May 17, 2004 | People with diabetes find that their health improves once they have been trained to manage their disease.

But in Arkansas, which has one of the highest diabetes rates in the nation, rural health care professionals have not had ready access to education to train their diabetes patients for self management.

Now they do, and the unique approach has drawn national attention in an article published in the April/May issue of The Diabetes Educator, a journal of the American Association of Diabetes Educators.

The article profiles the Diabetes Review Course, developed by the University of Arkansas for Medical Sciences in partnership with the Arkansas Department of Health to increase the availability of quality diabetes self-management training.

“The program allowed for all the colleges here at UAMS to come together and offer a continuing education program in diabetes, which is one of the most prevalent diseases in our state,” said Donna West, PhD, an assistant professor in the UAMS College of Pharmacy and first author of the article.

Other authors of the article are Patricia O’Sullivan, Ed.D., of UAMS’ Office of Educational Development; R. Jean Hine, Ph.D., of UAMS’ Department of Dietetics and Nutrition; Julie Hall-Barrow, M.S., of UAMS’ Rural Hospital Program; and Becky Adams, M. P.H., formerly with the Arkansas Department of Health’s Diabetes Prevention and Control Program.

The course was developed as a master’s degree project by Melissa Carozza, a graduate student of Hine’s.

Topics included acute complications of diabetes, management of diabetes in pregnancy, medical nutrition therapy and lifestyle modifications.

While the program was presented at UAMS in spring 2002 and again in October 2003, a majority viewed the seminars at teleconference sites outside Little Rock.

“It’s really a public health issue,” West said. “The course allowed for these rural health providers to have access to a top quality program without having to travel.”

More than 230 pharmacists, nurses, dieticians and others attended the first Diabetes Review. Participants came from all regions of the state. Registration and materials were free.

“Hopefully there will be more providers out there who have the most up-to-date knowledge and skills about how to help these patients care for themselves,” West said.

For instance, she said, diabetes patients need to know on a day-to-day basis how to check their blood sugar, eat properly, exercise and check their feet, which can have circulatory complications. There is evidence that patients are not properly controlling their diabetes, West said.

“One of the most expensive diseases for Arkansas is diabetes because some patients are not controlling their blood sugar, which in the long run leads to increased morbidity and mortality ” she said.

It’s a very complex disease, so it takes people with expertise in diabetes management to educate patients and help them manage their disease. It’s about educating and empowering the patients to care for themselves.

“What we were trying to do is provide a comprehensive training session for providers,” West said.

The American Diabetes Association recommends those with diabetes go through 10 one-hour educational sessions. Based on this, the Diabetes Review Course emphasizes that there’s more to educating diabetes patients than telling them “here’s your medicine, take it three times a day,” West said.

“It’s a behavioral change; the way you eat, getting enough exercise,” she said. “When you start talking about lifestyle changes, we all know that is very difficult.”

West said health care professionals are seeing Type II diabetes in younger and younger patients, caused in part by the “high-sugar, high-fat intake common in today’s fast food world.”

Attendees gave high marks to the course presentations. The positive feedback means there likely will be similar offerings of this multidisciplinary education program in the future.

“This course is an example of the efforts of several Colleges working together to improve health care in Arkansas,” West said. “Also, it allows the different health care professionals involved in helping the diabetes patient to get a more complete picture of how they each impact the patient.

Adams, former director of the Health Department’s Diabetes Prevention and Control Program, worked closely with the Diabetes Review Course and was second author of The Diabetes Educator article.

She said a major benefit of the program is reaching health professionals that would not have come into Little Rock for the training.

Adams said there is a plan to have an advanced course that focuses on diabetes complications, such as heart disease, and bring in experts to talk about those specifically.

“We have two audiences – new and upcoming diabetes educators and then seasoned educators who need more in-depth sessions on complications, life span, and case studies,” Adams said.

One of the best things that came out of this course was the assessment of what health professionals need in continuing education credit, Adams said.

“This way we can coordinate our efforts and provide what’s needed without competing or duplicating. With all of us working together we can make sure that what we’re offering is what they need.”

The Diabetes Review Course was videotaped. For information about the program videotapes, contact Kristin Allen, Diabetes Prevention and Control Program at the Department of Health at 661-2964.