Staying Power: You Can Manage Diabetes By Jill Jesso-White on May 7, 2020 in Community Health News Diabetics learn to manage medications, lifestyle at Community Health “My goal is to share my diabetes knowledge with our patients. From this, my hope is that they understand that they are not alone and that they have the ability to manage this diagnosis.” Michele Redmond, RN, BSN, CDCES Michele Redmond never knew her grandmother. She passed away when Michele was a toddler, but as a child Michele remembers her mother talking about diabetes, recalling how her grandmother cried because she’d lost her sight and was unable to see her beautiful granddaughters. Michele’s grandmother, diagnosed with Type 1 diabetes, eventually became a wheelchair bound amputee. As this illness touched multiple family members it became a passion of Michele’s to learn about diabetes and to share what she has learned about living with and managing diabetes. Michele Redmond, RN, BSN, CDCES is one member of a dedicated and skilled team of diabetes educators within the Community Health network that serves Rutland and Addison counties. Diabetes and COVID-19 The importance of understanding diabetes was elevated when the Centers for Disease Control (CDC) said, “Older adults and people of any age who have serious underlying medical conditions might be at higher risk for severe illness from COVID-19.” Diabetes was identified as one of the high-risk underlying conditions and the CDC urged those with diabetes and other underlying conditions like asthma and heart disease to stay at home and strictly follow the CDC recommendations. Credit: Vermont Dept. of Health The state of Vermont’s 3-4-50 Prevent Chronic Disease Program already focuses on Type 2 diabetes as one of four chronic diseases that causes more than 50% of deaths each year in the state. Diabetes education and self-management are integral to the program. According to the 2016 data from the Vermont Department of Health website, 10% of the residents of Rutland County and 9% of Addison County are diabetic. Community Health has been providing diabetes education to primary care patients since 2006. Between October 2018 and September 2019, 271 Community Health patients attended diabetes education programs that provide information, support and resources for self-managed care, medication management and lifestyle improvements like exercise and nutrition. Diabetes support has included practical cooking tips and a session on healthy foot exercises led by a local college athletics educator. The sessions are covered by insurance, at little or no cost to participants. Staying Power Community Health patients diagnosed with diabetes are referred to the education program by their primary care provider. Clinical staff and diabetes educators supply providers with detailed information about the education program and link them to one of the individual educators. Although many patients are seen for the initial education session, most don’t make it to the follow up sessions. The full program includes an initial assessment, additional education that is offered through either individual or group sessions, and then a follow-up three months later. The goal this year is to increase the number of patients who complete the entire diabetes education program by communicating the importance of learning all aspects of self-managed care and understanding how to live with diabetes. Top Notch Educators The Community Health program is accredited by the American Association of Diabetes Educators (AADE), now called the Association of Diabetes Care & Education Specialists (ADCES), which reviews the program’s educational plan as part of an annual status report. The annual report ensures that instructors have maintained their minimum requirement of continuing education and that the curriculum is up to date. The annual review also gives Community Health the opportunity to assess clinical outcome measures such as average hemoglobin A1C reduction by comparing before and after education results, as well as compliance with diabetes eye exams and foot exams. Community Health is also required to identify at least one Continuous Quality Improvement Project each year. This year the focus is on spotlighting the benefits and importance of completing the entire three-part program. In addition to an annual review, Community Health must apply for program reaccreditation every four years. The application for reaccreditation involves additional data review and updating of documents to ensure that the program is compliant with national standards. “Becoming a diabetes educator takes a lot of time and commitment,” Michele said. “All of us that are providing education are also working as nurse practitioners, primary nurses, medical assistants or care managers.“ Community Health’s certified educators must reapply for their individual certification every four years. During that time, each certified educator must complete 75 hours of diabetes-related continuing education. All other educators must maintain 15 hours of diabetes-related continuing education each year. Accredited diabetes educators currently staff Community Health’s Brandon, West Pawlet and Castleton offices and there are plans to add an educator in Rutland. The Community Health diabetes educators include: Robin Myers, DNP, FNP-BC, CDE, and Abigail Wikoff, APRN, at Community Health Brandon, Colleen Bates, MA, and Diana Johnson, RN, CDE, at Community Health Mettowee, Michele Redmond, RN, BSN, CDCES, at Community Health Castleton. Starting this year, the Certified Diabetes Educator (CDE) credential is changing to Certified Diabetes Care and Education Specialist (CDCES). Those who currently have the CDE credential have already passed a national certification exam and will not have to retake the exam to transition to the new credential. However, they must continue to meet the National Certification Board’s requirements in order to maintain that credential. This change was initiated back in 2017 and involved AADE members, insurance companies, providers, other diabetes organizations and groups representing people with diabetes. According to the ADCES, “the repositioning of the specialty is an outgrowth of our new vision to drive optimal outcomes through the integration of diabetes clinical management, education, prevention and support.” “My goal is to share my diabetes knowledge with our patients,” said Michele. “From this, my hope is that they understand that they are not alone and that they have the ability to manage this diagnosis.” Click here for information about the diabetes education program. For more information about diabetes educators see Diabeteseducator.org/ADCES.