Type 2 diabetes: Why our founder Dr Roshani cares about Self Management Education

Type 2 diabetes: Why our founder Dr Roshani cares about Self Management Education

December 15, 2019 0 By Jose Scott


hey guys I wanted to talk to you about
diabetes education class it’s something that I’ve been running for my patients
for about five years now and sometimes patients who have type-2 diabetes who
are invited to the class after they see us in the first consult
they want to know why they have to come to the class I wanted to say a little
bit about how this came to be and why diabetes education is such a huge part
of what we do here at Aasaan. in 2011 when I was moving back from the u.s. to
India I decided to certify as a diabetes educator certified diabetes educator by
the American Association of diabetes educators and my co endocrinologists my
medical colleagues were a bit surprised they were like you’re over qualified to
train to be an educator usually that’s done by dietitians nutritionists nurses
para medical staff who are much less medically trained than an endocrinologist
and I said the reason I want to do it is because that’s something between me and
the patient which in the u.s. system we prescribed for education and the patient
goes and meets the educator and we’re not aware of what exactly is happening
there and the doctor is basically in charge of the medication management
only and I felt that if I’m moving back to India I needed to know what was in
that middle section because it would be very important for me to know how the
patient should be educated and then I would customize that for the Indian
cultural requirements so I came to India with that qualification and I had been
away from India for ten years so I wanted to do the education myself
also selfishly because I really wanted to understand the cultural psychology of
the patient and how is diabetes managed in India what are the education of gaps
the knowledge gaps in the patient’s mind and I started to really do that
one-on-one most of the time for the first three years from 2011 to 2014 and
in three years time I had accumulated enough knowledge that I was able to put
together a curriculum which by the grace of God I was allowed to deploy at
Hinduja Hospital which is where I was working at the time and the management
was very supportive of this idea and I was able to now provide education in a
group format which had all the FAQ’s you could call them of patients in
India not understanding how to manage their diabetes along the way I had
learnt a lot from the patients about how to manage their food the food
preferences the emotional reactions to being diagnosed with diabetes or being
told that they might have to go on insulin and I became very fond of educating the patients so now with the group format what happens is there’s
patient to patient learning also it’s not just me educating a patient and in a
group of patients if somebody has a question and I answer it for them then
everybody else benefits it’s it’s a mutual win-win it’s a three-way win
actually so I continued doing that and then when I started Aasaan
of course continue doing that here we have the classes once a month and I see
the difference that somebody who has sat through the class and has type 2
diabetes even two years later they still remember the basics and that’s very
powerful it kind of makes all the difference if someone’s going to be able
to reverse the diabetes or not reduce medications get off of insulin people
need to know what to do with their nutrition their exercise their overall
lifestyle otherwise doctors are just trained that diet and exercise is
something the patient has to do and then the doctors training starts with how do
you write that first drug when that fails how do you write the second one
and I am sad to say that we were only trained to look at the patient as when
one drug fails how do you add the next one we were never trained in what to do
when the lifestyle changes fail rather it was somebody else’s problem or
somebody else’s responsibility and especially in India it’s not even standard of care not all patients get even a basic diabetes education from a
paramedical staff let alone an endocrinologist
so I’ve begin to begun to see that it’s extremely valuable and I don’t think any
doctor went into healthcare thinking that yay I’m going to now become an
agent of the pharma industry or an agent of the insurance industry most of us learn and do
medicine because we had a desire to help patients heal and somewhere along the
way we were trained to somehow react with pills and prescriptions to a
chronic disease to a lifestyle disease and now that I think about it just makes
me realize that how can a pill cure chronic disease it’s only going to
manage symptoms that’s what allopathy is so the educational piece becomes the
way out of that loop and our mantra has become better health with less
medication through lifestyle change I mean which of you has met anybody who
says I love popping pills I mean no patient wants it either so if no doctor
wants it no patient wants it this is where diabetes self-management education
comes in to fill the gap between that theoretical advice of eat less move more
or change your diet and exercise and some doctors who are having good intentions
will say diet exercise but they’re not trained in how to provide support to the
patient for that so yes I did go out of my way and get trained in many things
not just the CDE certificate but also the emotional spiritual behavioral many
things that I kept learning along the way to change my own behavior and then
help my patients to change their behavior so that’s why diabetes
self-management is such an important part of how we
manage type-2 diabetes because it’s a lifestyle disease once again talk to
your doctor about it get yourself educated if your C peptide is high
that’s what we look at is to help people reverse their diabetes and the
foundation of that is education and knowledge take care guys