|Year : 2015 | Volume
| Issue : 7 | Page : 26-28
Creativity and diabetes education: Essentiality, impact and way forward
Director, Sarda Centre for Diabetes and Self-Care; Founder, UDAAN, Aurangabad, Maharashtra, India
|Date of Web Publication||17-Apr-2015|
4, Venkatesh Nagar, Jalna Road, Aurangabad - 431 001, Maharashtra
Source of Support: None, Conflict of Interest: None
| Abstract|| |
The changing diabetes in children (CDiC) program is a unique program aimed at children suffering from type 1 diabetes. The whole focus of CDiC is to provide comprehensive care including diabetes education. Various innovative and creative diabetes educational materials have been developed, which makes learning fun. Lot of diabetes camps are held at CDiC, focusing on diabetes education, experience sharing and fun activities. CDiC faces many challenges in an effort to cater to the needs of most deserving children with type 1 diabetes mellitus (T1DM) throughout the country, to provide comprehensive care including self-sufficiency, to serve children for as long as possible and to ultimately have better outcomes for all children with T1DM. The CDiC program aims to make the child more positive, secure and hopeful and initiate and strive for comprehensive diabetes care for the economically underprivileged children with T1DM.
Keywords: Changing diabetes in children, diabetes, type 1 diabetes
|How to cite this article:|
Sarda A. Creativity and diabetes education: Essentiality, impact and way forward. Indian J Endocr Metab 2015;19, Suppl S1:26-8
|How to cite this URL:|
Sarda A. Creativity and diabetes education: Essentiality, impact and way forward. Indian J Endocr Metab [serial online] 2015 [cited 2020 Feb 28];19, Suppl S1:26-8. Available from: http://www.ijem.in/text.asp?2015/19/7/26/155363
| Introduction|| |
Children with type 1 diabetes mellitus (T1DM) have to deal with a complex and demanding daily treatment regime, which can have a negative impact on their quality of life (QoL) as well as pose an economic and psychological burden for them. Disease-specific QoL problems, including a negative impact of diabetes on daily functioning, and diabetes-related worries have been reported. 
Below is a case of T1DM in an underprivileged child named Suraj from the changing diabetes in children (CDiC) program which will help to understand the life of children with T1DM. He lives in a village. In order to reach the CDiC center he has to travel 60 km via public transport. The travelling cost is around Rs. 400. His mother, who works on a sugarcane farm, accompanies the child to the center as he cannot travel alone. Thus, diabetes management in such a child is no small task as T1DM is not just about taking insulin. It is a difficult and different situation from daily life, as whenever a child is diagnosed with a disorder, which is not curable, there is a need to learn many new things for survival and most of the learning needs to be continuous. Children with different ethnicities, culture and with different food habits visit the center and their main concern is about what they should eat.
Suraj told the helpers at the center that his parents cannot read and write. They can't interpret the glucometer readings. They have to take help of the neighbors in order to understand the readings. Furthermore, as they are children, they are more interested in playing than taking lessons on how to manage diabetes. Suraj's grandmother said that there is no doctor available in the village who knows about diabetes and its control.
A surprise visit to his village was planned by the CDiC team. The team met another child with T1DM who was on insulin. It was discovered that the insulin was stored in an earthen pot ("matka"). The main purpose of this was to keep insulin in a cool place. The ultimate goal of CDiC is to make the child and his/her family capable of accepting and managing diabetes.
Multiple aspects (physical, mental, psychosocial) of a child need to be dealt with while managing diabetes.  The challenges which actually CDiC faces is to reach out to the children with diabetes as per their age, cultural background, level of understanding, language of understanding and economic status. Medical guidelines are not of much help in such a scenario.
The whole focus of CDiC is to provide comprehensive care which includes diabetes education. So while providing insulin, glucometers and strips, CDiC also included, along the way, complete care which involves various methods of educating children, parents, healthcare workers as well as doctors. Thus, diabetes education is an important bridge between people with diabetes and good health.
Various innovative and creative diabetes educational materials have been developed which makes learning fun and includes Mishti story book: Story of a little girl with diabetes who shares her journey with diabetes; Novo Nordisk Teaches to Take Insulin Toy: A soft toy which demonstrates insulin site selection and rotation; Snake and Ladder Game: A board game to help the child learn 'do's and don'ts' of diabetes; Make a healthy change folder: This in an input consisting of healthy recipes, lifestyle tips on diet, exercise, insulin and monitoring as well as an insulin site rotation aid; hypo kit: Help the child prevent hypo's and consists of a snack box and water bottle to help them carry something to eat and water to drink; and a glycated hemoglobin (HbA1c) convertor: This calculator helps the child and their parents convert HbA1c readings in to average blood glucose. Most of these materials (videos, leaflets etc.) are in 10 languages. The underprivileged children love and cherish these innovative tools to learn. A child with diabetes needs empathy not sympathy and group education sessions go a long way in achieving it. When a child learns in groups they are more confident and thus such sessions are encouraged at all the centers of the CDiC.
Lot of diabetes camps (residential camps, touring camps etc.) were also held at CDiC. The focus in these camps is on three basic components which are essential for children in managing diabetes and making their lives better: Diabetes education, experience sharing and fun activities. Experience sharing is the most important component of such camps as it helps in boosting the confidence of children as they listen to the stories of those children who have successfully survived diabetes. Furthermore, a particular curriculum is made in year 2014 to make education sessions more effective.
More than 275 camps have been conducted all over India since 2011. In 2013, 4795 children attended the camps, but CDiC was able to reach out to about 2223 children. In 2014, till now 3192 children have attended the camps, with CDiC reaching to 1736 children.
There are many challenges faced by CDiC in managing T1DM as it requires self-care round-the clock. Moreover, even despite best efforts in managing diabetes, results are not good every time. It's a financial liability as it is not only related to insulin, strips, other medications, but also time away from business, while taking child to doctor, transport expenses, expenses related to providing nutritional food and coping with child's trauma, e.g. Suraj's mother has to miss her job for a day in order to accompany her son during the visit to CDiC center and that leads to an expenditure of Rs. 1000 including travelling cost. It also involves worrying about short term problems like hypos and long term complications. It may also involve a guilt feeling and feeling of failure for parents.
Thus the major challenges faced by CDiC are: To cater to the needs of most deserving children with T1DM throughout the country, to provide comprehensive care including self-sufficiency, to serve children for as long as possible and to ultimately have better outcomes for all children with T1DM. Thus the vision of CDiC is to initiate and strive for comprehensive diabetes care for the economically underprivileged children with T1DM.
Changing diabetes in children comprises of 21 centers and 27 satellite centers across India with leading doctors taking care of 4,063 children. There are about 3,00,000 insulin vials, 4,000 glucometers and 21,00,000 glucose strips for monitoring available. Test facilities for measuring HbA1c, complete blood count, microalbumin, fundus and thyroid stimulating hormone are present. Till date approximately 19,500 doctor consultations have been undertaken. As a result, several hypothyroid children have been detected early. Many eye problems are also detected in time.
There were around 1,931 doctors and 1033 paramedical staff trained through T1DM workshops. Along with medical knowledge, how to provide social and emotional support to children with T1DM are also discussed during these workshops.
The scientific committee is working on collating the tangible benefits observed in the QoL among the participating children and sharing their learnings. The first AACDiC meeting on diabetes in children was conducted in January 2013. This unique program is extended till 2017. All the children who are already registered in the program can get the benefit till they are 21 years. Although not documented, but smiling faces on these children with T1DM is testimony to the success of CDiC. These minute efforts of CDiC in improving the QoL of children with diabetes should not be underestimated as small steps mark the beginning of big success.
| Summary|| |
The main aim of the CDiC program is to make the child more positive, secure and hopeful and the way forward is to have better outcomes for all children with T1DM in all prospects so that they can grow into healthy adults.
| References|| |
Nieuwesteeg A, Pouwer F, van der Kamp R, van Bakel H, Aanstoot HJ, Hartman E. Quality of life of children with type 1 diabetes: A systematic review. Curr Diabetes Rev 2012;8:434-43.
Kumar KM, Azad K, Zabeen B, Kalra S. Type 1 diabetes in children: Fighting for a place under the sun. Indian J Endocrinol Metab 2012;16 Suppl 1:S1-3.