We are all aware of the statistics: the incidence of diabetes continues to rise dramatically worldwide. There are 18.8 million people that have been diagnosed with diabetes in the United States with an additional 7 million who have diabetes and have not yet been diagnosed (CDC, 2011). Each of these individuals could benefit from time with a diabetes educator, and many could use frequent visits to help support behavior change and consistent reinforcement for monitoring and taking the appropriate medications.
Not all patients are referred to diabetes educators for a variety of reasons, but already our caseloads are high, and reimbursement poor. We want all persons to benefit from education, but is it possible to do so with limited providers and limited reimbursement?
One issue, of course, is lobbying for more reimbursement to help draw in more individuals interested in diabetes care. Mentoring new health care providers in the field, as initiated by the National Certification Board for Diabetes Educators (NCBDE) in 2011, is also a way to establish a bigger base of knowledgeable providers.
However, at this time, manpower is short, and access to a diabetes educator is limited. Over the last few years, there have been numerous research studies to evaluate the effectiveness of utilizing lay and peer educators. This may be a bit disturbing to some, as these providers do not have the extensive training and education of an individual who has obtained certification as a diabetes educator.
There does, however, appear to be evidence that this may be an effective route to help provide more services to more people in need. That with oversight by diabetes educators to assure standards are met, trained lay and non professional health care workers may be able to provide basic diabetes education, and for less cost.
In order to maintain high standards, these individuals must understand diabetes, and be able to communicate correct information to individuals referred for education. One way for them to obtain education is through the AADE certificate program for Level 1 educators. Having community health workers adequately trained provides the patient with access to education through a wider range of access points. Accessing appropriate websites may also enrich their understanding such as ADA, JDRF and CDC.
I think for many, it is difficult to embrace this idea. However, with oversight by well qualified diabetes educators, this concept may help to reach millions more individuals with diabetes and pre-diabetes. Now that is a thought worth considering!
If you are utilizing the help of peer educators and non professionals in your programs, please share your thoughts with all of us!