Lifesaving lessons: Diabetes self-management classes help lower dangerous blood sugar levels

Texas is expected to have nearly eight million residents suffering from diabetes by the year 2040, according to a 2010 report released by the Texas Health Institute, State Demographer’s Office and Methodist Healthcare Ministries of South Texas.  In response to this epidemic, the Texas A&M Health Science Center Coastal Bend Health Education Center (CBHEC) Diabetes Education Program provides resources to residents and health professionals of the Coastal Bend on how to prevent and control this disease.

This program, accredited by the American Diabetes Association (ADA), educates the public about diabetes as a disease.  Diabetes self-management classes provide support to prevent onset of type 2 diabetes and to keep the disease under control once diagnosed. In addition, community events offer programs to schools and workplaces across the Coastal Bend. This year, a total of 3,227 people were touched by the efforts of the program. 

Diabetes self-management education (DSME) is a critical part of care for those with diabetes and, according to the ADA, is necessary in order to improve patient outcomes.  CBHEC’S Diabetes Education DSME classes are offered in English and Spanish to provide guidance with blood glucose monitoring, medication and insulin administration, nutrition support, and physical activity opportunities.  Attendance has increased drastically over the life of the program with 1,276 attending in 2013. 

Health professionals use the Hemoglobin A1C test to assess a person’s average blood glucose (blood sugar) levels over the past two to three months. It does this by measuring the percent of hemoglobin (the protein in our red blood cells that carry oxygen) that has glucose attached to it.  For people without diabetes, the normal range for the A1C test is between 4% and 5.6%. To control diabetes, the ADA suggests a target level below 7.0% in those who have already been diagnosed.

“We have one patient that came to class who is losing her eye sight and needs assistance when walking for guidance,” said Delia Martinez, the program’s interim coordinator.  “She came in with an A1C of 7.3%, which is good, but now it is down to 5.0% and she has lost 47 pounds.”

A key component to achieving success in a DSME class is the follow-up care. Every three months for one year, class participants are provided with complimentary follow-up labs and one-on-one consultation sessions.

“Follow-ups continue the education patients received in our class,” said David Leal, health educator.  “We can answer questions that patients are likely to have after trying to apply the strategies they learned in class.”

In 2013, 249 patients who participated in the initial DSME class had A1C levels greater than 10%. At this level, patients are at high risk for serious complications, such as skin disorders, high blood pressure, hearing and vision loss, amputation and even death. Of those patients, 79 (31%) returned for their follow-up appointment, at which their A1C tests revealed an overall decrease of 3.2% (from 11.97% to 11.6%).  This may not seem like much, but according to the United Kingdom Prospective Diabetes Study (UKPDS), each 1% reduction in mean A1C levels is associated with a 21% reduction in the risk of diabetes-related complications or death.

To lower A1C levels, Leal recommends that patients take their medications as directed and keep their appointments with their healthcare providers and diabetes education program.

“We empower participants of our program to make change,” Leal said, “change that is appropriate in each of their lives and individual situations.”

To learn more about the classes offered or to schedule an appointment, please call (361) 857-2945.