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Aug 28, 2014
Ask anyone in the Alabama public health department’s Diabetes Prevention and Control Program (DPCP) and they’ll tell you the NDEP’s Road to Health toolkit has lived up to its name, serving as a map to help educate Alabamans about diabetes in schools, senior centers, and prisons throughout the state.
Intended especially for African Americans and Hispanics/Latinos at risk for type 2 diabetes, the Road to Heath toolkit provides materials for community health workers to develop an outreach program that emphasizes type 2 diabetes can be delayed or prevented. Debra Griffin, the DPCP’s diabetes nurse educator, says Road to Heath is most effective for its simple, three-pronged message about healthy food choices, exercise and weight loss.
Students in the Diabetes Ambassador Program at Resurrection Catholic School with LaMont Pack (far left) and school principal Sr. Gail Trippett in March 2014
In the last year and a half, DPCP staff members have hosted Road to Health sessions at 15 senior centers, where they educated about 355 residents. And they trained employees at the Alabama Office of Minority Health, who, in turn, led a Road to Health course at four prisons.
LaMont Pack, the DPCP’s community-clinical linkages manager, says he’s also visited “churches that you can’t get to with a GPS” to spread the word about how to prevent and manage diabetes.
“The things you do to prevent diabetes are the same things you do to prevent its complications: nutrition and physical activity,” Pack says.
Meanwhile, Pack and his staff have used other NDEP resources to educate the younger generation about diabetes and its effects. In March, Montgomery, Ala.-based Resurrection Catholic School implemented the Diabetes Ambassador Program, in which seven student ambassadors educated their peers, teachers, school staff members, and parents about diabetes prevention. The students wore Blue Circle pins from the International Diabetes Federation to promote the global symbol for diabetes, and on March 25—Diabetes Alert Day—the school’s principal allowed students to wear the color blue (instead of their required uniforms) to raise awareness about diabetes.
Jul 31, 2014
As a dentist with type 1 diabetes, Dr. Martin Gillis not only brings first-hand experience of the disease to his role as a healthcare provider, he also understands that the best care for people with diabetes should come from a team of healthcare professionals who provide dental, podiatric, optometric and pharmacy (PPOD) services.
The National Diabetes Education Program’s (NDEP) resources have helped Dr. Gillis educate patients with diabetes and their healthcare providers around the world. Specifically, he has incorporated NDEP PPDOD information in his lectures on diabetes and oral health at the International Diabetes Foundation’s World Diabetes Congress and World Dental Federation’s World Dental Congress. Last year, Dr. Gillis received the Sir Alister McIntyre Distinguished Award for Integrative Medicine at the University Diabetes Outreach Program’s International Diabetes Conference in Jamaica, his achievements were profiled in the American Diabetes Association’s Diabetes Forecast.
“Oral disease needs to be related to the broad NCD (non-communicable disease) agenda by addressing how improvements in oral health will positively affect general well-being for a healthier society,” says Gillis, who serves as the registrar at the Provincial Dental Board of Nova Scotia in Halifax, Nova Scotia. “The connection between diabetes and oral disease does not exclusively reside in the relationship between periodontal disease and glycemic control, but extends to common modifiable risk factors such as poor nutrition, and the need to prevent and control diabetes and oral disease by building positive health behaviours through self-efficacy.”
Dr. Gillis will continue to lend his expertise to NDEP when he presents on team care and oral health and diabetes in the upcoming PPOD webinars, Working Together to Manage Diabetes: Tools and Strategies for Pharmacy, Podiatry, Optometry, and Dentistry. Click here for more information.
“To make positive change, we must foster partnerships among all stakeholders to reduce the social and economic burdens of oral disease and diabetes,” Gillis says. “I’m very thankful to have the opportunity to serve the National Diabetes Education Program in its valuable work to improve the lives of people with diabetes.”
Jul 03, 2014
For primary care physician Dr. Kevin Peterson, the National Diabetes Education Program’s (NDEP) resources serve the dual purpose of helping him educate his patients and meeting health reform’s goal of patient-centered care.
And Peterson—who has worked with diabetes patients since 1991—says that’s an important message for other primary care providers, not just because these clinicians treat so many diabetes patients, but also because this patient population now has better access to information about how to manage their disease. By his estimate, there are about 220,000 primary care providers and only about 4,000 endocrinologists, and diabetes is one of the most common diseases that a primary care provider sees.
“NDEP has always been good at understanding the importance of both the patient and the extended health care team,” Peterson says. “I think that the importance of that extended team is only increasing and getting larger. As that happens, it’s essential for the care to remain patient-centered.”
Through the years, Peterson has used NDEP’s resources to develop a maintenance-of-certification module for the American Academy of Family Physicians. And currently he uses NDEP materials—particularly those translated into multiple languages—for the “After Your Visit” summary that he’s required to submit for the federal government’s electronic health records incentive program. He’s especially excited about the Practice Transformation group, which he sees as an opportunity to help primary care providers keep pace with the rapidly changing U.S. health care environment.
“The speed of transformation just continues to accelerate with the introduction of accountable care and the many different models that are being proposed for reimbursement,” Peterson says, adding that regardless of the political landscape, having health care providers share financial risk and understand who their patients are will serve as a support for diabetes and all chronic diseases. “The transformation of care will continue to happen. We will be focusing more on support of diabetes outside of the practice and providing people with the tools of self-management that we did in the olden days when we waited for them to show up outside our door.”
May 23, 2014
Diabetes occurs in people of all ages, but it is more common in older adults. Close to 11 million people age 65 and older in the United States have diabetes. Research shows that older adults with diabetes are at risk for developing other health problems or already have complications such as nerve damage, vision problems and/or cardiovascular disease. The good news is older adults with diabetes can take steps to prevent or delay related health problems, and older adults at risk for type 2 diabetes can take steps to prevent or delay the disease.
The National Diabetes Education Program’s (NDEP) Diabetes Resources for Older Adults page features a collection of resources that are designed to help older adults learn about diabetes management and type 2 diabetes prevention. Caregivers and health care professionals of older adults may also find helpful tools to enhance their understanding of issues that affect this population. The page includes resources from the NDEP and other federal and non-federal health information sources. Resources are reviewed by independent experts on diabetes care for older adults.
To learn more, visit http://ndep.nih.gov/older-adults
May 02, 2014
Linda Haas, Ph.C., R.N., C.D.E. is a former Washington State and National ADA Diabetes Educator of the Year who has written and lectured extensively about diabetes care. Ms. Haas served as an endocrinology clinical nurse specialist at the Seattle division of the VA Puget Sound Health Care System (formerly the Seattle VA when she started), where she helped veterans with diabetes manage their condition and served as a consultant to staff on diabetes management and self-management education. She is also a past president of the American Association of Diabetes Educators (AADE) and past president, Health Care and Education, for the American Diabetes Association (ADA). In 2013 she received AADE’s Living Legend Award.
Q. Where did you start your career in diabetes education and management, and what is the biggest difference you’ve seen in the field since then?
A. “I was a research nurse at the VA in Seattle (and) worked with endocrinologists. Meters had just come into being then, or the ability to test one’s blood sugar, and I really thought that was cool and allowed the person with diabetes to take over their management if they had appropriate education. And then I got more involved and went full time doing diabetes education and became an advanced practice nurse.”
Regarding the biggest changes in the field since then, Ms. Haas cited two:
“One is glucose monitoring, although it hasn’t fulfilled its promise because I don’t think people have been instructed what to do with the information. In fact, I gave a talk in ’86 that monitoring is a means to an end; not an end in and of itself, which is what I think a lot of people looked at it as, which was in error. The other big thing I think has happened is that providers are finally starting to realize that it’s really the patient who does everything and not the provider. And so helping people make changes in their behavior is probably one of the most important things providers can do. Because you can prescribe all you want, but if the patient doesn’t take it, it’s not going to work. I think providers are finally reaching a point to where they’re willing to turn over the management to the patient, but that’s been something educators have been preaching for a long, long time.”
Q. What do you think is the greatest challenge that diabetes educators face today, and what suggestions do you have on how they can address that challenge?
A. “I think the greatest challenge is responding to the changing healthcare system and figuring out where they fit in. My advice to them would be to get involved with primary care—make themselves known to primary care providers; let primary care providers know of their value.”
Follow-up: How could diabetes educators make themselves known to primary care providers?
“What I found very helpful was meeting with the nurses. Because particularly with medical homes, it’s really the nurses who are doing a lot of the work. And I mean RNs, not the Advanced Practice Nurses, although the latter are doing a lot, too. But they’re doing more management, and it’s the RNs who are doing the self-management education. So by working with the nurses and helping them, you can be a valuable resource.
Q. What was the most rewarding aspect of your work at the VA?
A. “Working with the patients. They’re just wonderful. And I truly believe that without them, we would not be here today because they’re the ones who preserved our freedom. They were just delightful to work with.”
From 2008-2012, Ms. Haas served as the Metabolic Syndrome/Diabetes Clinical Nurse Advisor in the Veterans Health Administration’s Office of Nursing Services, which she also cited as a highlight of her career.
“The other thing that I found very rewarding was when I took the position with National Nursing Services and got to help advise on policy that would help staff and people with diabetes.”
Q. Are there certain NDEP resources that you have found most useful in your diabetes-education initiatives?
A. “I like the Diabetes Health Sense web resource that focuses on behavior change. And I use the slides all the time. I download them and incorporate them into my lectures.”
Q. What area of diabetes education and management do you think deserves greater attention?
A. “I really think the role of the patient within the family deserves more attention. I think the patient is the key person because he or she is the person with diabetes and the family is hopefully supportive.”
Follow-Up: Should there be greater attention on what families should be doing, or how the patient needs to educate the family?
“Both. And it’s not so much what they should be doing, but what they can be doing, because you don’t want to turn family members into diabetes police.”
As an example, Ms. Haas suggested discussions patients and families can have around healthy eating. She emphasized that people with diabetes don’t need to have special foods, but rather an understanding about eating well.
“We’re much less compulsive about saying, ‘You can’t have this’ or “You can’t have that,’ because you really can, you just have to work it into your overall meal plan.”
Follow-Up: What is your suggestion for the patient to help the family?
“Learning all they can, and bringing family members to classes and clinic visits to include the family members in everything that is going on.”
Q. As part of its new strategic plan, the NDEP is working to enhance its relationship with partners in clinical and community settings. How can these partner organizations benefit the most from NDEP resources?
A. “The materials are great, and they’re really evidence-based. I’ve worked on a couple, and we really had to follow what the evidence said. I think that is a huge advantage to those. Authors of these materials work very hard at keeping current and making changes when they need to be made, even though sometimes they’re painful.”
Q. Final thoughts?
A “I think NDEP is just an incredible organization and one that I look up to very much.”