I was recently at the Diabetes UK Annual Professional Conference at the Excel Centre London in early March, and listened to one speaker who challenged a way of thinking. He brought to us the topic of how to deal with the growing problem of obesity. However, instead of pointing the finger at the food industry and saying that we need to battle with them, he gave quite a different suggestion; we need to work with them and engage with them, not treat them as evil, as we do with the tobacco industry.
He illustrated his talk with slides about what is happening through community interventions for health in different places round the world. He demonstrated that the same way of working does not fit every culture, but that there are ways to change society from the community level. This in a western culture may involve such things as building design, which encourages people to walk up stairs rather than use lifts. It may involve proper food labelling on all foods, so that consumers know what they are buying, particular in the calorie content.
From my experience working with different groups of people, I believe we need to start educating people about what is healthy food and also inexpensive. We need to engage with the food industry at a community level, so that eventually that has a knock on effect on world food production. Even the concept of cycle paths in our city, we should be actively supporting, as this aims to make cycling safer and encourage more people to cycle to work or even to school.
It is so easy to think that as individuals we can make very little difference, but when lots of individuals work together, and are all chipping away, then it is possible to drive change.
The other thing that perhaps we as healthcare professionals can do is to help our patients with Diabetes take control of their condition. After all, what proportion of their life with diabetes do they spend with us? We need to find ways to help them work out what they can do to look after themselves and even improve their condition. One way is through structured education, and recently I have been on the training days for the DESMOND (Diabetes education for Ongoing and Newly Diagnosed) programme.
I have to be honest, that in the past I was not convinced, about structured education for those with diabetes. However, having read through the background reading and attended the 2 days of training, I can see how they could be beneficial. A Random Controlled Trial has demonstrated the ways in which the programme is effective. DESMOND is about encouraging and helping patients to work out what is wrong and how they can deal with it, including what small changes they might be prepared to make. I am about to run my first day with a colleague, who is a dietician.
It is not a course where we stand at the front as the experts and teach, but we are there with tools to enable the group of patients and carers to work things out together mainly, although there are times when we do have to give more input to help in the medical understanding.
If you have used DESMOND with patients, try and encourage more to be part of the programme locally. If you have not come across it before, why not visit a local programme; see for yourself what the benefits are, so that you can encourage your patients from your own first hand knowledge. It is one way of providing patients with the tools to manage their diabetes more effectively.
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