Diabetes Education Study Group

CHAIRMAN'S REPORT
Prof. Aldo Maldonato - September 1997

It is with great pleasure that I am once again able to thank Servier International for its most important sponsorship of the Diabetes Education Study Group of the EASD, with particular thanks to Dr. Didier Halimi, Director, and Mr. Dominique Gormand who has worked hard in organizing the DESG/Servier workshops and in the publication of the DESG documents

I should also like to address my thanks to the following Executive Committee members: Dr. Daniel Figuerola the Vice-President; Dr. Ivana Piva, our Honorary Treasurer; Mrs. Birthe Palmvig, the Honorary Secretary; Prof. Urban Rosenqvist the Director of Educational Strategies. My thanks also to Mrs. Melodie Käser in the Geneva secretariat.

Following the last General Committee meeting in Vienna, September 1996, two DESG/Servier partnership workshops have been held, new Teaching letters and further translations of the 5-minute Survival Kit have been published and an important WHO-Euro working group meeting was held relating to the setting up of an official curriculum for therapeutic education for patients.

DESG-SERVIER PARTNERSHIP WORKSHOPS
A total of 110 participants came to the two, 5-day workshops held from 5-10 and 12-17 October, 1996 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 worldwide, together with members of the health care team working closely with them. Participants came from Argentina, Austria, Barbados, Belgium, Brazil, Brunei, China, Colombia, Czech Republic, Denmark, Dominican Republic, Ecuador, France, Germany, Greece, Guadaloup, Hong Kong, Hungary, Indonesia, Ireland, Italy, Jamaica, Latvia, Lithuania, Malaysia, Martinique, Morocco, New Caledonia, Panama, Poland, Portugal, Russia, Singapour, Slovak Republic, South Africa, Spain, Switzerland, Taiwan, The Netherlands, Trinidad, Tunisia, Turkey, Venezuela and the UK.

The aim of that meeting was to illustrate the DESG model to physicians of non-European countries, in order to help strengthen diabetes health care. Small working groups were formed to demonstrate patients’ difficulties with different handicaps, e.g. loss of pain sensation, visual handicaps, loss of a member, paralysis, etc. Implementation of the two DESG posters and Teaching letters for interactive use was discussed using the Metaplan method and recommendations were invited from participants on how they would implement a 2-hour workshop in their own country, including the planning and listing of the practical activities and logistics involved.

A formal lecture from a representative of the World Health Organization was given covering key issues in quality improvement systems within the model of diabetes care in Europe and a questionnaire was completed in relation to recommended hours for education in type I and type II diabetes. An abstract produced in the Division of Therapeutic Education for Chronic Diseases giving this data was submitted and accepted for the IDF Congress in Helsinki (see annexe).

These workshops met with great success and will be held again from 4-9 and 11-16 October of this year.

IMPROVING LONG-TERM FOLLOW-UP OF PEOPLE WITH CHRONIC DISEASES - A ‘SURVIVAL KIT’ FOR GENERAL PRACTITIONERS
Following our workshop in 1996 in Malta, the production of a document for general practitioners in order to help them in the integrated follow-up of patients having long-standing chronic diseases has perforce been placed in abeyance for the moment. This has been due to the discussions for, the preparation of and the holding of a WHO Working Group meeting concerning the submission to WHO of a medical curriculum for members of the health care team. (Please see the next item in this report). This was one of the themes discussed during that workshop. The ‘Survival Kit’ for GPs will shortly be reactivated.

WHO-EURO WORKING GROUP MEETING
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 of this year. 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. Once approved by WHO-Euro, the document will be published as a Report of a WHO-Euro Working Group in order to allow the implementation of training programmes. WHO-Euro will then be able to have a description of a training curriculum, now so urgently requested, for therapeutic education and long-term follow-up of patients with chronic diseases. Only then may a structured implementation be recommended.

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 to be submitted to WHO-Euro. All aspects of the working paper were discussed and debated in detail in order to have the agreement of all experts, taking into account translation difficulties and varying healthcare systems within the different countries.

Prof. Maldonato, our new president will continue the educational activity of the DESG according to this WHO document.

THE DESG 5-MINUTE 'SURVIVAL KIT' FOR HCP AND PATIENTS
The DESG Survival Kit has now been translated into twenty three different European languages (Albanian, Arabic, Armenian, Bulgarian, Czech, Estonian, French, German, Georgian, Greek, Hungarian, Italian, Latvian, Lithuanian, Norwegian, Polish, Portugese, Roumanian, Russian, Slovakian, Spanish, Swedish, and Turkish).

This year has seen the publication of the long awaited French and German versions which have been published by Novo Switzerland. The German version will also be published by Novo Germany for wider distribution within that country. Certain authors involved in the origin of this kit and other members of the Diabetes Education Study Group have been very active in promoting its use.

PUBLICATION AND UPDATE OF TEACHING LETTERS
Two Teaching Letters have been produced this year. One entitled ‘Checklist for diabetic patient education’ an update of the original Teaching Letter, and the other entitled ‘Better long-term follow-up of a patient means ...’ a new Teaching Letter. All DESG members will receive these Teaching Letters which have been produced with the help of the current sponsors, Servier International.

FUTURE ACTIVITIES
As previously mentioned, two more DESG/Servier partnership workshops will be held this autumn. Further Teaching Letters are envisaged on ‘Motivating the diabetic patient’ an update of the original letter and ‘My patient is poorly controlled, how do I approach this problem?’ a new Teaching Letter. Small leaflets on such themes as ‘hypoglycemia’, ‘meal planning’, ‘follow-up of eye problems’ and ‘prevention of foot lesions’ are also being prepared with the collaboration of Servier for Type II diabetes.

SPONSORSHIP OF THE DESG
The continuing the sponsorship of 'Les Laboratoires Servier' has been, and continues to be of utmost importance to this Study Group and thanks are to be given for their warm collaboration and deep involvement in the DESG’s activities. Thanks in particular go to the directors Dr. Jean-Philippe Seta and Dr. Didier Halimi as well as to Mr. Dominique Gourmand.

PRESIDENCY OF THE DESG
As you know I became the President of the DESG at its foundation in 1979. The presidency was then taken by Dr. John Alivisatos of Greece followed by Dr. John Day of the UK. By election I then took the presidency again for the term of office 1993-95. As the sponsorship of the DESG also changed at the end of that term of office I agreed to the new sponsor’s wishes to continue for one more year. At that time a new President was proposed, Prof. Aldo Maldonato of Italy, but owing to other heavy commitments he was unable to accept this post until 1998. I have enjoyed a fruitful and stimulating presidency these last five years under the sponsorships of both Novo Nordisk and Servier International to whom the DESG gives deep thanks for their generous support. I therefore welcome Prof. Maldonato to this office and wish him a successful presidency.