#OnTheMap – Diabetes Self-Management Education

‘We are Here to Help’

Gwen Knight Ellen LaRiccia Melissa Stehwien Diabetes Education 2017
CRMG’s Certified Diabetes Educators     (L to R): Ellen LaRiccia, Gwen Knight, Melissa Stehwien

Cheyenne Regional Medical Group’s (CRMG) Diabetes Self-Management Education program offers support and education to people with type 1, type 2 and gestational diabetes as well as those diagnosed with prediabetes.

The Diabetes Self-Management Education program has been offered at CRMC for more than 10 years, and all of the program’s current certified diabetes educators have been on staff for more than five years.

“We have the resources and the experience to help community members who need to know more about the disease and who also need help managing it,” said Melissa Stehwien, the program’s coordinator and a certified diabetes educator.

What is Diabetes?

Diabetes is a chronic disease that occurs when the body either does not produce, or is unable to properly use, insulin. Insulin is a hormone that helps sugars reach the body’s cells, where it is used to provide fuel that the body needs to function.

Uncontrolled diabetes causes chronically high blood sugar levels, which can lead to serious complications, including heart attack, stroke, kidney damage, blindness and loss of limbs.

While there is no cure for diabetes, it can be managed, and that is where the Diabetes Self-Management Education program at CRMG comes in.

“The Diabetes Self-Management Education course is a foundation to help people with diabetes manage the disease and achieve a better quality of life, while preventing long-term complications,” said Gwen Knight, a registered dietitian and one of the program’s certified diabetes educators.

Outreach to Community

In 2016 more than 460 people participated in CRMG’s Diabetes Self-Management Education program as outpatients. The program’s diabetes educators also consulted with 513 inpatients with diabetes or prediabetes who were being cared for at Cheyenne Regional Medical Center.

Training tools used for diabetes education.

“This disease is becoming much more prevalent, both nationwide and locally,” said Ellen LaRiccia, who also works for the program as a certified diabetes educator. “And while our program is seeing more patients each year, we know there are many more people in our city and county who could benefit from the information and resources we offer. We want them to know we are here to help.”

Because cost can be a factor for people seeking assistance, the diabetes educators also want the community to know that the Diabetes Self-Management Education program is a covered

benefit for Medicare beneficiaries and many people with private insurance.

“It’s vitally important for people with diabetes to learn how to manage the disease properly,” Stehwien said. “We can provide the information and resources to help those who are newly diagnosed or who need some additional support and guidance.”


The Diabetes Epidemic

Diabetes has been on the increase in the United States for several years–so much so that many health professionals are now calling it an American epidemic.

The statistics below, from the American Diabetes Association®, show that the disease impacts about one out of 10 Americans, and is especially prevalent among people 65 years and older. Perhaps even more alarming is that many Americans have the disease and don’t know it.

  • Prevalence: In 2015, 30.3 million Americans, or 9.4 percent of the population, had diabetes.
    • Approximately 1.25 million American children and adults have type 1 diabetes.
  • Undiagnosed: Of the 30.3 million adults with diabetes, 23.1 million were diagnosed, and 7.2 million were undiagnosed.
  • Prevalence in Seniors: The percentage of Americans age 65 and older remains high, at 25.2 percent, or 12.0 million seniors (diagnosed and undiagnosed).
  • New Cases: 1.5 million Americans are diagnosed with diabetes every year.
  • Prediabetes: In 2015, 84.1 million Americans age 18 and older had prediabetes.
  • Deaths: Diabetes remains the seventh leading cause of death in the United States in 2015, with 79,535 death certificates listing it as the underlying cause of death, and a total of 252,806 death certificates listing diabetes as an underlying or contributing cause of death.

“A very small percentage of people who are eligible to receive diabetes education are referred to programs like this,” Knight said. “It is very underutilized.”

Another reason for underutilization can be fear:  “Sometimes people are afraid of what a diabetes diagnosis really means or may even be in denial,” LaRiccia said. “We can calm those fears by helping people have a better understanding of what diabetes is and how they can take care of themselves to reduce their risks and complications.”

While a referral is required to participate in the program, CRMG’s diabetes educators will initiate that process. “We want to be sure anyone who could benefit from this program has that opportunity,” Knight said.

       On the Map diabetes education training tools

Services Offered

CRMG’s outpatient Diabetes Self-Management Education is accredited by the American Diabetes Association, indicating that it meets rigorous national standards.

The program is appropriate for both adults and children diagnosed with diabetes.

Each participant receives up to 10 hours of instruction during the first year and from two to four hours in subsequent years.

Participants meet one-on-one with a certified diabetes educator and registered dietitian to learn skills that will help them live healthy, active lives.

The program is also able to help people with different kinds of diabetes. In 2016, about 8 percent of CRMG program participants had prediabetes, 10 percent had type 1 diabetes, 15 percent had gestational diabetes and 66 percent had type 2 diabetes.

The program is recommended when a person is first diagnosed with diabetes, for annual follow-ups and if any significant change occurs in the person’s health.

“We use a very individualized approach,” Knight said. “We work to determine the best course of treatment for each person, with the goal of helping each participant achieve improved health and improved quality of life.”

Topics covered may include:

  • Medical nutrition therapy
  • Exercise prescription
  • Medication instruction
  • Prevention and treatment of acute and chronic complications
  • Self-monitoring of blood glucose
  • Stress management
  • Healthy eating
  • Staying healthy for a lifetime
  • Preconception/pregnancy management or gestational diabetes management
  • Telemedicine
  • Continuous glucose monitoring training
  • Insulin administration
  • Insulin pump training
  • Instruction on insulin delivery devices

“We understand how hard it can be to change lifestyles and habits,” Stehwien noted. “The good news is that we have a solid track record of helping people make the changes needed to help them successfully manage this disease and focus on moving forward with their lives.”