Each person is unique in their combination of physiological, lifestyle, cultural, emotional and cognitive needs and responses to experiencing life with diabetes. Never has the requirement for personalized diabetes care been more accepted and possible.

Empowerment to practice self-care

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CDE clients understand their doctor or other healthcare professional is not solely responsible to ‘look after’ their diabetes. People with diabetes themselves must make choices and decisions about managing, caring for and coping with their condition daily. These decisions can significantly affect their health and well-being, positively or negatively.

It is thus vital that people with diabetes are empowered to make informed and insightful choices and decisions.

Unfortunately, funders of healthcare often ignore 'diabetes education', the process by which specially trained health professionals coach people with diabetes to acquire the skills and confidence to perform meaningful self-care across a lifespan of developmental changes and milestones. In contrast, we consider diabetes education to be one of the most important aspects of successful diabetes care. We place significant focus on providing our clients with insight and problem-solving ability in addition to correct information. We encourage each of our clients to consult with their diabetes educator regularly to prevent rather than treat any foreseeable problems.

Facilitation of self-care by a passionate Management Team of health care professionals with specialized training and knowledge is essential in the care of diabetes. The members of the Diabetes Team provide diagnosis, counselling, coaching, education, treatment and lifestyle options, support and motivation.

In addition to a doctor, input from a diabetes educator, dietician, podiatrist, ophthalmologist, pharmacist, biokinetics and psychologist (amongst others), is necessary at various times to maximize care and quality of life.

Importantly, the doctor is not the head of this team – it is the person with diabetes and their family.

Community Diabetes Associations like Youth With Diabetes, Diabetes South Africa and SA Diabetes Advocacy are a vital part of the wider diabetes team to provide support and advocacy where most diabetes care occurs – in the community.

It is essential to ensure that diabetes and its associated risk factors are 'Treated to a Safe, Individualized Target' – a best-practice approach adopted by the CDE.

The treat-to-target approach ensures that both people with diabetes, as well as their treating healthcare providers, know and understand the individualized health targets to aim for.

Ideally, as clinically indicated, every person with diabetes would know what their targets are for things like:

• HbA1c
• Fasting, pre-meal and post-meal (as advised), blood glucose readings
• ‘Time-in-range’
• Cholesterol and other serum lipids (fats)
• Blood pressure
• Body composition
• Waist circumference

In addition, kidney function, growth (in children) and eyes and feet need to be checked.

These important parameters need to be measured regularly, and treatment therapies need to be proactively adjusted and fine-tuned by healthcare professionals to help achieve the needed targets. The aim is to prevent ill-health, and promote wellness and best quality of life, using as few scarce health resources as needed.