ED: Those with type two diabetes are almost routinely referred to a diabetes educator. But those with type one can benefit just as much.

To whom does the job of managing type one (T1) diabetes belong to – the patient, GP or endocrinologist? Type 1 diabetes mellitus management should be a team effort. There are approximately 120,000 Australians with type one diabetes compared to about 2,000,000 with type two diabetes (T2). Both forms have similarities but are vastly different conditions.

Team approach may work best

The cornerstone of management is the GP (generally the first point of contact), who oversees the provision of comprehensive care for the T1 patient. The GP’s role is very local. Support and encouragement are essential for the T1 patient to better self-manage. And involving a Credentialed Diabetes Educator (CDE) and Endocrinologist are important parts of care.

Ms Leontine Jefferson, Diabetes Educator

Some patients may be new to T1 in their adult years, yet others grew up with it. However, they may not have seen an educator/specialist for a variety of reasons. Encouragement from the GP goes a long way to re-establishing healthy relations with a team of health care professionals, perhaps better than the lone approach to taking care of the patient with T1.

A care plan (EPC) under a team care arrangement (TCA) is the best way to refer T1 patients to a CDE. This way the patient can claim a Medicare rebate. Each T1 patient should get enough visits with an educator – a minimum of three visits each year, allocated appropriately.

What will patients gain from a CDE?

Firstly, up-to-date information around the management of their condition. This includes the latest technology such as insulin pump therapy, continuous glucose monitoring, flash meters, bolus calculators, closed loop options, and implantable sensors. Furthermore, general diabetes education is also critical. We are always learning and growing.

Assisting patients and relieving some of the burden that comes with this chronic condition is invaluable.

Providing greater freedom and control for “the T1” ultimately improves health outcomes long term. We are all part of the same team and the patient living with T1 is the driver, and all those in support make their drive a pleasant and safe one. Recognising our roles will go long way to making a smoother journey.

Key messages

  • Type 1 patients need tailored support to help them self-manage.
  • The team is the GP, endocrinologist and credentialed diabetes educator (CDE).
  • A CDE provides education and puts the patient in touch with technological advancements.

References available on request.

Questions? Contact the editor.

Author competing interests: nil relevant disclosures.

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