An Occupational Therapist’s Role as a Diabetes Educator
Interested in becoming a Diabetes Educator? This guest post, written by Occupational Therapist and Certified Diabetes Educator Debra Sokol-McKay, shares how you can get started in this specific field of OT. We want to give Debra a huge thanks for sharing her insight with us!
Diabetes is a complex disease – one filled with the potential for many problems and complications. It can be life threatening as well. A diabetes educator is a healthcare professional who is specialized and certified to teach someone how to manage their diabetes.
What Do Diabetes Educators Do?
Diabetes educators teach their clients the tools and skills necessary to control their blood glucose and avoid long term complications due to hyperglycemia.
Occupational therapy practitioners have an important role to play in this as well. OTs can teach their clients how to live a healthy lifestyle to prevent diabetes or live with diabetes as well as how to continue managing diabetes when they experience a disabling complication like vision loss, stroke, neuropathy, or any other disabling condition such as arthritis or tremors.
How Diabetes Education Can Be Incorporated in Your Practice
Many occupational therapists can incorporate elements of diabetes education into their current practice. For example, an occupational therapy practitioner can discuss the need for a foot exam and have a client examine their feet after a bath or before getting dressed. An OT practitioner can follow a client’s meal plan during a cooking session and instill healthy cooking methods.
If a client is unable to depress the dosage dial on an insulin pen to administer their insulin, an OT can provide a tailored hand strengthening program. An OT can help a client to develop a sustainable and individualized exercise program for weight management. An OT practitioner can teach techniques and tools for controlling tremors when inserting a test strip into their blood glucose meter.
An advanced OT specializing in vision loss may work with a client that has vision impairment to manage all areas of diabetes self-care including use of a visual or talking blood glucose monitor, non-visual insulin measurement, and adaptive techniques for portion control.
An OT whose expertise lies in physical disabilities can assist a client with a stroke to perform blood glucose monitoring and insulin measurement one-handed and how to engage in exercise with hemiplegia or hemiparesis. Lifestyle management can also be an area of advanced practice for OTs working with persons with diabetes.
Lifestyle change may require the OT to teach and promote integration of new habits and routines into their lifestyle, which might include new medications and added physical activity. Some OTs are also specializing in obesity management.
Since 90% of persons with Type 2 diabetes are obese or overweight, these OTs also need to have advanced expertise in all facets of diabetes self-care. These interventions are all within the scope of practice of occupational therapy and are examples of activities that enable clients to achieve their objectives in managing diabetes.
Occupational therapists need to recognize when their clients are experiencing low blood glucose and what treatment is necessary. They need to recognize anxiety and depression related to diabetes and what interventions might be necessary.
Occupational therapists should be able to recognize the multitude of complications and how they impact the function of their client with diabetes. They also need to aware of when they can no longer meet the specific needs of their client with diabetes and need to refer to other healthcare professionals.
How Can You Become a Certified Diabetes Educator?
Occupational therapy is a qualifying profession to become a Certified Diabetes Educator. The certifying body of diabetes educators is the National Certification Board of Diabetes Educators (NCBDE). To become a Certified Diabetes Educator an Occupational Therapist must be licensed and hold at least a Masters’ level degree in their profession.
Have 2 Years of Practice
The occupational therapist must have 2 years of practice within their field and a minimum of a 1000 hours of providing diabetes education experience earned within 5 years before the application date, with a minimum of 20% of those hours accrued in the most recent year preceding application. These changes have been updated since April 1, 2021 due to the current health crisis. Be sure to check the NCBDE site for the most current requirements.
A minimum of 15 clock hours of continuing education [see why MedBridge is My OT Spot’s recommended CE provider] applicable to diabetes is required to sit for the exam. The continuing education activity must be earned within the 2 years prior to applying for the exam and be approved by a provider on the NCBDE List of Recognized Providers.
There are over 25 providers including AOTA, the American Diabetes Association, and the American Association of Diabetes Educators. A 4-hour written certification exam is required. The written exam consists of 200 multiple choice questions with each question designed to test if the candidate possesses the knowledge necessary to perform a task or has the ability to apply it to job situation.
Healthcare professionals seeking certification as a diabetes educator require an understanding of the pathophysiology of diabetes, it’s many types, modifiable and non-modifiable risk factors, the current interventions and the evidence behind those treatments, among other things.
They must know the myths and realities of diabetes. Diabetes self-management education requires the ability to assess all barriers and design and help a client implement interventions that support effective diabetes self-care. Keeping abreast of new information, medications, technology, nutritional regimes and research is key. Like most fields, diabetes changes rapidly and often.
What OTs Don’t Do
Even if an occupational therapist is a diabetes educator, he or she does not recommend changes in medications or meal plan, does not provide initial instruction in use of a blood glucose meter, nor teach insulin injection techniques.
An OT diabetes educator does not suggest appropriate blood glucose ranges, how to deal with persistent hypoglycemia, or what to do on a sick day. These situations require the intervention of a Certified Diabetes Educator, whose backgrounds are as nurses or dieticians.
Additional Helpful Resources
Currently, occupational therapists that want to provide correct diabetes information need to look to the field of diabetes education or fellow occupational therapy practitioners who have become diabetes educators. There are many books and educational websites available that can provide baseline knowledge about diabetes and it’s treatment.
The most comprehensive publication is the diabetes educators desk reference, “The Art and Science of Diabetes Self-Management,” most recently updated in 2019. Occupational Therapists can and should play a critical part in this important role.
One resource that AOTA has to offer is their current Diabetes Fact Sheet, available here. (This was developed by Debra herself!)
A good first step when deciding about becoming a Diabetes Educator is to seek permission from your local diabetes center to attend and observe the 10-hour group sessions they provide clients that are funded by insurance.
This can acquaint you with what basic diabetes education consists of and introduces you to the local Diabetes Educators for future collaboration.
About the Author
Debra A. Sokol-McKay, MS, OTR/L, CDE, SCLV, CVRT, CLVT, is a licensed occupational therapist, a private practitioner and consultant on diabetes and disability and vision loss. Debra co-authored the 2016 textbook “Low Vision Rehabilitation: A Practical Guide for Occupational Therapists,” and wrote its chapter “Managing Diabetes and Medication.”
She has been a certified diabetes educator for over 20 years, twice served as chair of the Disabilities Practice Group of the American Association of Diabetes Educators (AADE) and was the second lead author of its Disabilities Position Statement. She presented on diabetes and disability numerous times at the AADE conference and the national vision rehabilitation Envision conference.
Debbie wrote the OT and Diabetes Fact Sheet (linked above) for the American Occupational Therapy Association (AOTA) and co-presented AOTA’s podcast on diabetes. She has been teaching diabetes at the Masters and Doctoral level for the past 12+ years at Salus University.
This post was originally written on July 13, 2020 and updated on February 17, 2022.