Diabetes Educators: Resource for Diabetics With Medicare

A dearly loved relative of mine was recently diagnosed with diabetes at the age of 76 and the following day I received a long distance call from his distraught wife, Betty.

"Please help us! Sam's been diagnosed with diabetes and we don't know what to do. The doctor gave him a prescription for a pill and a blood sugar machine and told him not to eat sweets but we don't know how to use the machine or what to do with the blood sugar results once we figure out how to use the machine. We also don't know what kind of diet he should be eating, what activities he can/ can not do, or the potential side effects of the new medication. Can you help us?"

I have many years of experience as a home care nurse instructing seniors in diabetic care, but I lived 1000 miles away from Betty and was feeling helpless about her pleas. I was also angry about the cavalier way that the doctor had treated Betty and Sam and was getting angrier by the minute.

"Didn't the doctor give Sam a written diet?"

"No."

"Do you know what Sam's blood sugar reading was?"

"350." (quite high).

"When is Sam's next appointment with the doctor?"

"Three months."

I could scarcely believe what I was hearing. Without proper instruction, Sam was at high risk of having high or low blood sugar reactions, either of which could become life threatening if both he and his wife did not understand what to do to prevent, recognize and treat them. Trying to keep the alarm out of my voice I said, "Sam needs to see a diabetes educator."

"A what?"

"A certified diabetes educator (CDE). It's a nurse, or in some cases a dietitian, pharmacist or social worker who has received specialized training in diabetes education and management and has passed a formal examination. Sam's medicare and medicare supplement insurance should cover the cost of a consultation and the educator will be able to contact Sam's doctor for specific orders and will then be able to answer all your questions."

"Where do I find a diabetes educator?"

"You can call the doctor's office and ask for a referral, or if he won't give you a referral you can call the American Diabetes Association (ADA) or your local hospital."

While still on the phone, I quickly logged onto my computer and found the name of a certified diabetic educator that was near Sam's house. As Betty wrote down the number, I was already starting to feel better because I knew that with comprehensive instruction and support the chances of Sam bringing his blood sugar levels down and preventing complications was good.

20.9% of all persons over the age of 60 suffer from diabetes. Because most seniors have friends or relatives who suffer from diabetes and know someone who has experienced diabetic complications, it is usually scary for an elderly person to hear his or her doctor say, "You have diabetes."

Also, many seniors have set routines and habits that may need to change in order for them to get their blood sugar levels under control and prevent complications. Certified diabetes educators can teach a newly diagnosed diabetic, or any diabetic currently experiencing difficulty with diabetic self-management the following information:

• What diabetes is.
• How to make changes in health habits.
• How to use oral diabetes medication or how to inject diabetic medication such as insulin or byetta.
• How to use a blood glucose monitor to check blood sugar levels.
• How to keep track of blood sugar results.
• The signs and symptoms of low and high blood sugar.
• How to take care of an insulin reaction.
• How to handle sick days.
• What symptoms/ blood sugar levels to report to the doctor.
• When to seek emergency medical assistance.
• How to make dietary choices that adhere to the diet prescribed by the doctor.
• How exercise/ activity levels affect diabetes.
• How to care for their feet and to recognize diabetic foot ulcers.

In addition to a primary care provider and a certified diabetes educator, it may be necessary for a diabetic to see an endocrinologist (doctor who specializes in treating diabetes), eye doctor (because diabetes can affect the blood vessels in the eyes which can lead to blindness if untreated), podiatrist, and last but not least, a mental health professional such as a social worker, psychologist, psychiatrist or marriage and family therapist to help with the emotional side of living with diabetes. Social workers can also help find medical and financial resources.

In summary, seeing a diabetes educator soon after the initial diagnosis is one of the most important things a senior can do to ensure they become educated in the self-management of their diabetes so they can prevent diabetic complications or at least receive treatment for complications as soon as possible.