“…Studies indicate that instructors without specialized training in diabetes (51, 83-89), behavioral interventions (74,76,79,90 -92), teaching and learning skills (53, [93][94][95][96][97], and counseling skills (78,98) may not focus on patient behavior change, and therefore, clinical outcomes may not improve. Quality diabetes care and education require that professional staff have continuing education in diabetes educational strategies and behavioral interventions beyond their basic preparation (77,78,85,87, 94,98,99).…”