loss
Use of more
Daily insulin requirement of 200 units or more
Resistance to concentrated insulin
Most common cause OBESITY
injected insulin (U500)
Prednisone (to block
antibodies)
Complications of Insulin Therapy
Complication Description
Due to insufficient insulin caused by:
Morning
Dawn Phenomenon relatively normal BGL
Hyperglycemia until 3 am, then begins to rise (due to
nocturnal surges in GH secretion)
Insulin Waning progressive in BGL from
bedtime to morning (due to evening NPH
dose administered before dinner)
Somogyi Effect normal or BGL at
bedtime, a at 2-3 AM to hypoglycemic
levels and a subsequent due to
counterregulatory hormones
Management
Dawn Phenomenon
Injection of evening
intermediate acting insulin
from dinner to bedtime
Insulin waning evening
dose of intermediate or long
acting insulin or add 1 dose of
insulin before evening meal
Somogyi Effect - evening
dose of intermediate insulin or
bedtime snack
Oral Hypoglycemic Agents
Oral Hypoglycemic Agents
Issues in Diabetes Care
Management
PRESENTED BY:
NELSON E. NICO, R.N.
Issues in Diabetes Care Management

The nurses role in diabetes care may be as a specialist or as part of general care -
primary or secondary. Wherever care is given, the emphasis is always on patient self-
management.
Rights of patient to choose among treatment modalities should be addressed and it
requires nurses to change and modify roles as health-educator, care provider and as
an advocate for diabetic patient.
Nurses caring for patients with diabetes need to be working towards the same
objectives, therefore target-setting and determining priorities for managing their
condition are important aspects of care. But to no avail, nurses and patients may still
encounter issue with chosen plan of care, despite of effective communication
among health professional and significant others.
Issues in Diabetes Care Management

Diabetes and Psychological care

People with diabetes experience disproportionately high rates of

psychological disorders, with depression and anxiety being the
most common diagnoses. Some studies have suggested that
approximately 40% of patients will have significantly elevated
symptoms of depression.
 Issues in Diabetes Care Management

Cultural and religious origins will inform the decisions that most patients make about
managing their condition

Lack of knowledge about diabetes and available services for treatment and support.
Poverty
Fatalism
Religious Convictions
Diet restrictions and Exercise interventions
Values and health behaviors
Language
 Depression and Diabetes

PSYCHOSOCIAL FACTORS IMPACTING ON TREATMENT ADHERENCE IN DIABETES

Stigma Research has found that the experience of stigma is common among
diabetics and often leads to treatment non-adherence. All participants in a study on
adolescents with Type 1 diabetes based in the United States reported feeling
stigmatized due to their diabetes (Buchbinder et al., 2005).
The participants in this study were upset due to the reactions of their friends and
strangers towards their diabetes. Some of the common social meanings attached to
diabetes that lead to stigma include the conceptions that it is an infectious disease
(Lin, Anderson, Hagerty, & Lee, 2008) and that it is a self-inflicted disease of
individuals who lack self-control, who eat to excess and are overweight (Broom &
Whittaker, 2004, p.2373). Certain forms of health promotion media have been found
to reinforce the view that diabetics are failing to take proper responsibility for their
health (Broom & Whittaker, 2004, p.2373).
Depression and Diabetes

Identity Issues Research on diabetes indicates that identity issues have a significant
effect on treatment adherence. The need for identity coherence - the maintenance
of personas exemplifying enduring conceptions of oneself (Swann & Bosson, 2008)
and the wish to attain ones desired identity affect diabetes self-management.
Diabetes treatment plays an ambivalent role in identity issues, sometimes preventing
individuals from achieving their identity goals - achieving their desired self and
participating in activities integral to ones self-concept (Swann & Bosson, 2008) - and
sometimes allowing individuals to attain their goals.
Depression and Diabetes

Diabetes treatment involves the adoption of significant changes to lifestyle.

The treatment and the illness itself introduce major disruptions to daily
routines and activities (Mamykina, Miller, Mynatt, & Greenblatt, 2010). The
experience of identity disruption can be anxiety-producing (Mendes &
Akinola, 2006) and this may lead individuals to maintain a connection with
their habits before they were diagnosed with diabetes in order to maintain a
coherent identity between their pre- and post-diabetes perception of
themselves (Mamykina et al., 2010).
 Diabetes and Effect on Cardiovascular System
Circulatory System

High blood glucose levels can contribute to the formation of fatty deposits in blood
vessel walls. Over time, that can restrict blood flow and increase the risk of
hardening of the blood vessels (atherosclerosis).

Lack of blood flow can affect your hands and feet. Poor circulation can cause pain
in the calves while youre walking (intermittent claudication). People with diabetes
are particularly prone to foot problems due to narrowed blood vessels in the leg and
foot. Your feet may feel cold, and you may be unable to feel heat due to lack of
sensation.
 Diabetes and Effect on Cardiovascular System

A condition called diabetic neuropathy causes decreased sensation in the

extremities, which may prevent you from noticing an injury or infection. Diabetes
increases your risk of developing infections or ulcers of the foot. Poor blood flow
and nerve damage increase the likelihood of having a foot or leg amputated.

Cardiovascular system is one of the most important systems in the human body. It
is comprised of the heart, blood and blood vessels. Blood is being pumped out
from the heart and is the one responsible in delivering oxygen and other nutrients
to all the parts of the body. It also cleans up our body by picking up the waste
products on its way back to the heart so our body can get rid of them.
 Diabetes and Effect on Cardiovascular System

Diabetes and cardiovascular system diseases has been recognized to be closely

related to each other for some time now due to the so-called insulin resistance
syndrome or metabolic syndrome. Some examples of the commonly diagnosed
cardiovascular disease are coronary heart disease, stroke, high blood pressure and
other heart conditions.

Cardiovascular diseases are the major cause now of deaths related to diabetes. In a
study published few years back in the Journal of the American Medical Association,
deaths due to some heart conditions went up by 23% in diabetic women despite the
27% drop of the same in non-diabetic women. As for diabetic men, there is only
about 13% decrease in heart disease related deaths as compared to the 36% drop
in non-diabetics. Thus, the two indeed go together.
 Diabetes and Effect on Cardiovascular System
Risk Factors

Diabetes is now considered by the American Heart Association a major risk factor in
cardiovascular diseases. Other factors that contribute to the possibility of acquiring
cardiovascular diseases in diabetic patients include hypertension, smoking,
and dyslipidemia.

Hypertension. Hypertension in diabetes is considered a major contributor to the increase in

mortality from cardiovascular diseases. Diabetic patients, especially those with Type 2, need
to always have their blood pressure checked every visit to the doctor. Self-monitoring at
home is also a must to maintain and control the rise of blood pressure. Intensive glycemic
control may prove to reduce the risk of cardiovascular events, although not directly. This
can be more beneficial in controlling micro vascular complications, but still, assessing all risk
factors and properly managing them is a big step in preventing occurrence of any
cardiovascular diseases.
Diabetes and Effect on Cardiovascular System

Smoking. Smoking has been determined dangerous to our health. Studies

show that smoking indeed increase risk of premature death and
cardiovascular disease in diabetic patients.

-Dyslipidemia. Dyslipidemia is abnormal concentrations of lipoproteins in the

blood or high cholesterol and high levels of triglycerides. Diet and exercise
can improve cholesterol levels and there are prescription medications that
your doctor can recommend.
Diabetes and Effect on Cardiovascular System
Prevention

As the old saying goes, prevention is better than cure. There are many ways on
how to prevent the increased possibility of cardiovascular events in diabetic
patients. Several alterations or modifications to the risk factors can be done to
maintain your health despite diabetes.
The simplest step one can start with is to stop smoking. Diabetic or not, cessation
of smoking will really prove beneficial to ones overall health condition.
Maintaining blood pressure to less than 130/85 or 130/80 mm Hg helps control the
occurrence of hypertension. Having a body mass index (BMI) of less than 27 is also
a must for diabetic patients to control their overall condition.
Diabetes is indeed a life-long condition that demands a lot of attention. There
may be no hard and real cure for this disease, but it can be maintained and
controlled by proper care and having thorough knowledge and understanding
about the condition.
DIABETES SELF CARE
MANAGEMENT AND
TRAINING
PRESENTED BY:
MERYLL L. MONGAYA, R.N.
 Role of self-care in management of
diabetes mellitus

The needs of diabetic patients are not only limited to adequate glycemic control but also
correspond with preventing complications; disability limitation and rehabilitation.
7 essential self-care behaviors in people with diabetes
1. healthy eating
2. being physically active
3. monitoring of blood sugar
4. compliant with medications
5. good problem-solving skills
6. healthy coping skills
7. risk-reduction behaviors.
 Diabetes self management education

The American Association of Clinical Endocrinologists emphasizes the importance of

patients becoming active and knowledgeable participants in their care.

WHO has also recognized the importance of patients learning to manage their
diabetes.

American Diabetes Association had reviewed the standards of diabetes self

management education and found that there was a four-fold increase in diabetic
complications for those individuals with diabetes who had not received formal
education concerning self-care practices.
Diabetes Education

seeks to reach these goals:

provide knowledge and skill training;

facilitate problem-solving;
help individuals identify barriers;
motivate for lifestyle adaptation; and
develop coping skills to achieve goals.
 Diabetes self-management education

Assessment and development of an instructional plan.

to identify, prioritize, and work toward individualized goalsbehavioral changes
that lead to better self-management skills and self-care behaviors.
multi-layered plan is implemented, the diabetes educator is able not only to
provide digestible amounts of information and instruction but to assess the
patients progress in learning, skill development, and behavior change.
Measuring, monitoring, and managing outcomes information helps the educator
plan appropriate follow-up interventions, informs decision-making, and drives
healthcare delivery.
Self Management Assessment:
 Diabetes self-care Activities

Changesin self-care activities should also be

evaluated for progress toward behavioral
change.

Self-monitoring of glycemic control is a

cornerstone of diabetes care that can ensure
patient participation in achieving and
maintaining specific glycemic targets.

Irrespective of weight loss, engaging in

regular physical activity has been found to be
associated with improved health outcomes
among diabetics
 Barriers to diabetes care

Socio-demographic and cultural barriers such as poor access to drugs,

high cost, patient satisfaction with their medical care, patient provider
relationship, degree of symptoms
unequal distribution of health providers between urban and rural areas
have restricted self-care activities in developing countries.
affordability by the patient, belief by providers that medications cannot
cure patient condition, no confidence in their own ability to alter patient
behavior were identified.
(adherence, attitude, beliefs, knowledge about diabetes, culture and
language capabilities, health literacy, financial resources, co-morbidities
and social support) and clinician related factors (attitude, beliefs and
knowledge about diabetes, effective communication).
DIABETES NURSING EDUCATION
ADNEP

The Association of Diabetes Nurse Educators of the

Philippines, Inc (ADNEP) is a duly recognized
continuing professional education (CPE) provider
by the Professional Regulation Commission Board
of Nursing (PRC-BON) and specialty organization
of the Philippine Nurses Association (PNA).
Vision:
A respected group of globally competent diabetes nurse educators moving
people to action towards high level wellness.

Mission:
Establish the diabetes nurse educator as an integral part of the diabetes team.
Ensure the promotion of comprehensive diabetes education and care to people with
diabetes and the population at risk through the provision of standardized training and
certification of diabetes nurse educators.
Effect positive changes in diabetes education and care through research.
Promote health and prevent diabetes mellitus through consciousness raising.
Establish linkages with government and non-government agencies locally and
internationally.
PHILIPPINE ASSOCIATION OF DIABETES EDUCATORS

- is a multi/interdisciplinary group composed of

physicians, registered nurses, registered
nutritionists-dietitians and allied health
professionals.
- involved in the care of persons with diabetes as
well as their significant others.
- their advocacy is the team approach towards
the prevention and control of diabetes in the
Philippines.
ASSOCIATION OF DIABETES NURSE EDUCATORS OF THE
PHILIPPINES

- is an organization of registered nurses trained in diabetes education.

Vision:
is to be a respected group of globally competent diabetes nurse
educators with the mission of moving people to action through
continuous training, research, linkages, and collaboration. We aim to
establish the diabetes nurse educator as an integral part of the diabetes
team.
Course description

Title of course: Diabetes Education Training for Registered Nurses, Registered

Nutritionists-Dietitians and Allied Health Care Professionals
Diabetes Education Training (DET)
- Program is a comprehensive 14-day training. It covers basic and clinical
knowledge on diabetes and its complications including screening,
diagnosis, pharmacological and non-pharmacological management.
- Also included is one (1) day Diabetes Conversation Map (DCM)
facilitators training conducted by DCM Expert Trainer for Philippines and
four (4) hours exposure to clinics and diabetes club visits.
Philippine Center for Diabetes Education Foundation
(PCDEF).
Prof. Augusto D. Litonjua,

Philippines
foremost endocrinologist, and
a group of dedicated doctors
banded together in October
1990, and along with other
diabetes lay crusaders.
Vision:
We see a citizenry that is
knowledgeable about diabetes
mellitus and skillful in the prevention
and management of the disease.

Mission:
We aim to improve the quality of
life of Filipinos by developing and
providing a comprehensive and
effective diabetes education
program for the country.
DIABETES NURSING EDUCATION IN UK

Oxford centre diabetes

and endocrinology
Diabetes Nurse Training
Primary care diabetes course

- aims to teach primary care nurses many of the fundamentals of

diabetes including home blood glucose monitoring, insulin therapy
and injections and adjusting insulin therapy together with the basics
of foot care and assessment of the diabetic patient clinically.

The diabetes specialist nurses were heavily involved in producing

the Oxfordshire Diabetes Resource Pack in November 2000 which is
an educational pack linking primary and secondary care.
Insulin conversion course

- annual insulin conversion course aimed at primary care nurses and

general practitioners which runs over one day and includes case studies.

Diabetes Control and Complications Trial

(DCCT)
-first showed the benefits of tight glycemic control for people with type 1
diabetes and the challenge for health care professionals is to develop a
system of healthcare which improves glycemic control, minimises the risk of
hypoglycaemia, improves quality of life and well-being and which does not
require huge resources.
DIABETES NURSING EDUCATION IN THE USA

Diabetes education, also referred to as diabetes self-management

education or diabetes self-management training, is performed by health
care professionals who have appropriate credentials and experience
consistent with the particular profession's scope of practice. Diabetes self-
management education is defined as the interactive, collaborative,
ongoing process involving the person with diabetes or pre-diabetes and/or
the caregivers and the educator(s).
The process includes:

Assessment of the individual's specific education

needs
Identification of the individual's specific diabetes self-
management goals
Education and behavioral intervention directed
toward helping the individual achieve identified self-
management goals
Evaluation(s) of the individual's attainment of identified
self-management goals
Proper documentation of all education encounters
How to become a Certified Diabetes Educator (CDE)?

first meet the eligibility requirements set forth by the National Certification
Board for Diabetes Educators (NCBDE).

is ahealth professional who possesses comprehensive

knowledge of and experience in diabetes management, prediabetes, and
diabetes prevention. A CDE educates and supports people affected by
diabetes to understand and manage the condition.
promotes self-management to achieve individualized behavioral and
treatment goals that optimize health outcomes.
NCBDE was established in 1986 as an independent organization to promote
the interests of diabetes educators and the public at large by granting
certification to qualified health professionals.
PROGRAM OFFERINGS:

MSN Diabetes Nursing

RN-to-MSN Diabetes Nursing
RN-to-BSN/MSN Combined Option
Diabetes Nursing Certificate
 DIABETES NURSING IN AUSTRALIA

The Australian Diabetes Educators Association

(ADEA)
- was formed in 1981 and is the leading
Australian organisation for health care
professionals providing diabetes education
and care.
- certification trademark of the Credentialled
Diabetes Educator (CDE) in 1986.
- implemented a professional recognition
and development program to support
diabetes educators working towards
achieving and maintaining status as a CDE.
ADEA

promotes evidenced-based best practice diabetes education to ensure optimal

health and wellbeing for all people affected by, and at risk of, diabetes.

accredits post graduate courses in diabetes education and management.

Credentialling and Re-credentialling Program, a voluntary professional development

and recognition program for full members. ADEA offers professional development
events and activities and endorses those developed by other organisations.
God Bless
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