Fighting diabetes with education: The Dia Mitra project, Gwalior

Sir,

“---the doubts that have arisen in your heart out of ignorance should be slashed by the weapon of knowledge. Armed with yoga [knowledge], O Bharata. stand and fight”.

Lord Krishna, speaking to Arjuna. Bhagavad Gita 4.42.

That the diabetes epidemic needs urgent attention, to minimize the negative impact on societal health, cannot be overemphasized. That sustained, concerted action, involving all stakeholders, including people with diabetes, and their health care professionals, too, needs no explanation. Not only has patient centered care been accepted as the basis of diabetes therapy, experts now promote the need for active involvement of the family and community in caring for people with diabetes.[1] Family therapy and peer support have been proven to be effective interventions in various clinical settings.

While the rest of the world terms India as a resource-poor country, the reality, at least with regards to diabetes care, is different. We are a socioculturally rich country with a strong family fabric and binding community ties. We have an extensive human resource of educated, aware, and concerned, people.[2] [3] Unfortunately, this human resource has not been utilized optimally for the care of diabetes. India does not have any structured course for peer educators, and has just begun to train diabetes educators in the past few years.

To satisfy this need, and to make use of our untapped rich human capital, in a systematic manner, we need active collaboration between clinicians and educationists. The DiaMitra (Friends of Diabetes) project, conceived and implemented at Gwalior, Madhya Pradesh, India, is playing a central role in this mission, working to educate the public, about various aspects of diabetes health, through its team of trained lay educators. These volunteers receive formal training from the Indira Gandhi National Open University (IGNOU), New Delhi, approved 6-month long Certificate Course in Diabetes Care for Community Workers (CDCW), targeting 10 +2 pass individuals and paramedical health care professionals. A detailed and comprehensive curriculum, designed and revised in collaboration with leading diabetologists and endocrinologists, is followed in the course. This includes practical and theoretical topics as diverse as physiology, behavioral change counseling, prevention and management of complications

With these educational programs, India will be able to educate and empower all its concerned family members, friends and peers, who wish to support people with diabetes. These formal certification programs will also spur interest in research related to patient empowerment, as well as structured peer and community support, and improve the public health impact of various noncommunicable disease programs being launched by the Government of India.

By popularizing initiatives such as these, we can emerge as an Action Leader, as well as Thought Leader, in converting India's image from the Diabetes Capital, to the Diabetes Care Capital, of the world. Stronger collaboration with respected professional bodies and platforms, such as the Journal of Social Health in Diabetes, will contribute to the enhanced success of this endeavor.

• References

• 1 Kalra S, Sridhar GR, Balhara YS, Sahay RK, Bantwal G, Baruah MP. et al. National recommendations: Psychosocial management of diabetes in India. Indian J Endocrinol Metab 2013; 17: 376-395
• 2 Aswathy S, Unnikrishnan AG, Kalra S, Leelamoni K. Peer support as a strategy for effective management of diabetes in India. Indian J Endocrinol Metab 2013; 17: 5-7
• 3 Kalra S, Unnikrishnan AG, Skovlund SE. Patient empowerment in endocrinology. Indian J Endocrinol Metab 2012; 16: 1-3