According to IDF’s Diabetes Atlas there are over 130 million people living with diabetes in the Western Pacific and over 387 million people have diabetes globally with dramatic increases seen in countries all over the world primarily related to changing lifestyle. Diabetes Mellitus Type 2 (DMT2) now figures as the most prominent emerging chronic disease. Diabetes carries with it substantial immediate and long-term healthcare costs with the greatest social and economic burden carried by the financially disadvantaged the most devastating being in low- and middle-income countries, where four out of five people with diabetes are living and where general access to diagnosis and affordable care for chronic disease and diabetes is especially limited .
Diabetes is a major health burden with grave impacts on the society, family and person concerned, if not diagnosed, managed or controlled. There are now proven strategies to prevent the onset of diabetes and its complications, which will save lives and money in the long term. However, due to the non-acute nature of these silent conditions, these preventive strategies which have proven to be efficacious in controlled settings, are often not implemented in the real world due a lack of motivation, mandate and care coordination, as well as insufficient resources, support and incentives.
In the updated draft of the Global Plan of Action for the Prevention and Control of NCDs (2013–2020), the WHO articulated its vision of a world free of avoidable burden of Non Communicable Disease based on the overarching principles of using a life-course approach to empower people and communities and adopting an evidence-based and multisectoral strategy through partnerships . Despite the challenges due to diabetes in the WP Region, researchers and care professionals had provided notable examples in early detection of diabetes and its complications through government policies as well as prevention of onset and progression of diabetes and its complications using innovative and collaborative approaches. A multipronged strategy using both bottom up and top down approaches to raise awareness, detect early cases and prevent diabetes and its complications has been proposed by the Western Pacific Declaration on Diabetes.
Better Diabtes Care International is a institutional partnersip initiative for diabetes care. The pilot project will include the SEARO and Western Pacific and includes two main components i) Integrative healthcare delivery approach and ii) community based delivery model for eye screening.
Community-Based Integrative Healthcare Delivery Approach
Using a population-based case identification and multidisciplinary team approach for disease management through an integrative framework, (2) promote behavior changes in patients to foster self-care, (3) introduce tools to allow family physicians to modify their practices, and (4) encourage local community action to support patients and providers.
Community Mobilization: Strategies within the community will be initiated to mobilize local resources within patient and provider groups. This will include local leaders, religious leaders, health professionals, pharmacists, people with diabetes and volunteers. Women volunteers and members from all sectors of the rural society will be recruited.
Meetings will be held with patient representatives, local leaders, religious leaders, health professionals, pharmacists to explore the establishment of additional patient support mechanisms such as support groups, becoming a leader and a resource to the community. In addition volunteers will be trained to identify undetected cases of diabetes with risk score (a non invasive assessment for diabetes). Physical activity will be promoted through organizing local sports including football, group exercise sessions and walking groups.
Assessment: The preliminary assessment of the project will focus on the stakeholder participating in the project: patients with diabetes, family physicians, local leaders, religious leaders, health professionals and pharmacists. In addition number of activities for volunteer and the local leaders, religious leaders, health professionals and pharmacists for educational dissemination will be assessed. Finally the number of undetected cases of diabetes through community volunteers will be registered.
Community Based Delivery Model for Eye Screening
From March 2014 The Sekwa Institute of Medicine and Da An Healthcare Group of Sun Yatsen University , Guangzhou PR of China and local governments, launched a unique initiative for the development of a Diabetic Retinopathy Screening and Detection Delivery Model for China with the aim to improve the diagnosis and control of diabetes at community level. The following components are included in this model:
The ETDRS classification system of diabetic retinopathy is used for the diabetic retinopathy grading. This classification was developed by the Early Treatment Diabetic Retinopathy Study (ETDRS) and has been considered as the “gold standard” for classifying the severity of diabetic retinopathy. The concept of independent third-party services making it possible for the project to use this gold standard (ETDRS) to provide reliable clinical scientific data for medical research clinical evaluation, management and clinical follow-up. To facilitate the clinical practice for ophthalmologists in Diabetes Care adopting the international standards for diagnosis and management.An accreditation system for fundus photography reading accessible to all partners in the network will be established.Quality-Controlled Clinical Laboratory Tests Support - high standard quality-controlled clinical laboratory tests support to the community to further ensure the improvement of the diabetes community care. The Regional Medical Centers - Qualified regional centers approved by an internationally certified accreditation system for general diabetes care will be established.
For more information, please visit BDCI website at bdci.pro