Diabetes Education Study Group

CHAIRMAN'S REPORT
Prof. Aldo Maldonato - September 1998

Having taken over the presidency of the DESG in January 1998, I shall report here on the activities undertaken since then. For the sake of completeness, however, I will also mention the activities performed under Jean-Philippe Assal’s presidency since the last General Committee meeting held in Helsinki, July 1997.

First of all I have the great pleasure of thanking Servier International for its continuing sponsorship of the Diabetes Education Study Group of the EASD, with particular thanks to Dr Didier Halimi, Director, and Drs Mike Sumpter and Fréderic Fasano who are working hard to continue a most fruitful collaboration between Servier and the DESG.

I wish also to address my thanks to the Executive Committee members: Dr Daniel Figuerola, the Vice-President; Dr Ivana Piva, the Honorary Treasurer; Ms Birthe Palmvig, the Honorary Secretary; and Dr Stéphane Jacquemet the Director of Educational Strategies. My warmest thanks also to Ms Melodie Käser, who from the Geneva secretariat has helped and is still helping a lot in the transfer of the presidency to Rome, and to Ms Margaret Algermissen, in the Rome secretariat.

Following the last General Committee meeting in Helsinki, July 1997, two DESG/Servier partnership workshops have been held, new Teaching letters and the new Patient Education Basics for type 2 Diabetes have been published as has the important Report of the WHO-Euro working group meeting on Training healthcare providers in Therapeutic Patient Education.

DESG-SERVIER PARTNERSHIP WORKSHOPS
A total of 90 participants came to the two, 5-day workshops held from 4-9 and 11-16 October, 1997 in Grimentz, Switzerland on the theme: Improvement of Diabetes Care: from learning concepts to implementation of educational programmes. Among the participants were people from the Servier subsidiaries world-wide, together with members of the health care team working closely with them. Participants came from Azerbaijan, Belgium, Brazil, Chile, China, Czech Republic, France, French Overseas Territories, Hungary, Indonesia, Ireland, Italy, Jordan, Kuwait, Mexico, Morocco, Netherlands, Poland, Portugal, Russia, Slovak Republic, South Africa, Spain, Switzerland, Syria, Tunisia, Turkey, UK, United Arab Emirates and Venezuela.

The aim of those meetings, which were held for the second consecutive year, under Prof. Assal’s presidency, was to illustrate the DESG model to physicians of non-European countries, in order to help improve diabetes care.

These workshops continued to meet with great success and will be held again from 10-15 and 17-22 October of this year at Villars, Switzerland.

WHO-EURO WORKING GROUP REPORT
As you already know, at the request of Dr. J. E. Asvall, Regional Director of WHO-Euro in Copenhagen, Denmark, Prof. Assal (DESG President and Director of a WHO Collaborating Centre) held a WHO Working Group Meeting in Switzerland in June 1997. This meeting was aimed at producing a document dealing with the training of healthcare providers in the field of therapeutic patient education and long-term follow-up for chronic diseases. Fifteen experts coming from ten European countries met over a four-day period to critically discuss, appraise and amend a detailed draft working paper in order to agree upon the final document which was then submitted to WHO-Euro.

It is with great pleasure that I can announce that, after much refining, mainly thanks to the efforts of the Geneva group, the document was finally printed in June 1998, with the following title: ‘Therapeutic Patient Education. Continuing education programmes for Health Care Providers in the field of prevention of chronic diseases’.

After some minor corrections to the first print, the document is now in press and will be published by the end of this year. This Report will be distributed to all European governments.

It will be an important task of the DESG for the next few years to work on its implementation in the field of diabetes.

PUBLICATION AND UPDATE OF TEACHING LETTERS
Four Teaching Letters have been produced in 1997, under Prof Assal’s responsibility: No.11 entitled ‘Checklist for diabetic patient education’ and No.13 entitled ‘Motivating the diabetic patient’ were updates of the original Teaching Letters; whereas No.12 entitled ‘How to improve follow-up in the long term disease’ and No.14 entitled ‘My patient is poorly controlled, how do I approach this problem?’ were new.

A new series of Teaching Letters has been started this year, which will be published together with the completion of the update of the original Teaching Letters.

FIRST DESG MEETING IN CAPRI.
To produce the new series of Teaching Letters, a meeting was held in Capri, from 2-7 April, 1998, with the participation of 30 doctors, nurses, dieticians, psychologists, etc. As a result of 5 days’ hard work in small groups using Metaplan first and then computers, five new Teaching Letters were drafted, entitled:
‘Right from the beginning: education at the time of diagnosis’,
‘Diabetic retinopathy and therapeutic education’,
‘Therapeutic diabetes education in (summer) camps’,
‘The function of psycho-social support in diabetes education’,
‘Diabetes education and cost control’.

During the meeting, the writing was interspersed with interactive sessions on the following topics: Bio-psycho-social approach to chronically ill patients, Active listening and the no winner / no loser method, Control mechanisms - understanding and helping understand.

The first of those Teaching Letters has already been produced and the second one is being printed. The three others will be published at the beginning of next year.

During this year the updating of the original Teaching Letters will be completed by the publication of the two last ones: ‘Educational approach to the elderly diabetic patient with special needs’, and ‘Continuing and reinforcing patient education’.

All DESG members will receive these Teaching Letters which have been or will be produced with the help of the current sponsor, Servier International.

PATIENT EDUCATION BASICS
A new series of documents on different topics containing basic therapeutic education for type 2 diabetic patients was initiated in 1997 as a fruit of a stricter collaboration between DESG and Servier International.

These documents aim at providing easy-to- use educational tools for the Health Care Provider wishing to educate the diabetic patient, but unable to find time for a thorough systematic approach.

In each of them the very few most essential messages are summarised and illustrated by drawings.

The list of the already produced Patient Education Basics is the following:
No.1 ‘How to prevent low blood sugar’,
No.2 ‘Lose weight by eating better’,
No.3 ‘Diabetic retinopathy and follow-up of eye problems’,
No.4 ‘Prevention of foot problems’ (1997);
No.5 ‘"You have type 2 diabetes"”- meaning and Implications’,
No.6 ‘Preventing late diabetic complications’ (1998).

During the current year two more Patient Education Basics will be produced: one about Loss of pain sensation, and the other one about Improving follow-up in the long term disease.

UPDATING THE LIST OF MEMBERS
The old DESG Membership List needed a thorough update since, during the DESG’s 20 years’ existence, many members have retired, some changed their interest or activity and a few unfortunately are deceased. Therefore, together with my initial letter to all members, we sent an update membership form, to be faxed back to Rome.

Having sent 2200 letters at the end of May, we have already received about 500 return faxes and we are still receiving several forms every day. Therefore the list that we are distributing here (see attachment) should be considered entirely provisional. Its aim is to help us improve the update of members’ data, with the aid of the attached forms.

At the beginning of next year we shall cancel all data which will not have been updated.

PARTICIPATION IN GRIMENTZ WORKSHOPS
The Grimentz Seminars constitute an established model of interactive learning of educational skills.

This year the DESG has provided the funding for the participation of some members to two workshops held in Grimentz, from 20-26 June and 27 June-3 July, organised by Dr Alain Golay and Prof Jean-Philippe Assal respectively.

The first seminar was held on ‘Cardiovascular risk factors and diabetes’, consisting mostly of small group workshops with some introductory plenary sessions. Two participants’ expenses have been waived by the DESG.

The second seminar was held on ‘Chronic illness – revisiting the art of healing’. The main themes were: 1) The WHO programme on training the Health Care Providers in respect of Therapeutic Patient Education for patients having chronic diseases; 2) Quality of care: five approaches forgotten by medicine; 3) Models of Therapeutic Education involving philosophers, pedagogues, etc.

As in the previous seminar, there was a multidisciplinary participation of doctors, nurses, psychologists, pedagogues, dieticians, etc. Eight participants’ expenses were waived by the DESG.

ENLARGEMENT OF EXECUTIVE COMMITTEE
The 1996 update of the DESG Constitution, previewing the enlargement of the Executive Committee from five to seven members, has not yet been implemented.

As per the current Constitution, the present Executive Committee has accepted to propose to the General Committee two additional members for election to the Executive Committee, in addition to those to be elected in order to replace the two officers whose mandate expires this year.

FUTURE ACTIVITIES
As previously mentioned, two more DESG/Servier partnership workshops will be held this autumn, and new Teaching Letters and Patient education basics will be published and distributed.

One small expert meeting of 4-6 experts will be held in Capri from 11-15 October, 1998, with the aim of planning and building-up a Web page for the DESG.

A larger meeting of 60-70 participants will be held from 20-25 March 1999, again in Capri, on the central topic of the implementation of the WHO-Euro Report on Therapeutic Patient Education in the field of diabetes. The participants should be all the members of the General Committee.

Prof. Aldo MALDONATO
President, Diabetes Education Study Group
September, 1998