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! Prepare Individuals to ! Make informed decisions ! Engage in effective diabetes self-management ! Implement self-care behaviors that allow
individuals to maximize their physical and psychological well-being.
AADE, The Diabetes Educator, Sept/Oct 2003
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Franciosi et al. Diabet Med 2011
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www.idf.org and at www.smbg-iwg.com
1. Only when PWD (and/or their care-givers) and/or HCP have knowledge, skills and willingness to incorporate SMBG & therapy adjustment into their diabetes care plan !
2. Consider at the time of diagnosis-enhance understanding of diabetes as part of individuals’ education, & facilitate treatment initiation & titration !
3. Considered as part of DSME to better understand disease. provide for pt participation in control & treatment, modify behavioural & pharmacological interventions!
4. Individualize SMBG protocols (intensity and frequency) to address each individual’s specific needs & requirements for data on glycaemic patterns, & monitor impact of therapeutic decision making&
5. Purpose of performing & using SMBG data should be agreed between PWD & HCP. Agreed-upon purposes/goals and actual review of SMBG data should be documented !
6. SMBG use requires an easy procedure for patients to regularly monitor the performance and accuracy of their glucose meter &
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Is it worth it????? OR…Are we doing something wrong?
Malanda, Bot, Nijpels. Diab Care Jan 2013
Polonsky, Fischer. Diab Care Jan 2013
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Knowles, M. M. S. (1970). The modern practice of adult education (Vol. 41). New York: Association Press.
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1 Zull, JE (2004) The art of the changing brain. Educational Leadership
! Knowledge is a means to an end rather than an end in itself
! Useful knowledge is knowledge that helps individuals better manage and/or live with their diabetes
! Knowledge which does not contribute to a higher goal is not worth teaching, nor does it help change behavior
C*-D')A&D+#),&')+*2"2>&d@+(&"#&(@)&>-+'l&4(+*>)(7K-N&,-&6&>)(&(@)*)
! Context driven learning is brain friendly
! Teach what is meaningful
The physiology of insulin secretion
! We remember what WE believe is significant ! Biological depression, extended stress and
chronic illness can cause cognitive deterioration
Zull, JE (2004) The art of the changing brain. Educational Leadership
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o Take an interest o Partnership o Positive feedback o Encourage expression
of ideas, reasoning, feedback
o What do you think would happen if …?
No Judging
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“…fasting hyperglycemia plays a major role as soon as the HbA1c level rises above 8.4%”
Relative contributions of postprandial (!) and fasting (") hyperglycemia (%) to the overall diurnal hyperglycemia over quintiles of HbA1c. a, significant difference was observed
between fasting and postprandial plasma glucose (paired t test); b, significantly different from all other quintiles (ANOVA); c, significantly different from quintile 5 (ANOVA).
Monnier L et al. Dia Care 2003;26:881-885 Copyright © 2011 American Diabetes Association, Inc.
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