The challenge

Education is a fundamental part of diabetes care. People with diabetes have to take responsibility for managing their condition on a day-to-day basis. Therefore, it is imperative that they understand their diabetes and know how to treat it, whether through insulin replacement therapy, or through lifestyle management.

The aim of education for people with diabetes is to improve their knowledge and skills, enabling them to take control of their condition and to incorporate self-management into their everyday lives. The ultimate goals of patient education are to improve to control of vascular risk factors, and to aid the management of diabetes-associated complications, if and when they develop, to improve quality of life.

Patient-education programmes should meet quality criteria laid down by the 2005 Diabetes UK and Department of Health Patient Education Working Group ‘Structured Patient Education in Diabetes’ report; in summary, education programmes should:

• Have an underpinning philosophy and be evidence-based
• Have a structured curriculum
• Have trained educators
• Be quality assured
• Be audited

The following programmes continue to meet these quality criteria although it is recognised that many other programmes also meet these standards and others are working hard to achieve them.

• Dose adjustment for normal eating (DAFNE)
• Diabetes education and self management for ongoing and newly diagnosed (DESMOND)
• Diabetes X-PERT Programme
• Diabetes Education Network
• Quality Institute for Self Management Education and Training (QISMET)

NHS Diabetes aspires to see a life-long approach to education interventions. However, only 11% of people with Type 2 Diabetes report being offered structured education, according to the 2007 Health Commission Survey. This suggests the majority of healthcare providers have found it difficult to implement and resource the quality education programmes that meet these standards.

How NHS Diabetes is supporting you?

Being a publication partner, NHS Diabetes fully endorses the NICE quality standard for diabetes in adults – standards one and two state that:

• People with diabetes and/or their carers receive a structured educational programme that fulfils the nationally agreed criteria from the time of diagnosis, with annual review and access to ongoing education.
• People with diabetes receive personalised advice on nutrition and physical activity from an appropriately trained healthcare professional or as part of a structured educational programme.

NHS Diabetes supported a scoping exercise that provided an overview of the current issues and developments in the organisation and delivery of diabetes services in the UK, including patient education and self-care support. The report, published in 2010, describes the need for both structured and flexible models of education, such as peer educators. Other key themes included the need for ongoing follow-up education, greater accessibility, increased patient choice, and greater integration with the care system.

Education of health Professionals

Appropriately trained staff with the appropriate philosophy is crucial to the delivery of diabetes care that supports self management whilst dealing with the challenges of competing personal and health agendas a person with diabetes may have.

NHS Diabetes has led the development of an on line education programme to promote the safe use of insulin.