Diabetes Literacy

Seventh Framework Programme European Commission

Martha Funnell

    "Patients aren't interested in diabetes, but they are highly interested in their own diabetes".

    At the event Diabetes Literacy. Strengthening Diabetes Self-Management for All in Europe (Brussels. November 17, 2015), Martha Funnell from the University of Michigan in the US talked about What, Why and How of Diabetes Self-Management Education (DSME) . She advocated patient centered, modern teaching strategies: "Patients aren't interested in diabetes, but they are highly interested in their own diabetes".


    Patient centered teaching strategies should be based on adult learning. It means teaching is no lecture, and should respond to questions based on patient concerns. They are empowerment-based and should integrate clinical, behavioral and psychosocial perspectives. The patient experiences serve as the curriculum, including an assessment of the role of family members and friends in making healthcare decisions.

    Reality of diabetes

    Diabetes education is essential because the reality of diabetes is that 99% of diabetes management is self-management.

    Martha Funnell: "Self-management and patient decision-making greatly impact outcomes. From research and practice we know that self-management is primarily affected by psychosocial issues and diabetes-related distress"… "Initially focused on knowledge and compliance as the major outcome, recently it is recognized that we should address knowledge, behavior and psychosocial aspects, along with providing on-going support".

    Diabetes Algorithm

    In a joint position statement of major US diabetes organizations, ms. Funnell and co-authors recently introduced the Diabetes Education Algorithm. This is an evidence-based visual depiction of when to identify and refer individuals with type 2 diabetes to DSME. The algorithm defines four critical time points for delivery and key information on the self-management skills that are necessary at each of these critical periods: at  diagnosis, an annual assessment of education, nutrition and emotional needs, when new complicating factor influence self-management and when transition in care occurs.

    The algorithm relies on five guiding principles and represents how DSME should be provided through patient engagement, information sharing, psychosocial and behavioral support, integration with other therapies, and coordinated care. The education algorithm can be used by health care systems, staff, or teams, as well as individuals with diabetes, to guide when and how to refer to and deliver/receive diabetes education. The ultimate goal of the process is a more engaged and informed patient.


    Note for editors:

    Martha M. Funnell, MS, RN, CDE, FAADE is Associate Research Scientist of Learning Health Sciences and Adjunct Lecturer of Nursing at the Department of Learning Health Sciences of Michigan University Medical School. She published over 170 peer-reviewed publications, and was co-author or editor of 6 books. Her research interests include patient empowerment, diabetes self-management education and support, patient-centered medical homes, care management for chronic disease and shared decision-making. Ms. Funnell is member of the Scientific Advisory Board of the Diabetes Literacy project.

    Diabetes Literacy (www.diabetesliteracy.eu) is a pan European project aimed at strengthening patient self-management by exploring what exists and works, as well as the potential for improvement. The Diabetes Literacy project (2012/2015) received funding from the European Union's Seventh Framework Programme for research, technological development and demonstration. The project is implemented by a Consortium of research organizations from six EU Members States, three non-EU Member States and two collaborating partners.

    On November 17 2015 the Diabetes Literacy consortium has organized its final public event in the Management Centre Europe in Brussels, back-to-back to the 3rd European Health Literacy Conference. Event website: http://ehlc.eu-ems.com/practical.asp?event_id=253&page_id=2285

    Further information: info@diabetesliteracy.eu