The vast majority of the 122 respondents from 57 countries completing the survey on educational practices identified themselves as physicians. Respondents reported on:
Providers of diabetes education
Physicians were identified as the main provider of diabetes education in most regions, as shown in the figure below. The exception was in the Eastern Mediterranean and Middle East Region, where pharmacists were most likely to provide education. Respondents were allowed to select more than one category in their response.
Short training courses of 40 - 120 hours were most often the mechanism for training, as indicated in the figure below, when respondents were asked to indicate how people were trained to be educators in their country. However, the African and South-East Asian Regions reported that there was very limited or no training available.
Availability of teaching tools
Teaching tools were reported to be available in all regions, but every region supported the need for computerized resources and networking opportunities. The media proved to be the tool most available in all the regions. Respondents expressed interest in having an international summit address the global needs and problems related to diabetes education, and identified IDF as a resource for support in training (see the Caribbean example), and the development of practice standards.
The survey indicated that people with diabetes in general had a good understanding of and appreciated the role of diabetes educators, as shown in the figure below. This was in contrast to health authorities, and to some extent, physicians, some of whom were reported not to understand the role of diabetes educators in a few of the regions. Nonetheless, respondents reported that the majority of physicians in all regions, except Africa, did promote and refer patients for diabetes education. In addition, all of the respondents were aware of published studies validating the importance of education.
Although all countries reported that people with diabetes had access to diabetes education, the vast majority indicated that there were barriers.
Barriers were identified and analysed according to four categories outlined in the 'Barriers to Diabetes Care' instrument1Simmons D, Weblemoe T, Voyle J, Prichard A, Leakehe L, Gatland B. Personal barriers to diabetes care: Lessons from a multi-ethnic community in New Zealand. Diabetic Medicine 1998; 15(11):958-964., which is used to measure the healthcare provider's perceptions of barriers.
Each of the four categories referred to specific problems:
The categories most frequently reported as being significant barriers were the external physical and educational, as indicated in the figure below. In other words, financial resources, limited access, lack of knowledge and educational resources were perceived to be the biggest challenges.
Training and advocacy efforts directed toward health ministers and public awareness were some of the mechanisms most often identified as means to address these barriers.
