Can a diabetic educator help decrease HbA1c level?
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- Answered 30 Oct 2019 Conflict of interest declaration: None I’ve taken a broad meaning to ‘educator’ and taken it to mean any form of patient education for diabetes. A 2018 rapid review “Review of evidence to inform a best practice model of community diabetes education”  concludes: “Evidence, based on limited low quality studies, includes diabetes education on foot care, psychological, lifestyle, nutritional education that may be translated, and delivered in a group-setting, individually or in combination. Sessions vary between 15 minutes to 2 hours each session, and duration of programs may vary from 1 week to up to 2 years. Diabetes education may include verbal, written, visual, technology-based, or face-to-face strategies/interventions, delivered by multidisciplinary team of trained individuals. Evidence suggests that these trained individuals may include community health workers, credentialed diabetes educators, and healthcare workers with different levels of expertise. There is no 'one size fits all' model and different education programs are required to suit local community needs. This review identifies a context-adapted service delivery model for Type 2 diabetes mellitus, a practical three step approach (as part of an overarching framework) to promote positive behaviour change, as well as nine national standards for diabetes self-management and support; all of which could inform best practice for incorporation in models of community diabetes education. Evidence included involve the tailoring of diabetes education to include individualised assessments of cultural dimensions and modifications sensitive to varying degrees of acculturation, social-economic status, and language ability.” With regard, specifically, to HbA1c they report on the 2017 Cochrane systematic review “Psychological interventions for diabetes‐related distress in adults with type 2 diabetes mellitus” , which reports: “Compared to usual care, psychological interventions appear to have small and uncertain beneficial effects on self‐efficacy and HbA1c after 6 to 12 months.” References 1) https://monashhealth.org/wp-content/uploads/2019/01/Rapid-Review_Community-Diabetes-Education-0910-Final.pdf 2) https://www.ncbi.nlm.nih.gov/pubmed/28954185