The following study from the Thomas Jefferson University Hospital describes diabetes as “a self managed disease whereby the patient provides 95% of the daily care”. It continues that education is the prerequisite and ongoing contact (coaching) maintains compliance and saves lives as well as health care cost.


HealthWorks – Achieving Balance with Diabetes

A Diabetes Self-Management Education Program

of Thomas Jefferson University Hospital


Diabetes is a common, serious, and costly disease that affects an estimated 16million people in the United States. It impacts many aspects of the lives of diagnosed patients and their families, the health system, and society. People with diabetes are more likely than their non-diabetic peers to have heart attacks, strokes, amputations, kidney failure, and blindness. As a result, they have a more frequent and intensive visits within the health care system. A great number of hospitalizations are for acute problems such as foot ulcers, acute myocardial infarction, circulatory and nerve problems, and pneumonia.1 As evidenced by the Diabetes Control and Complications Trial (DCCT), many of these complications can be prevented with better glucose control.2


Because diabetes is a self-managed disease with the patient providing more than 95% of the daily care, patient education is the fundamental prerequisite for diabetes Self-management.3 Diabetes education is viewed by many as a “process” whereby a patient develops his/her knowledge base and improves his/her skills related to compliance with the recommended treatment plan. Modern diabetes self-management education programs emphasize patient empowerment rather than strict adherence to a regimen.4 HealthWorks at TJUH has been designed to support the current model of self-management education. In order to accomplish this, the program places emphasis not only on one’s knowledge and skill level, but most importantly on improving one’s self-confidence by helping them to:


• Identify and set realistic goals;

• Problem-solve

• Manage stress caused by living with diabetes;

• Identify and obtain social support; and

• Develop a plan for changing behavior


1. Patient-reported outcomes measurement to be featured in diabetes management

study. UHC Clinical Practice Alert. June 1997.

2. Implications of the Diabetes Control and Complications Trial. Diabetes Care 1998;21; Suppl.1:88-90.

3. Anderson RM, Fitzgerald JT, Oh MS. The relationship of diabetes-related attitudes

and patients’ self-reported adherence. Diabetes Educator 1993; 19: 287-292.

4. Anderson RM, Funnell MM, Butler PM, Arnold MS, Fitzgerald JT, Feste CC. Patient

empowerment. Diabetes Care 1995; 18(7): 943-949.



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