Preparing for an epidemic

While the prevalence of diabetes has been steadily increasing, practice nurses and GPs have had limited access to useful and informative education resources, writes Annie May.

Every day in Australia an estimated 275 people develop diabetes. It's the nation's sixth leading cause of death. Today, the total number of Australians living with diabetes and pre-diabetes is estimated to be at 3.2 million. By 2031, this figure is expected to rise to 3.3 million.

Yet despite these staggering figures, there is some concern that not enough health professionals have enough knowledge in diabetes education and care.

Australia currently has about 1000 diabetes educators, some full-time, some part-time. But it is simply not possible for these educators to see all diabetes patients, says Associate Professor Margaret McGill, diabetes educator and manager of the Diabetes Centre at the Royal Prince Alfred Hospital.

This, she says, is why practice nurses have a very important role to play in diabetes education.
"Diabetes patient education has long been recognised as a vital and integral component of successful diabetes care and can prevent or delay potential complications," says McGill.

"Nurses, particularly in primary care, have always played a key role in the management of diabetes, and as the disease becomes increasingly prevalent, that role becomes more important."

The problem is that the employment of diabetes educators hasn't been consistent to match the increase and, says McGill, diabetes educators, practice nurses and GPs have had limited access to useful and informative diabetes education resources. Particularly in remote and rural areas.

"Available, and truly useful, professional education resources has been scant. In city areas, there is access to professional development, but not so much in rural areas," she says.

Recognising the need for more resources, Baker IDI Heart and Diabetes Institute and MSD last month launched of a new online tool, Journey for Control.

It has been designed to provide diabetes educators, practice nurses and other healthcare professionals with information and resources to help patients better understand their diabetes and achieve better control of their condition.

"We believe the Journey for Control online tool is an important step forward in improving diabetes management in this country," says Associate Professor Jonathan Shaw, associate director of health services, at Baker IDI.

"It's one of the most comprehensive resources available to demonstrate what happens to the body when living with diabetes, and how to manage the day-to-day challenges of diabetes. The tool features animated videos and interactive risk calculators which are designed to help patients prioritise their lifestyle modifications and make changes to improve outcomes."

Available online at no cost, making it widely accessible to all Australian health care professionals, the tool provides patient-friendly information that can be used to facilitate one-on-one discussions between a health care professional and their patient, or used in group diabetes education.

It can also be updated periodically with the latest information about diabetes, as well as new educational features.

McGill says the tool can work on two levels. Practice nurses can use it to increase their knowledge, as can patients. However, she says it has the potential to have its biggest impact if used together.

"A practice nurse can put it up on the computer in the practice and talk it through with the patients. Making it as interactive as possible will result in better outcomes," she says.

"As diabetes management becomes more sophisticated with a greater array of agents to select from and combine to help our patients reach their goals, it is beneficial to have access to resources that can support evidence-based medicine, especially resources that help us make the right choices for individual patients as one size does not necessarily fit all."

With so much of diabetes needing to be self-managed, making sure patients have as much information on the disease as possible is vital.

"Diabetes has to be self-managed - most people with diabetes only see their GP 12 hours a year. The rest of the time, they are on their own, so it's when they don't have the information to properly manage the disease when complications occur," McGill says.

And apart from the health implications, these complications also cost a lot - for the person and Australia.

In 2003 diabetes was estimated to cost Australia over $6 billion each year. And while there is no doubt diabetes is a serious health crisis, it doesn't have to be all bad news.

"With proper management, complications can be avoided and the cost will be reduced," says McGill.

"And practice nurses are in a great position to equip people with diabetes with these management skills. With the increasing prevalence of diabetes, it is almost a certainty that a practice nurse will have to care for someone with diabetes. It they haven't yet they soon will, so they need to be prepared.

"It is an epidemic. Because of this, it is the responsibility of any health professional to have a working knowledge of diabetes."

To access the new online diabetes education tool, Journey for Control, or for further information, visit www.msdjourneyforcontrol.com.au

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