Long Term Conditions: Diabetes
Title
Patient/ Professional Journey
Author
Joan McDowell
Project Lead – Diabetes
National Education Co-Ordinator for Diabetes in Scotland
Purpose of the Paper
This paper outlines the knowledge, skills and understanding required of professionals when communicating and educating patients with diabetes.

Background
People with diabetes are required to participate in self management of their long term condition. Professionals support people with diabetes to become experts in their own care.
Context
The Short Life Working Group in Diabetes 1 identified 3 levels of patient education according to clinical need. The levels are education at diagnosis; ongoing education and focused courses that meet specific criteria either that of structured patient education or else of a clinical need e.g. pump therapy. The knowledge, skills and understanding required of professionals changes according to the patient journey 2,3,4 . Coupled with that, the educational theory that underpins education and communications changes as the patient becomes more expert in self management. Patients themselves have a role to play in their own education and in supporting others with diabetes, The role of the patient is therefore mapped according to the time line of living with diabetes. The first box in the table has deliberately been left blank. This recognizes that most people experience some element of shock when diagnosed with diabetes and need some time to come to terms with the diagnosis in the first instance.
Outcome
This paper has been agreed by the steering group of the post of Project Lead-Diabetes and the Scottish Diabetes
Education Advisory Group.
Joan McDowell,
August 2011

Table 1: Mapping the patient/professional journey: Diabetes Care
Time line Professionals Educational theory
Diagnosis
Level 1: Core Skills
Level 2: Living with diabetes
Continual Contact
GP/Consultant
DSN/PN
GP/Consultant
DSN/PN
Dietitian
Podiatrist
GP/Consultant
DSN/PN
Dietitian
Podiatrist
Psychologist,
Schools
Skills required
Andragogy/ Dictate Clear communicator
Facilitator
Listening skills
Empathy
Andragogy/ Dictate Ability to: impart knowledge; pace the giving of information; teach a skill ; reassure.
Discuss changes to lifestyle e.g. food, physical activity, smoking
Andragogy/ Facilitate Availability
Discernment
Listening
Ability to:
Empower;
Motivate;
Professional
Knowledge and
Understanding
Expert diabetes clinical knowledge.
Knowledge of how to teach information.
Knowledge of how to teach a skill.
Behavioural change.
Expert diabetes clinical knowledge.
Knowledge of how to teach information.
Knowledge of how to teach a skill.
Behavioural change.
Psychological impact
(HADS, PIDPAD)
CHO counting
Weight management programmes
Smoking cessation
Patient support
Peer support
Peer support

Level 3: Managing diabetes
Structured Patient education
Level 3: Managing diabetes
Ongoing structured education
Team
Team
Self-management resource/ Facilitator
Encourage;
Praise where there is evidence of selfmanagement
Motivational interviewing
Psychological assessment
Philosophy of care
Aims and learning outcomes
NICE criteria clinics
Facilitation skills
Behaviour change
Care planning around person’s goals and problem solving
Structured patient education
Peer learning and emotional support
Self-
Management/Facilitator
Availability
Discernment
Listening
Ability to:
Empower;
Motivate;
Encourage;
Praise where there is evidence of selfmanagement
Motivational interviewing
Psychological assessment
Structured patient education
Intensive insulin therapy
Motivational interviewing
Promoting behavioural change
Counselling
Empowering
Self-management
Long term conditions
Peer review for others
Quality assurance
CHO and insulin dose adjustment
Peer support

References
1. Bath L (2009) Short Life working group of type 1 diabetes. Scottish Diabetes Group, Edinburgh http://diabetesinscotland.org.uk/Publications/Final%20report%20of%20the%20Type%201%20Diabetes%20Short%20Life
%20Working%20Group.pdf
2. Diabetes UK (2011) An integrated career and competency framework for dietitians and frontline staff. Diabetes UK, London http://www.dmeg.org.uk/Doccuments/Dietetic%20Competency%20Framework%202011.pdf
3. RCN (2006) Specialist nursing services for children and young people with diabetes. RCN, London http://www.rcn.org.uk/__data/assets/pdf_file/0009/78687/003015.pdf
4. Trend UK (2011) An integrated career and competency framework for diabetes nursing. 3 rd edition SB Communications, London www.trend-uk.org