created: 01.10.2004
last modified: 01.10.2004
The first steps unavoidably lead to a diabetes Training Seminar. Every patient has the right to a competent medical training. The health insurance companies take the cost. Nevertheless only 15% of all diabetics have ever attended a structured training course. The reason? Default, lack of interest or information.
But it's obvious, "trained diabetics" are better off! They seldom have metabolic crashes or hypoglycaemia, they seldom are ill and suffer less consequential diseases.
Step by step
The first contact person should always be the family doctor. He checks whether a pathological blood glucose level is the case. (Mostly he is also the one who diagnoses diabetes)
After the diagnosis, no matter whether type-1 or type-2 diabetes, the doctor is going to confer with the patient about which training and which therapy will be the best for him. Here it is important to include the patient's needs and ideas besides the medically necessary requirements. The treatment follows the patient and not vice versa. The disease alone has high demands and needs to be integrated into the patient's daily routine as good as possible. This is the only way to guarantee a continuously working therapy.
Expert advice
Manifold programs can be a guideline when choosing the optimal training course. First of all there is a difference between type-1 and type-2 patients. If the doctor doesn't do the course himself he sends the patient to the next diabetic specialised doctor or clinic. Qualified diabetes-specialised personnel only may moderate training courses. The German Diabetic Society has set up quality standards to acknowledge the therapeutic institutes. The criteria break down to three levels, depending on quality and variety of the courses offered:
1. "Basic acknowledgement"
2. "Advanced acknowledgement with diabetes-specified quality management"
3. "Clinical Diabetes centre DGG"
Which training fits me?
Every diabetes is different and needs to be treated individually. Anyway, it is possible to divide the necessary training courses into four types.
Treatment and training room for (type-1 and type-2 patients)
1. Basic therapy (without insulin)
2. Therapy with oral anti-diabetics
3. Insulin therapy: subdivided in conventional insulin therapy (CT) and intensive conventional insulin therapy (ICT)
4. Therapy with insulin pumps
Before you decide for one of the options, you need to pay attention to the state of your health, your age, your personal living conditions and the type of your diabetes (1 or 2). In addition various institutes offer ambulant or stationary treatment and training programs.
The Basic therapy mainly is for type-2 diabetics, who can be treated with diet and exercise alone. About 80% of all diabetics are struggling with overweight. Over several weeks they learn about a diet with a positive impact on the diabetic metabolism and also estimating bread units correctly is taught. Besides, enthusiasm for sport is to be awakened and integrated into every day life of the patients.
If the basic therapy is not enough to control the blood glucose level an additional therapy with anti-diabetic oral medication is necessary. The pills are no substitution for insulin. The body's own insulin production is to be supported by the medical treatment and the long time blood glucose level is to be decreased.
Conventional and Intensive Conventional Insulin Therapy
The insulin therapy is an essential part for type-1 diabetics and, depending on their classification, also suitable for type-2 diabetics. The correct usage of insulin is in the focus of the training course. In homogenous small groups (in means of age, type and requirements) of 4-5 participants the course goes over 5-12 double lessons. Main points are insulin and injection technique, blood glucose self control and the right interaction of effect, dosage and meals. The Intensive Conventional Therapy allows a lot more flexibility. This enables the injection of short effect insulin and old insulin on the basis of blood glucose self control. A trained usage makes a flexible every day life and a well-set blood glucose possible.
The Conventional Insulin Therapy is more suitable for type-2 diabetics (as long as a sufficient remaining insulin secretion is provided). A daily routine and regular eating habits are the main condition. This kind of therapy with mixed insulin depends on a fixed amount of carbohydrates that need to be consumed during the day. You will need to eat your insulin profile, and it will have a fixed rhythm. This makes it unsuitable for the demands of every day life (job, family).
The insulin pump therapy is an extended form of the Intensified Conventional Insulin Therapy. With the size of a credit card and the strength of a deck of cards the pump is attached to the abdomen. Via a catheter the insulin reaches the fat tissue. Every two days the pump, which contains short time insulin only, gets exchanged. It offers the diabetic a mostly flexible Lifestyle. The need for insulin apart from the nutrition is covered by smaller doses of short time insulin.
Bottom Line
In line with the structural program all health insurance companies take the cost of training courses. In addition the insurance companies offer the opportunity to take part in a training program for hypertension, if it is needed. Prevention programs for overweight are going to get more attention in the future. The number of consequential diseases and treatment cost is due to be decreased in the long run.
A Diabetic can't know everything, the first step a free and easy-going life is to integrate the knowledge into the daily routine. Diabetes can't be cured, which makes it even more important to make the disease fit for every day life.
Author:
Steffi Dörries
Translation:
Christian Kern
Quelle:
www.patientenprogramme.de
www.deutsche-diabetes-gesellschaft.de
www.zi-koeln.de
