Diabetes Self-Management
Diabetes is a disease with no cure. It is a chronic condition that must be controlled daily using such tools as your doctor's advice, diet, exercise and life-long education.

The Christian Hospital Diabetes Institute can help with your diabetes diagnosis, treatment and management. Specially trained clinicians and dietitians teach you about eating healthy, exercising and taking your medicines correctly. They work with you and your doctor to create a plan just for you.

Services available to diabetes patients, their spouses/significant others and families:

• Assistance from a registered dietitian
• Exercise planning
• Individual consultations
• Instruction from a certified diabetes educator
• Meal planning
• Personalized education plan
• Small group sessions
• Support group

The Importance of Education
Diabetes education enables you to make -- and sustain -- life changes to manage your disease. 

This education might be referred to as diabetes self-management education (DSME) or diabetes self-management training (DSMT). The goals of DSME are to optimize metabolic control, prevent acute and chronic complications, and achieve quality of life while keeping costs acceptable. Nationally, self-management programs have shown positive results for people with diabetes. Medicare and most insurance companies cover DSME.

About Our Program
The Christian Hospital Diabetes Institute offers comprehensive diabetes education to people with diabetes, their families and spouses/significant others. Group or individual instruction is offered to adults with type 1 diabetes, type 2 diabetes, gestational diabetes and impaired glucose tolerance or pre-diabetes. Day and evening classes are offered at the St. Louis-area and Edwardsville locations. A referral from your primary care provider, endocrinologist or health-care provider is required.

Our program consists of:

• A two-hour assessment and introduction to behavior change 
• A four-hour core curriculum: The Basics of Diabetes
• A two-hour meal planning class

Class topics include:

• Benefits of self-monitoring blood glucose
• Changing behaviors for successful diabetes self-management
• Chronic complications
• Diabetes overview and treatment
• Hyperglycemia
• Hypoglycemia
• Methods for evaluating control
• Nutrition basics
• Record-keeping
• Relationship between carbohydrates and blood glucose control
• Sick days

Classes consist of the 10 areas of the National Standards for Diabetes Self-Management Education. Program participants have follow-up appointments at one-, three- and twelve-month intervals with a six-month follow-up telephone call. Follow-up sessions include a check on progress toward self-management goals, and a discussion of new goals, barriers to achieving goals, and a review of the Standards of Care.  Additional instruction is provided if needed.  Participants may receive follow-up any time and are encouraged to call or stop by the Diabetes Institute for information.

Self-Monitoring of Blood Glucose
Self-blood glucose monitoring (SBGM) allows people with diabetes and their physicians to make informed decisions regarding medications, meal plans and exercise programs.  Self-blood glucose monitoring provides immediate feedback to those who want to assess their body's response to changes in their self-management routine.

The advances in technology have resulted in an array of blood glucose meters to meet almost all individual preferences, needs and limitations. Our staff can help you understand and incorporate self-blood glucose monitoring into your treatment program.

Medical Professionals
People with diabetes need routine medical care and education to prevent acute complications and to reduce the risk of long-term complications. A physician-coordinated team should deliver treatment and care. The team, which includes the patient, may also include professionals have special training and interest in diabetes:

• Dietitians
• Exercise Therapists
• Mental Health Professionals
• Nurses
• Physicians

Standards of Care
The American Diabetes Association Standards of Care have become widely endorsed by many organizations. 

A1C
Reflects the average blood sugar for the past three months

• Frequency: at least twice annually or (four times annually if treatment changes or the goal is not being met)
• Goal: less than 7percent (Any decrease (improvement) in A1C reduces the risk for long-term complications.)

Weight

• Frequency: check at each regular diabetes visit

Blood Pressure

• Frequency: check at each regular diabetes visit
• Goal: less than 130/80 mmHg

Lipid Panel

• Frequency: annually
• Goal:
  • LDL less than 100 mg/dl
  • Triglycerides less than 150 mg/dl
  • HDL greater than 40 mg/dl for men and greater than 50 mg/dl for women

Microalbumin Test
An early indicator of kidney failure

• Frequency: annually

Dilated eye exam
Nearly 45 percent of people with diabetes have some degree of diabetic eye disease.  Diabetic eye disease usually has no symptoms; regular eye exams are important for early detection and timely treatment. A dilated eye exam is the best way to detect diabetic eye disease.  Drops are used to enlarge the pupils; this allows the eye care professional to see more of the inside of the eye to check for signs of disease.

• Frequency: annually

Foot exam, comprehensive

• Frequency: annually

Foot exam, visual inspection

• Frequency: more often for high-risk foot conditions

Medical Nutritional Therapy
Managing the overall nutritional needs of the non-pregnant patient with diabetes in relation to weight loss, consistent carbohydrate counting with specific calorie levels and sick day management

• Frequency: as needed to meet treatment goals

Physical Activity Plan

• Frequency: as needed to meet treatment goals

Flu Vaccine

• Frequency: once per year

Pneumonia Vaccine

• Frequency: as recommended by your health-care provider

Dental Care

• Frequency: at least twice per year

Other specialties, such as psychosocial and skin conditions

• Frequency: as recommended by your health-care provider