Support, empower, educate
Patient education and support are crucial for effective diabetes management, right? So far, so uncontroversial – but what should that education encompass? Who should provide it, where and when? These are just some of the questions addressed in our latest module.
In his new module, An introduction to patient education in diabetes, which launches this week, Dr Joao Filipe Raposo traces the development of patient education in diabetes back to the earliest days of insulin treatment - in fact, almost to the moment insulin was first discovered by Banting and Best.
“Education and patient involvement were fundamental to achieving the benefits of insulin,” he points out. “For the first time in the history of medicine, patients had to be involved in their treatment and surveillance, since it was not possible to keep patients with a lifetime condition in hospitals, and with multiple daily injections of insulin. Since that time, in Canada, in the USA, in Portugal, patient education has been a requisite for healthcare providers.“
As well as being a professor at the NOVA Medical School in Lisbon, Dr Raposo is Clinical Director of Portugal’s Diabetes Association (the APDP) and President of the Portuguese Diabetes Society. He credits diabetes patient organisations such as these with much of the early advances in this field, citing the example of Ernesto Roma – the APDP’s founder. As an intern at the Massachusetts General Hospital, Dr Roma visited Joslin’s celebrated diabetes clinic in Boston, where Banting and Best sent the first vials of insulin in 1922. On his return to Lisbon in 1925, Roma set about introducing not just insulin therapy but education in the skills patients required to use it effectively – creating an educational department at the association that provided group lessons and individual tuition in nutrition, insulin administration and glucose monitoring.
It’s a story that was to be repeated many times over in the years after insulin therapy was first introduced (RD Lawrence and the British Diabetic Association is another example - see https://easd-elearning.org/exercise-and-insulin-a-powerful-combination/).
Times – and treatments – have changed considerably since then and Dr Raposo’s module is a valuable guide to the evolution of the tools and terminology employed in diabetes patient education over the years – including key concepts in disease models, behaviour change and self-care behaviours. The module also includes practical case studies highlighting the benefits of particular approaches to diabetes patient education, barriers to effective education and the role of technology in diabetes self-care and structured education.
Any opinions expressed in this article are the responsibility of the EASD e-Learning Programme Director, Dr Eleanor D Kennedy.