Diabetes Educators on the Front Lines of Care

Guest Post by David Kliff, Editor, Diabetic Investor

This weekend, the most dedicated people in diabetes  will gather in Baltimore for the American Association of Diabetes Educators (AADE) conference. Year after year, these amazing people gather to see all the latest toys in the toy chest, learn about all the new drugs, and share insights into how they are impacting the lives of the patients they work with. Although I cannot be with them this year, I am there in spirit, as being a diabetes educator isn’t an easy job but it is a very rewarding one.

This year should be very interesting for diabetes educators as there are so many new toys in the toy chest. There are multiple CGMs, a plethora of way cool whiz bang insulin pumps, “smart” pens galore, and let’s not forget the uncountable number of way cool whiz bang apps. Heck, there are times I’m sure these educators feel more like technicians, with all these toys patients are using.

Yet in this digital age where the patient’s smartphone is becoming the hub of their diabetes management, one has to wonder what education will look like in just a few short years. In some respects their job is about to get much easier, especially with insulin-using patients. As insulin dosing algorithms become more commonplace and CGM usage expands further, the educator will spend less time explaining the complexities of insulin dosing and more time on making sure the system is set up properly.

The same goes for insulin pump patients. With sensor-augmented pumps becoming the standard, education will become more systems-oriented.

Although diabetes educators will work with any patient, it’s no secret that when it comes to diabetes education, insulin-using patients vastly outnumber non-insulin using. Now this may seem logical, as how much education does it take to learn how and when to take a pill? However, as I have noted several times this week, it is this group that needs education the most. It is this group where education has the greatest impact. Unfortunately, it is also this group that is the most difficult to reach.

Herein lies the dilemma. Exactly how do these educators reach these people? Making life more difficult are the all the way cool whiz bang systems that offer coaching along with their way cool whiz bang toy. And let’s not forget that the pharmacist is also seeking to coach patients, as are insurers and, of course, the patient’s physician.

It’s easy — well, easy for me — to understand why these patients who need the help often tune out. Not only are there multiple options to choose from, education does not produce immediate results; it takes time away from their schedule and it can increase, NOT decrease, the patient workload.

For these reasons, I believe educators should depart from the past and their overly clinical approach to education. It’s time to make education fun and rewarding: something the patient wants to do. Going to see or interface with an educator should not be viewed as a chore or a trip to the dentist’s office to have root canal work done. It should be viewed and positioned as part of a process, helping the patient navigate the choppy waters of diabetes management.

Now don’t get me wrong, there are people and groups who do this very well. However, they tend to focus on insulin patients and they lack significant reach. There are some 30 million or so patients with diabetes in the U.S., and how many educators? Simple math tells us that even if educators worked 7 days a week, they could not reach the number of patients who need their help.

Quite frankly, I’m not sure there are any surefire ways to engage these patients. I am a strong proponent of using incentives, but as effective and proven as they are, no one wants to provide the incentive. Educators cannot afford to do this; companies lack the will and vision to do this.

Still, we must applaud these people for the work they do. Diabetes educators are on the front lines and have to deal with sometimes snarky patients, toy makers with lousy customer service, uncaring insurance companies and physicians who believe they are the smartest people on the planet. Yet they are extraordinarily dedicated and passionate about diabetes. So to all educators, a huge thank you from me. You do great work and the world is better off because of you.