The number of people with diabetes in China is the highest in the world, and one out of every three to four people with diabetes in the world comes from China. In recent years, the number of people with diabetes and the high-risk groups in China have increased rapidly. Systematic scientific, life-oriented and personalized education related to diabetes plays a very important role in the family and life outside of hospital treatment of diabetes. Some studies show that for every 1% decrease in glycosylated hemoglobin, the microangiopathy and nephropathy caused by diabetes can be reduced by 50%. With good glycemic management, most patients can avoid the end of going on dialysis. And it is proven that the patients with good blood glucose management are not the ones who use the most medication, but the ones who receive education and are able to carry out healthy diet, appropriate exercise, etc. on their own. Diabetes education: an effective treatment Q Why do we need diabetes education? A Xiaowei Guo: Through education, we can change patients’ awareness and help them develop healthy living habits. ”Education is a very important form of treatment for people with diabetes.” Xiaowei Guo gets right to the point and points out the important role of diabetes education. Heredity is a major cause of diabetes, and genetics is an unchangeable factor. “We can’t choose our origins, but we can choose to walk our own path. What is that path? In terms of diabetes it is lifestyle change. If a person does not believe in the role of a good lifestyle and does not have the knowledge and skills to do so, how can they do it? Therefore, it is necessary to be educated, recognize the concept and learn the skills.” Guo Xiaowei told reporters. Lifestyle changes permeate every aspect of daily life. How much should you really eat every day? How to eat? …… These questions may seem too small to be taken for granted, but they are very important. Because life cannot be sustained without the intake of energy. “Through education, patients are equipped with the means to solve these problems. For the patient, the first step is to learn the theory and know why to change; and then to learn the skills and know how to change; and then to make up one’s mind and make the change. For the educator, it is also important to assess whether the education is working and to correct the problem in a timely manner.” Without education, this whole process would be difficult to move forward, according to Guo Xiaohui. However, it is never easy to change a lifestyle that has been developed over time. Society is developing and civilization is improving, but that doesn’t mean people’s lifestyles are getting healthier. Cars are everywhere, bicycles are gradually “fading out”, the simple lifestyle of the past no longer exists, and many problems have arisen one after another. On the road to diabetes education, Guo Xiaohui will have a long way to go. ”In addition to lifestyle, education also includes patient self-management. For example, how to measure blood sugar, when to measure, and how to deal with hypoglycemia when it occurs. Patients can only control their own destiny if they master this knowledge themselves.” Guo Xiaowei introduced. There are various ways of education, including theoretical lectures, group discussions and one-on-one education, and different forms of education serve different purposes. Among them, one-on-one education is the most effective, mainly focusing on skills training, teaching patients how to measure blood sugar and inject insulin through lectures and operations, demonstrations and counter demonstrations. 80% of patients have received education but the quality is still difficult to assess Q What is the current level of diabetes education? A Xiaowei Guo: There are still very few diabetic patients who can really manage themselves well. In the interview, Guo Xiaohui gave a set of data: half of the patients who came to the hospital with undiagnosed diabetes, only 1/3 of those diagnosed with diabetes received treatment, and only 1/4 of those who received treatment were well controlled. It is clear from these statistics that the current state of diabetes treatment is worrisome. How many people have received formal diabetes education? And how many people can really make changes in their lifestyles? Guo Xiaohui told the reporter that through the survey, it was found that many of the patients receiving treatment had received diabetes education, but not many of them were really willing to make changes. Through a questionnaire survey of some large hospital outpatients, 80% of them answered that they had received education, but the quality of education was still very poor. It is difficult to make a comprehensive assessment of education through previous surveys. Diabetes education in many hospitals across the country only stops at inpatients, while outpatient clinics are not dedicated to patient education because diabetes education has not been given enough attention and the benefits of diabetes education are not seen. “In fact, education for diabetic patients in the outpatient setting is the most important.” Guo Xiaowei noted. Speaking of another reason for the lack of diabetes education in outpatient clinics, Guo said, “In Beijing and Shanghai, education is done relatively well because outpatient costs are reimbursed. But in many areas, the reimbursement rate for outpatient medication is particularly low, so many patients give up coming to the clinic for financial reasons and instead buy some random medication and take it on their own. In this way, many diabetic patients lose the opportunity to receive education.” Standardize education and certification first Q What important work has the Education Group of the Chinese Medical Association Diabetes Branch carried out? A Guo Xiaohui: Training diabetes educators and certifying education management units. ”First of all, an important work carried out by the school group is training diabetes educators and certifying educators.” Guo Xiaohui introduced that, up to now, more than 500 educators nationwide have been certified by the Chinese Medical Association for diabetes educator training. Diabetes educators need to be qualified to practice for doctors, nurses, dietitians and other medical-related professions. As an education provider, in addition to the theoretical knowledge of diabetes and operational skills, they should also have the skills to conduct education. Secondly, a diabetes education management unit certification is conducted. According to Guo Xiaowei, the units that apply for certification are based on “diabetes management team,” “premises,” “education curriculum system,” “regular follow-up system,” and “evaluation system. The accreditation process is based on six criteria: “diabetes management team,” “premises,” “educational curriculum,” “regular follow-up system,” “evaluation system,” and “management and support services for subordinate units. Guo Xiaohui introduced that the accreditation process is now in its second phase, with 99 units accredited in the first phase and more than 200 hospitals already registered for the second phase. The purpose of the accreditation process is to promote the standardization of diabetes education management in China, so that patients with diabetes can receive high-quality education. In order to implement systematic and standardized education, the group will also launch targeted education programs. “Foreign diabetes management programs have become more mature. For example, the structured glucose management program in the United Kingdom provides a standardized glucose management model for many European countries. Through online registration, patients everywhere can participate in the program and learn how to manage their blood glucose. One particularly important issue is how to eat, and the program provides a detailed introduction.” Guo Xiaowei points out that education programs like the one in the United Kingdom provide a good reference case. Diabetes education should be paid for by a third party Q What are the current difficulties in promoting diabetes education? A Xiaowei Guo: The lack of sustainability and the quality of education still needs to be improved. Diabetes education has made initial progress, but what worries Guo Xiaowei is that it is very difficult to sustain diabetes education, and the key issue is funding. In China, the lack of a third-party (health insurance and social insurance) payment mechanism has greatly restricted the advancement of diabetes education. At present, patients who progress to diabetic nephropathy and have to undergo dialysis due to deterioration of their condition have their dialysis costs reimbursed by medical insurance, while there is no third-party payment for patient education, which involves less investment and more return, which, according to Guo Xiaohui, is really putting the cart before the horse. “There are more than 100 million diabetic patients in China, and if these patients’ conditions deteriorate and they have to undergo dialysis, it will be a huge amount of money. Therefore, third-party institutions should weigh the need to pay for education in order to benefit in the long run and to develop in a lasting way.” From the hospital side, there are no diabetes education positions set up yet. Guo Xiaohui believes that education should be incorporated into hospital management and hopes that patient education will be included as an indicator in future hospital grade reviews, so that third parties are also made aware of the importance of diabetes education. Of course, the first step is to have a good design that can provide evaluable information for third-party payers. Because the lack of a third-party payer mechanism also affects the motivation and incentive to educate, its quality is then greatly reduced, which is another problem currently faced. ”Therefore, in the future, diabetes education should be included in the third-party payment mechanism.” This is the point that Guo Xiaowei kept emphasizing during the interview. She hopes this day will come soon.