When talking to our patients about managing their diabetes, we often focus too much on the “how” and not the “why.” We may recommend patients stop smoking, eat better, or exercise regularly. But how many of our patients truly understand the benefits of these actions in controlling their diabetes and staying healthy?
Evidence from the Centers for Disease Control and Prevention (CDC) shows that higher levels of “patient activation,” or a patient’s active engagement of their skills, knowledge, and confidence, when making health care decisions leads to better health outcomes. When we take a moment to truly explain the benefits of exercise, for example, our patients are more likely to take proactive measures to maintain good health.
Diabetes remains the 7th leading cause of death in the United States.
The medical community is placing a renewed emphasis on diabetes prevention and control. 38.4 million people in the United States—11.6% of the U.S. population—have diabetes, according to the CDC. Around 97.6 million people aged 18 or older—38% of the U.S. population—have prediabetes. People with diabetes experience poor health outcomes and spend 2.3 times more on health care costs than those without diabetes.
What’s more, diabetes control and treatment are also costly to the medical community and the insurance providers reimbursing providers for the care they provide. The total annual cost of diabetes in the U.S. is $413 billion, making it the most expensive chronic condition in the nation. One of the best ways to ensure patients remain active in their health care decision-making is through engaging and interactive education.
For our patients to truly maintain good health and avoid complications from diabetes, cardiovascular disease, and obesity, it’s imperative that we focus on how and why.
A Proactive Approach to Diabetes Education
The University of Illinois Chicago’s Diabetes Empowerment Education Program (DEEP™) is a diabetes self-management education (DSME) program designed to empower individuals with diabetes to make proactive changes in their diet, activity, and understanding to better their health outcomes.
The DEEP™ curriculum is designed to teach self-management practices for preventing and controlling diabetes. Its collaborative, interactive format has been the gold standard for diabetes education and has improved people's lives.
The DEEP™ workshop consists of six weekly sessions lasting an hour and a half. Participants engage in demonstrations, hands-on learning, and problem-solving techniques. The curriculum allows participants to learn from one another through eight modules that build on one another each week.
AFMC DEEP™ Lead Trainers
Nine AFMC employees completed a 20-hour training to become licensed peer educators in Arkansas, allowing them to conduct DEEP™ workshops in the community.
Jamey Mantz, AFMC outreach specialist and registered nurse, and three of her colleagues then went on to complete advanced training to become lead trainers, enabling them to provide training for others in Arkansas who wished to become peer educators.
Jamey and her peers conducted peer educator training for several community health workers and pharmacy techs for the Arkansas Rural Health Partnership (ARHP) and the University of Arkansas for Medical Sciences (UAMS). Attendees who completed the training learned the skills needed to conduct community workshops in the areas where they live.
“We’ve found that people who attend the community workshops already know a little about the disease. So, we encourage them to share what they know so they can learn from each other,” Jamey says.
Participants learn key information about diabetes and its risk factors and prevention techniques. “We try to present in the communities that need it most, giving participants examples of how high blood sugar affects the body.”
Hands-on Activities Add Impact to the Curriculum
Hands-on activities complement the curriculum and provide engaging, interactive ways to teach participants about diabetes. One activity involves passing around three plastic baggies filled with red liquid of various consistencies. Each baggie represents a different blood glucose level: 100, 200, and 400 mg/dL. Participants can feel how much thicker the liquid is in the 400 mg/dL baggie than in the 100 mg/dL baggie
“We then tell them to imagine your body pushing that thick, thick blood through your veins,” Jamey says. “Then, they begin to understand the causes of damage to the heart, loss of circulation, and kidney problems. It’s an eye-opening visual for the class.”
For most, once they participate in the activities, they begin to understand why their bodies act the way that they do. Thanks to the broad curriculum, which touches on topics like diet, exercise, stress, and medication, participants see the whole picture.
The curriculum also gives the trainers new insight into the struggles that individuals with diabetes must overcome. “This program touches on so many areas that most of us don’t even think about,” Jamey says. “In the module that covers Medication and Medical care, we cover the importance of taking your medicine and how to communicate with your health care providers. Someone who has diabetes may be on 10 different medications. Imagine how confusing it can get when you have 10 different pills to manage.”
“After becoming certified and leading the community workshops, you begin to understand how patients can have so many problems. Then, the conversation turns into ‘I hear where you’re coming from. Here’s how we’re going to help you navigate those challenges.’”
Giving Hope to the Communities that Need It Most
Because the DEEP™ curriculum covers so many different aspects of diabetes, it’s a suitable learning tool for any area of the state, even in areas where resources are scarce. “When we conduct a workshop in a rural part of the state, we know that attendees may not have easy access to fresh fruits and vegetables, which are key to a healthy diet. The curriculum teaches them how to work with what they have to prevent and control their diabetes,” Jamey says.
That could make all the difference for patients in rural areas. Many of them would be more likely to practice healthy habits if they knew how to do better. “One thing I hear from people in the community a lot,” Jamey explains, “is that their providers are telling them to work on their diet and to exercise. That’s great. But what does that mean to the patient?”
For patients who don’t exercise often, doing so regularly can be overwhelming, especially when they don’t know how much exercise their provider is recommending. “I always tell them just to move around,” Jamey says. “Let’s go to the mailbox and back. Let’s vacuum around the house. Let’s work in the yard. To control your diabetes, you don’t have to be involved in structured exercise all the time. Sometimes, just simple movement can be beneficial.”
Perhaps most importantly, effective, patient-centered education gives individuals hope. For many in rural areas, a diabetes diagnosis can be a death sentence. “They’ve seen their friend or relative lose a limb to diabetes. Someone else they know had to undergo dialysis. Others may have died. So, when they receive a diagnosis, they sort of give up hope,” Jamey says. “By bringing this type of education into their community, we renew their hope. They now believe they can do this. They are going to be okay. They’re going to be able to live their life, even with their diagnosis.”
Learn more about the DEEP™ program and ways you can become a peer educator in your community.
Explore our resources for addressing health disparities, including evidence-based guides for cardiovascular health, helpful tip sheets for controlling diabetes, and delicious recipes for maintaining a healthy diet.
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