FINANCING DIABETES EDUCATION PROGRAMME IN HEALTHCARE INSTITUTIONS IN NIGERIA

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With the current prevalence at 366 million persons living with diabetes, the importance of Education cannot be overemphasized for persons living with diabetes and normal individuals. This figure will continue to rise as a quarter of this number may have diabetes without knowing.

Education is one of the cardinal principles of management of diabetes, especially prevention strategies. This is important because, the knowledge about diabetes is dynamic. Most health care professionals were trained with textbooks whose information is obsolete as year’s progresses.

Diabetes Education as currently outlined in International Diabetes Federation (IDF) curricula as simplified into Diabetes Conversation Map Education tool is very handy for not only persons living with diabetes but healthcare professionals manning the health institutions.

IDF recently commenced a pilot project training facilitators to incorporate this education tool into existing or non existing education programme in health care institutions. This noble project needs to be expanded to cover both public and private hospitals in cities and rural areas.. IDF alone cannot foot the bills of these training hence the need for Government and public spirited individuals and organizations to sponsor this project to rapidly integrate Diabetes Conversation Map Education tool into healthcare systems especially in sub-saharan Africa and Nigeria in particular.

There are currently three IDF trained Expert trainers on Diabetes Conversation Map Education tool in Nigeria. They have been involved in training healthcare professionals from selected institutions to integrate this tool into the healthcare system. The Ministry of health needs to support this effort of IDF by collaborating with these trainers to get these trainings to as many states as possible.

This is important and urgent as we don’t have a current statistics on the prevalence of Diabetes in Nigeria. It is common knowledge and observation that many persons especially the working population are coming down with diabetes, if nothing is done about this, the transformation agenda of the present Administration in Nigeria will loose the manpower to drive the change.

Isaac Akogu

Conversation Map Expert Trainer

Nigeria.

iakogu@yahoo.com,08037002025

Diabetes aids, articles, financial matters etc: BREAST FEEDING AND TYPE 1 DIABETES MELLITUS

Diabetes aids, articles, financial matters etc: BREAST FEEDING AND TYPE 1 DIABETES MELLITUS: "New! Diachieve Brand Diabetic Supplies & Health Products EasyHits4U.com - Your Free Traffic Exchange - 1:1 Exchange Ratio, 5-Tier Ref..."

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BREAST FEEDING AND TYPE 1 DIABETES MELLITUS

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Breast feeding is the act of feeding the young with milk produced from the udder of the mother. This is a natural process in mammals.
The breast milk in the first few days following birth contains colostrums which is made up of rich protein and antibodies required by the young to withstand infection.
In humans, this is advocated for with slogan “Baby Friendly” Exclusive Breastfeeding. The usual practice among young ladies is to switch to cow milk shortly after birth. Some complain that their breast could go flat if the continue on breast feeding for a long time, others do this as a show of affluence.
The health implication is this; the young baby does not differentiate protein at the early age before the age of six months hence introduction of cow milk makes the child to develop antibodies and considers other proteins that the child produces later in life as foreign especially those hormones produced from the pancreas like insulin. This is the basis of auto-immune disease. Such a child is at high risk of developing type 1 diabetes mellitus which is an auto-immune disease. Majority of children with type 1 diabetes is as a result of this phenomenon. Though other conditions like viral infection example miscles, rubella and cocksakie virus could predispose to type 1 diabetes.
It is therefore advisable for nursing mothers to breast feed their young ones for at least six months before gradual introduction of substitutes. Except in cases of HIV infected mothers.

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SIXTY-SEVEN MINUTES ‘67’ MINUTES OF SELFLESS SERVICE FOR A CAUSE- DIABETES AWARENESS

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The United Nations declare today as Nelson Mandela day and the World is encourage to dedicate sixty seven minutes of their time towards a cause.
The exemplary life of his Excellency the ‘Mandiba’ Dr Nelson Mandela who spent sixty seven years of his 93 years in life fighting for social justice has provided a challenge to every human being today on earth.
How are you spending your own sixty seven minutes today? I am dedicating mine to creating Diabetes Awareness in public places, market stores because Diabetes is a time bomb that is plunging a lot of families into poverty and loss of loved ones.
I will urge Dr Nelson Mandela to add his voice to the forth coming UN summit on Diabetes and other non communicable diseases (NCDs) for a need for the governments and donor groups to set up global fund to address the present challenge Diabetes and other NCDs are posing to the entire human race, this is a worthy social health Justice.

Challenges of Free Diabetes Education program.

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Diabetes Education program comes in different forms today. The media and health institutions conduct different education program or the other to ensure patients living with diabetes live well. However, the challenges abound regarding standardization of the education curricula.
It is unfortunate that while delivering diabetes education in a state hospital, I once witnessed a nurse instructing the patients not to eat any food containing carbohydrate. I asked why, the simple answer was that; somebody with diabetes should not eat any carbohydrate because of sugar. I went further to ask, are you aware that the so-called proteinous foods like beans also contain carbohydrate? she was surprised. I then disclosed my identity as a diabetes educator and a conversation Map Expert Trainer. The important thing to remind patients is that, we advocate use of complex carbohydrate which is a mixture of roughages and fibers to delay the glucose absorption and make insulin work gradually and well.
The challenge of offering diabetes Education is enormous. The person delivering the education will always say that it is a volunteer job he or she is doing. Since there is no remuneration, it is not considered a serious business. But it has always been said that any thing worth doing is worth doing well. Conducting free diabetes education program is faced with a lot of challenges. The diabetes Educator will have to source for writing materials, and sometimes refreshment for the participants to encourage them to attend. When a monetary fee is attached to such education, most people cry out that treatment of diabetes is already expensive, but the cardinal management principle of diabetes rest on education.
The question then arises, should diabetes Education be free or priced and if it should? Who should foot the payment? Is it the patient, or the government? This is a rhetorical question that requires an answer.
The Government through the Ministry of Health should liaise with stake holders like Diabetes Association and other NGOS to organize workshops and trainings for health care providers and patients. An appropriate framework can be agreed on and uniformly carried out across the country simultaneously in health care institutions. Such pragmatic action on Diabetes Education will help reduce the prevalence rate of diabetes currently on the increase. Such scheme can only be sustained with good financial support from government and donor groups.
It is hoped that the forth coming UN summit on Non communicable diseases in September, 2011 will get heads of governments’ commitment and support from donor groups towards formation of a common fund globally to fight diabetes and other non communicable diseases.

ISAAC AKOGU BPHARM,CDE

Diabetes a Burning Issue on the Global Agenda, Not limited to Global health Agenda.

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Incidence of diabetes is increasing Worldwide at a rate that eclipses most other diseases. The WHO estimates that by the year 2030, more than 366 million people will be living with diabetes, this is ten times the number affected by Hiv/Aids. It is even more devastating in that of this figure, more than 298 million people will be living in developing Countries, where the World is currently battling poverty and hunger amongst other challenges.
The major point is this, who will take up this diabetes challenge, why do we all seem not concerned about this epidemic yet we all are either directly or indirectly being affected by diabetes? This is a question I want to pose to every human living currently on planet earth.
As we prepare to celebrate this years’ World Diabetes Day come November 14th , with a theme ‘Diabetes Education and Prevention’, let us strife to know more about diabetes. Research has shown that with Education, Glycaemic control is improved and frank diabetes preventable.
As world leaders meet to discuss diabetes and other non communicable diseases come September, 2011, emphasis should be focused on Diabetes Education.

DIABETES EDUCATION USING SIGN LANGUAGE

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Diabetes is a metabolic disorder which is chronic in nature. It requires education to be able to cope with the challenges it presents.
Diabetes education already is being recognized within the medical community to be a therapy hence different tools need to be employed to drive home knowledge.
For persons living with hearing impairment as a disability, they must not suffer or lack information because of these challenge. The introduction of sign language has made it easy for educating those with hearing impairment.
Conducting diabetes education using Sign Language is a technique that should be developed specifically for persons living with diabetes and hearing impaired as well.
Currently, existing Sign language symbols are not developed to meet these challenge but with concerted effort and research and effective collaboration, this is achievable. The present revolution in global diabetes awareness must not leave behind these set of persons.
The International Diabetes Federation through collaboration with stakeholders have been able to develop educational materials in many languages of the World, they need for Sign Language for persons living with Diabetes and challenge of hearing.
In sub Saharan Africa, there are a teeming population of persons with this condition and illiterate as well.

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Therapeutic Diabetes Education a necessity to check the trend of Diabetes Epidemic

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Therapeutic Diabetes Education a necessity to check the trend of Diabetes Epidemic
Apollinaire Bouchardat 1883
Appollinaire Bouchardat in his book Le Diabètè sucrè published in 1883, was the first to promote urine self testing for glucose as a basis for management of persons with t ype 2 Diabetes. He recognized the need for involvement of the individual living with diabetes in management.
Jean Philip Assal in the 1970s introduce the essential role of patient education as a therapy for diabetes. He structured diabetes education involving specialist and this brought about the revolution in many diabetes units in many hospitals and eventually to the founding of EASD many years ago.
The management of diabetes today could be hinged on four cardinal principles, these include: Diet, medication, exercise and patient education. These principles are anchored on education. The extent of involvement of education as a therapy in many health institutions managing diabetes vary across the various continents and countries alike.
In the USA, considering the huge budget diabetes has placed on her health care services, patient education has effectively been introduced as a therapy in many health centres managing diabetes the result is better control and understanding of diabetes by the patient. In many countries of Europe, it is gradually being introduced in to their health care systems, especially the Diabetes Conversation Map Tool kit has helped to make this integration easy and effective.
In the middle east, awareness about diabetes is on the increase. This will be climaxed by the International Diabetes Federation (IDF) congress taking place in Dubai later part of year 2011. Many Governments in these region need to make a statement regarding diabetes management and incorporation of diabetes education as a therapy towards better management and control.
In Africa, the story is not the same. North African countries have better diabetes awareness and diabetes education has long been introduced into their diabetes management programmes, though much need to be done in area of training and renumeration for diabetes Educators who are scarce and unrecognized in most cases. In sub-Saharan Africa their seems to be no recognition of diabetes educators, though with some improvement in East Africa, but in west Africa, much needs to be done. Diabetes Education is mostly carried out by persons not fully equipped to deliver the content in line with standard diabetes curricula as outlined by IDF, hence there is no uniformity of standard, the result is wrong teaching based on what the health educator feels or think he knows about diabetes.
Diabetes is a giant that should not be treated with kids glove. It is complex disease, in which research has shown in clear terms that though not curable yet but can be managed and the person living the disease can enjoy a full life.
With the forth coming UN summit on NCDs coming up in New York in September, 2011, the world need to rise to the challenge diabetes is posing with over 285 million persons world over living with this condition and a quarter of this figure are unknown. The awareness programmes currently channeled towards HIV/AIDs, if half of it is focused on diabetes and other non communicable diseases, millions of lives will be saved and money expended on management will be used for other daring needs.
Doctors, Pharmacist, Nurses, Nutritionist and \Dieticians and other members of the health care profession need to understand that management of diabetes is a team work and there is a need to under go some forms of training to effectively deliver diabetes education to patients. It is important to always note that Diabetes Education as a Therapy in management of diabetes, however there need to be standard in the curricula. It must be inline with current practice and guideline by the International Diabetes Federation.

Living with Diabetes and participating in Elections

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Diabetes is a chronic disorder in which the body loses its ability to effectively utilize glucose for production of energy due to abnormally with insulin function or action.
Living with diabetes is a daily challenge. It requires an individual understanding the physiology of his or her body. The total glucose level of an individual is a combination of what is eaten and the time the food is consumed.
Diabetes does not stop one participating in any Endeavour of life however, the individual need to adopt special approach towards planning to carry on with daily routine.
The Elections period is here, however, participating in the election to avoid a problem requires some careful planning on the part of anybody living with diabetes.
For a person living with diabetes, before going for elections, the person needs to know what is the state of the blood sugar, take breakfast and drugs or insulin before and go to the polling station with snacks. If the person is on insulin, launch pack must be carried along to avoid complications like hypoglycemia which is an emergency and considering that it is crowd, wrong decisions may be taken during such eventuality.
The authorities conducting elections should have a plan for people with diabetes and other health challenges and get necessary first aid measures readily available at polling centres.
Living with diabetes does not stop an individual participating in election but wrong planning could

Conversation Map Integration into Health Care Systems-NIGERIA

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The importance of Education towards effective and collective management of a person living with diabetes can not be overemphasized. With recent research publications on the improved glycemic control in patients who encounter educational intervention.

The escalating prevalence of type 2 diabetes is threatening to undermine healthcare systems throughout the world.The latest Internationl Diabetes Federation(IDF) estimates suggest that 380 million people will be affected by 2025, with one person dying every 10 seconds. Diabetes is increasingly a problem in developing regions of the world, where the number of people affected has risen dramatically in recent years. At the beginning of the 20th century, diabetes was rare in Africa, but with the rapid urbanization and change in social life style in the 21st century there has been a rise in the disease and its complications.
One of the most effective weapon to fight this global epidemic is Education. A potent tool to fight ignorance which is further fueling this epidemic of diabetes. The type of education is that which involves the patient discussing his or her experience in a learning atmosphere while learning as well. In other words a participatory learning process.
Healthy Interactions USA INC. came up with Conversation Map TM Tool for engaging patients in useful conversations about there experience and with useful guide of a trained facilitator, wealth of learning takes place and the commitments made by patients are more lasting.
With the introduction of Conversation Map Training Tool into the Nigerian Health Systems, how well can it be sustained? Is a silent question with no tangible answer.
Eli Lilly sponsored some Trained Conversation Map Expert Trainers to conduct a noble scheme. The trained about 72 diabetes Educators from across the six geopolitical zones of Nigeria all converged in Abuja, Nigeria. With this training, the 72 persons comprising doctors, pharmacists, nurses, lab scientists, social workers among others were empowered to train patients. This will definitely have a multiplier effect on their various glucose controls. However, the various diabetes educators need to be encouraged to do more in their various localities. The Ministry of Health should make special allocation towards building capacity from primary health care level to Tertiary level to enable prompt education of patients. The major problem of break down of this scheme is finance, in terms of transport and logistics for the educators and need for re-training.
Conversation Map Tool should be deployed in all our health institutions to help us reduce the statistical predictions of prevalence rate estimates in few years ahead. Currently, the Map is made in English language, French and Arabic. We need them translated to our local languages in various geopolitical zones to enable effective use for optimum benefit. With strong political will, this is possible.