AADE Sets Its Sites on Going Global

June 16, 2016

It’s November, also known as National Diabetes Month, a time in our diabetes world when we in the United States raise awareness about diabetes and the importance of proper care and education. At AADE we proclaim the first full week of November National Diabetes Educator Week. It’s November 6–12 in 2016.

      And on the global front, World Diabetes Day (WDD) is November 14, 2016. WDD, first celebrated in 1991, was created by the International Diabetes Federation (IDF) and the World Health Organization (WHO) due to concerns about the health threat of diabetes. In 2006, WDD became official with United Nations Resolution 61/225.¹ This year’s WDD theme is Eyes on Diabetes. It will focus on the importance of screening for early diagnosis and treatment of type 2 with the goal of reducing the risk of serious complications.¹

      We have so much progress to celebrate, but we also have extensive work ahead worldwide to raise awareness of the prediabetes and diabetes epidemics and communicate the imperative of early, aggressive care and self-management education.

      During this month, think locally. Take actions within your workplace and communities to draw attention to diabetes and the important work we all do.

      With my goal to familiarize you with the 6 key strategies in AADE’s 2016-2018 Strategic Plan (read in full at diabeteseducator.org/strategicplan), the sixth strategy is: Explore opportunities to expand the impact of Diabetes Self-Management Education and Support through global initiatives and partnerships.

      Your AADE leadership believes that a global strategy should be part of AADE’s strategic plan. The world is increasingly connected through technologies and other resources that enable us to instantaneously connect and work with people and entities around the globe. It’s never been easier! This ease of communication allows AADE to assess the needs of diabetes educators and diabetes-focused entities and allows us to share our expertise and sizeable human and educational resources. We, as you’ll see from the two Change Champions profiled on the opposite page,share similar goals with diabetes educators around the globe to deliver evidence-based Diabetes Self- Management Education and Support (DSMES) and assure that knowledgeable and credentialed providers deliver DSMES. Our mutual end goals are also similar to reduce the human and financial burdens of diabetes.

      And the global burden of diabetes is significant. According to the IDF, 415 million adults now have diabetes, and by 2040, 642 million adults will have diabetes.² The WHO, in their Global Report on Diabetes, notes a quadrupling of adults with diabetes since 1980, mainly type 2 diabetes.³

      Over the years, AADE has engaged in several international efforts, and leaders have represented AADE and our members at the annual European Association for the Study of Diabetes (EASD) and the IDF meeting, held biannually. In September, I had the pleasure of presenting AADE-based research promoting the value of diabetes education, at the Federation of European Nurses in Diabetes (FEND) meeting held in conjunction with EASD in Munich, Germany.

      During the next year or so, AADE will assess the global landscape to determine how AADE and our members can bring our experiences, expertise, and resources to make the biggest impact. We’ll seek out organizations around the globe whose goals are aligned with ours. We’ll carve out our niche and partner with organizations and entities that assist AADE in making an impact. We’ll keep you posted as we strive toward our outcome to develop a global strategy and an international market approach. If you have thoughts, experiences, or opportunities for AADE’s leadership and staff, please share them.

      In conclusion, I want to thank you for the opportunity to serve as your 2016 president. It’s been an honor and privilege. I encourage all AADE members to get involved. You are critical to our mission, both home and abroad!

REFERENCES

 

1. International Diabetes Federation. World Diabetes Day 2016. http://www.idf.org/wdd-index/#. Accessed August 23, 2016.

 

2. International Diabetes Federation Diabetes Atlas. http://www.diabetesatlas.org/. Accessed August 23, 2016.

 

3. World Health Organization. Global report on diabetes. http://www.who.int/diabetes/global-report/en/. Accessed August 23, 2016.

I grew up in Israel with a mother who had type 1 diabetes. She always took amazing care of herself. She was an inspiring role model for me about how to live with diabetes and continue doing what you enjoy in life. Her motto was always be positive.

I have two degrees in nutrition/dietetics with a specialization in diabetes. I recently completed my PhD. Throughout my professional life, I have worked in the field of diabetes treating type 1, type 2, and gestational diabetes. In 2002, I received Dietitian of the Year from the Israeli Diabetes Association.

In Israel, there are approximately 600 000 people. Seven percent of the population has diabetes, and another 7% has prediabetes. There is a higher prevalence of diabetes and prediabetes among specific populations, such as Arabs, ultra-orthodox Jews, and those from low socioeconomic populations.

Diabetes education has been recognized in Israel for the past decade but mainly among a small number of health care professionals. Diabetes education is not part of the standard medical care and has not yet been recognized as a profession.

Since 2014, I have been leading a national endeavor to establish Therapeutic Patient Education in Israel. As part of a team (The OTZMA or- ganization), we have been working with the Ministry of Health to integrate Therapeutic Patient Education as part of the basic diabetes care treatment.

After learning about the different professional education courses avail- able around the world, we built a diabetes education course for health care providers. We developed an accreditation and certification program that is based on 2 components: a multiple-choice question diabetes exam, based on the U.S.-based NCBDE certification, and an objective-structured clinical exam, which allows the health care provider to demonstrate their practical Therapeutic Patient Education skills.

We have already held 3 successful sessions and have trained 115 diabetes educators around Israel. One of the courses was culturally adapted and conducted in the town of Nazareth to train Arab health care practitio- ners (HCPs). We are now in the process of expanding the course for other HCPs such as pharmacists, physiotherapists, and social workers.

One of our aims is to develop a larger diabetes educator network around Israel and provide ongoing training. The program is still in its early days, and much work still needs to be done. We are in the process of devel- oping a website intended for diabetes educators and have already offered a couple of standalone practice sessions.

The feasibility of this project relies on several Change Champions from within the health care system and from the community that together believe in the ability to make a substantial change in delivering diabetes self-man- agement education in Israel. This amazing achievement was made possible with the spirit and vision of Prof Raz, Prof Karasik, Dr Segal, Dr Herman- Baham, Dr Singer, and Dr Tamir, who have dedicated their professional life to promote chronic care education in Israel.

For the past 9 years I have, through my employer Healthy Interactions, trained a variety of health care providers from more than 120 countries around the globe on how to use their product, Conversation Map tools, to provide DSMES and more recently within a digital engagement platform. Conversation Map tools are now available in over 120 countries and in 38 languages. A core focus of this tool is the AADE7 Self-Care Behaviors melded with patient engagement. Prior to my current position, I was the program director of approval and provider services at AADE.

Working with the health care community internationally comes naturally to me. I came to the United States from Poland when I was a little girl and learned how to fit in to new environments quickly. Perhaps the skill that most helps me is problem solving and finding common ground to help others come up with solutions to their own challenges.

A trend I’m witnessing globally is that governments are beginning to cover DSMES delivered by skilled diabetes educators. Structured, evidence- based diabetes education, called “therapeutic” education, is now available globally, including Europe, Asia, and Africa. More doctors and professors of medicine are involved in incorporating DSMES into existing health care systems and are focused on improving the care of people with diabetes.

The demand for diabetes educators is growing globally, but there aren’t enough of us. This presents an opportunity for AADE members who have a quest to expand their career internationally. AADE members can present research internationally, sign up for a career opportunity in a foreign country, or find a mentor who is already working abroad.

Our strength as AADE members is access to a wealth of resources and clinical skills amassed with our collective years in diabetes education. Diabe- tes educators in other countries have not yet accumulated this. For example, I just came back from Pakistan where the dietitians want to learn about us- ing carbohydrate-to-insulin ratios for dosing rapid-acting insulin. The doctors in Pakistan want to know about how to create an evidence-based education program. Other health care professionals want to create a certification process to become credentialed in diabetes education.

Health care providers from around the globe can gain this knowledge and more from being an AADE member. On the converse, AADE members can learn from members who work and/or live internationally through men- toring opportunities. The United States has a very culturally diverse popula- tion of people with diabetes. Diabetes educators from other countries can provide us with ideas on how to tailor our approaches, not just with advice on didactic information but also on the ways that people interact or learn.

Paul Lasiuk, CEO of Healthy Interactions, and Pete Gorman, co-founder, have been my Change Champions. They’ve been instrumental in my success bringing Conversation Maps tools international. Both Paul and Pete have created an organizational culture that allows each team member to be independent, creative, and feel supported.