see a need to address more than just the effects of diabetes, hypertension, obesity and prediabetes—we must confront the lack of quality education and culturally competent care available to people living with chronic illness in our community.  

While health care providers are often quick to blame diabetic patients for therapeutic inertia we, as health care providers, play a significant role in helping them manage their chronic illness. By simply prescribing more medications and disregarding other aspects of diabetes management, we’re failing to address the root causes of their health problems.  

Let’s look at the big picture of diabetes management: nutritional components, exercise  regimens, and a variety of medications.

If a patient sees specialists for all these elements, they must schedule multiple appointments with separate co-pays. They may have to take several days off work, and some face additional childcare costs to accommodate  those appointments. It’s no wonder we see so much therapeutic inertia. 

To make life easier for people coping with chronic illnesses, we’ve created the Intensive Diabetes Education and Support (IDEAS) Program. Participants value our program because it packs the core components of diabetic care into a single day. We focus on providing patients  and their care partners (like family members or friends) with the tools to successfully manage diabetes.  

A day in the IDEAS program 

We offer our program at the Utah Diabetes and Endocrinology Center. Although we have  specialists to discuss different components of diabetes, we know that diabetes often happens within a social context. Many participants prefer learning from their peers rather than through lectures alone. We use a small group format and encourage people to bring their care partner along to learn with them.  

Coping with diabetes: First, a social worker discusses coping with diabetes. People with diabetes statistically have higher rates of depression and anxiety, so we believe coping is at the core of self-care activities. If you are struggling to cope, it’s harder to motivate yourself to take your medications, exercise, or eat right.  

Setting SMART goals: Next, we talk about SMART goals, or specific, meaningful, adaptable, realistic, and time-bound goals that we want to accomplish. By the end of the day, we want our participants to set a goal they will work towards in the next 24 hours, and something they’ll work on for the next three months.  

Discussing diabetes: After we set our goals, a certified diabetes care and education specialist provides more context on what diabetes is, and how it impacts our patients’ lives. These discussions include what labs to expect, possible complications of diabetes, how to troubleshoot glucose levels, and recommendations for regular screenings and vaccines. 

Eating habits: Eating habits heavily impact our patients’ quality of life. Even when physicians recommend healthy changes, many people struggle to make those changes because they don’t understand why they’re important. 

First, we talk about the basic physiological components of diabetes. We draw the connection between sugar and insulin so patients can understand: “As I eat more sugar, I know it turns into fat cells, and those fat cells lead to more insulin resistance.”  

Then we move on to healthy eating habits. Our participants learn about the plate method, and how to manage carbohydrates based on their specific needs. We discuss a list of food and portion sizes.  

Each person learns to make educated choices that will help them take control of the way they eat and feel.  

Up-to-date treatments: Although newer medications and treatments for diabetes have become more accessible, many patients haven’t had the opportunity to learn about them. Technologies like glucose monitoring systems, smart insulin pens and insulin pumps simplify self-care. Innovations in medications and other treatments, like bariatric surgery or GLP-1s and SGLT-2s injectables, can aid in weight loss more than dated alternatives. 

Primary care sheet: At the end of the day, we give our patients a primary care sheet and summary to help them keep track of new medication recommendations, basic screening and vaccination information, and their goals moving forward. We also embed these documents  into EPIC so participants can share what they have learned with their primary providers.  

Cultural competencies and considerations: Spanish IDEAS program 

Because of our culturally diverse region, we also offer the program in Spanish. We ensure participants have providers that speak their language and understand their community dynamics. We personalize the experience by including culturally appropriate recipes and tips. For example, some patients might prefer a Latin dance class to going for a walk. We also discuss questions or myths about diabetic treatments specific to Latinx cultures.  

Even though it is just a one-day program, it has lasting effects. People have developed a support system that transcends the classroom. One group put mile markers along a local walking path to celebrate their progress and changed their community’s perspective on being more active.  

Our program teaches the value of improved diabetes management, weight loss and overall quality of life.

We have witnessed powerful and inspiring changes in our participants. 

From opening up to family and friends about their diabetes, to achieving their SMART goals, people have gained new confidence and outlooks on life.