Wednesday, June 27, 2012

Question time of our Diabetes Educator Peta Tauchmann on "Who is a Credentialed Diabetes Educator ? What happens in the first consultation with a Diabetes Educator and  What information is required from the GP?"

A Credentialed Diabetes Educator is a skilled specialist  who has completed post graduate tertiary study and structured clinical supervision in their role.  We are usually Registered Nurses although there are some dieticians who are also Credentialed as Diabetes Educators.  The term is trademarked which means that we cannot use the term Credentialed unless we have met these strict professional development requirements.  We are trained in advanced clinical aspects of diabetes management and are qualified to assess the patient and draw conclusions regarding diabetes self management and treatment options.  We offer advice regarding living with diabetes -  healthy eating, activity, counseling, and technical advice regarding tools of diabetes self management such as insulin and blood glucose testing.  Experienced Diabetes Educators may choose to develop additional skills in insulin pump therapy, flexible insulin dosing, and some go on to train as Nurse Practitioners. 

At the first visit to the Diabetes Educator I prioritize the needs of my patient according to their current treatment, health goals, and diabetes control.  I also take into account other health concerns and co-morbidities when assessing the patient.  A first visit will take about an hour to properly identify issues and develop strategies for change. 

If the patient has just been diagnosed with diabetes, the focus is on helping the patient to understand the condition and how the choices they make affect their diabetes and long term health.  This includes information about physiology of diabetes, treatment they are prescribed, the role of healthy eating and activity, and technical aspects of their self management.  I will also discuss complications and screening for the patient with an uncomplicated diagnosis. 

If the patient presents with hyperglycaemia then the approach is to identify and problem solve the possible causes of this.   Screening involves reviewing lifestyle choices and treatment.  Technical skills such as insulin administration are also checked.  Self-management is always the first consideration for a Diabetes Educator, however we will also identify situations where treatment needs to be reviewed.  for this reason including information about other medical conditions and all prescribed medication is useful. 

I always ask the patient to bring their diabetes equipment (meter and insulin supplies) as we can use these to check how they are performing technical tasks.  It also gives me the opportunity to see if their equipment is working properly and if not to replace this for them. 

With this in mind the referral needs to be clear about why the patient has been asked to attend the Diabetes Educator.  Are they recently diagnosed or is there a particular problem we need to address.   If they are starting insulin information regarding the type of insulin, device prescribed, starting dose and plans for dose adjustment need to be included.  Including medical history, treatment prescribed (for all medical conditions) and current pathology ( A summary diabetes screen or separate HbA1c, E/LFT, Cholesterol and Microalbumuria) means we are fully prepared for the consultation.  If the patient is referred under a Diabetes Care Plan there is a requirement from Medicare that the Care Plan, Team Care Arrangement and Allied Health (EPC) referral are also provided to the Diabetes Educator. 

Peta Tauchmann RN
Credentialed Diabetes Educator
PO Box 882
Mt Gravatt, 4122
0409 807 420

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