Diabetes Peer Education | the view from China

Nora Saul, M.S, R.D., L.D.N., C.D.E.
Nora Saul is a Certified Diabetes Educator and Manager of Nutritional Education at Joslin Diabetes Center.

This blogger has been on the move.  If you recall, I was in ‘Vegas two weeks ago and wrote about the use of technology to help with diabetes education and self-management and to more efficiently use the limited time patients have to spend with health care staff.

Last week I attended the International Diabetes Symposium in Nanjing China and learned a completely different approach to education.

China has edged ahead of India: it has the dubious distinction of being the country with the greatest number of people with diabetes.

Unfortunately, their robust drive for economic growth has produced a society with a number of the problems seen in Western developed nations: skyrocketing obesity, a physically sedentary population and the introduction of fast, convenient high-calorie, high-fat “fast food.” 

In addition, their one-child policy often has parents and grandparents using food to dote on their children.  The streets were awash with overweight boys and adolescents.   And their physicians are tremendously overworked, seeing 50 to 100 patients a day.    This leaves limited time to get across all the information and skills patients need to adequately manage their diabetes.

One of the effective tools they have been using is a peer-education model.

In this paradigm, professionals train selected patients called peer counselors to talk with their friends and neighbors with diabetes about how to care for their diabetes.

Patients tend to trust people they know who are like them, that is to say, in the same situation.  The cost is low; in general these people are volunteers and can decide along with the patients the setting to disseminate the information.  Often the peer counselors choose fun activities that appeal to both parties.

And the results have been good.  Patients’ knowledge and skills regarding diabetes have increased and more importantly their A1Cs have declined.

This Is Nice to Know But So What?

Why this is important is, it brings home that there are both many ways to teach diabetes self management concepts and many types of treatment approaches.   A one-fits-all approach isn’t necessary or realistic.   So when you are working with your health care provider and/or educator, if something isn’t working, you should ask if there might be a different way of tackling the problem.

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