Ensuring that people affected by diabetes are at the centre of their care: Highlights from the #19ADC

It’s back to business as usual this week in the ACBRD office. However, we have taken time to reflect on last week’s Australasian Diabetes Congress (ADC: 21-23 Aug, Sydney). It was fantastic to hear so many of our esteemed colleagues, peers and friends share their inspiring research, work and lived experiences

One of the opening sessions of the conference – the ADEA Symposium: Collaborating with Lived Experience– was heartfelt and inspiring, reminding us all that the person with diabetes should be central in all of the work that we do. The session opened with Kim Henshaw (Consumer, Community and Stakeholder Engagement Specialist, Diabetes Victoria (DV)) who spoke of her personal journey of living with type 1 diabetes. Carolyn Jones (Consumer Engagement Manager, DV), provided an overview of the steps that DV has undertaken since 2016, to increase its capacity for engaging with people with diabetes including establishing a ‘consumer engagement framework’. Susanne Baxandall (Advocacy Coordinator, DV) shared how the framework has benefited her work as a health professional in advocacy, including her work with VicRoads to improve the letters sent to people with diabetes about their driving licenses. The symposium concluded with Tony Seymour (Consumer Advisory Committee, DV) discussing how his lived experiences are contributing to the organisation’s policy and strategic priorities, and the positive impact this can have for people with diabetes, the organisation and the wider health professional community.

On Wednesday afternoon, the ADEA symposium on paediatrics covered many psychological aspects of diabetes care in younger people. First up was Kristine Heels (Diabetes Educator, The Children’s Hospital, Westmead). She gave a presentation on how the hybrid closed loop system has been implemented in their hospital. One of the behaviours they have observed is that young people turn off auto-mode (the system’s ideal setting) due to alarm fatigue. Next was dietitian Dr Carmel Smart (John Hunter Children’s Hospital) who presented on nutritional challenges and solutions for families of very young children with type 1 diabetes. Giving insulin before meals is important and one challenge she covered was fear of hypoglycaemia around meal-times. Some strategies that families find helpful for managing this fear are: to be aware that insulin takes some time to start acting; to only bolus for a small amount of carbohydrate; and to follow-up the meal two hours later with a snack (as this is the risky time for a hypo if the child has not eaten enough at the previous meal). The third presentation was from Anne McCrea (Social worker, John Hunter Children’s Hospital). She discussed developing emotional intelligence in children with diabetes, and about working with children to address their fears and concerns about diabetes. The last presentation in this session was from dietitian Kristine Lobley (The Children’s Hospital, Westmead). Her presentation was on working with families from culturally diverse backgrounds. She spoke about considerations such as social isolation if abstaining from religious events (e.g. Ramadan) and different parenting styles.

Diabetes self-management can be challenging for all people living with the condition. However, those from minority populations face additional psychosocial burden and are recognised as being at increased risk of long-term complications. We were very pleased to attend an ADEA session titled Education and Management for Specific Populations. Collectively, the presentations focused on Indigenous health and Culturally and Linguistically Diverse (CALD) populations, with a stand out being a presentation from Kristie Cocotis, Diabetes Victoria. Kristie’s work, which was titled ‘Identifying priority populations for diabetes in pregnancy resources’ highlighted Indian, Chinese and Karen (Myanmar) women as the CALD populations with the greatest unmet need for culturally tailored resources about pregnancy in women with diabetes. Diabetes management during pregnancy is of crucial importance to both mother and baby. Culturally relevant pictorial guides which support women from CALD backgrounds have the potential to improve emotional and physical health outcomes and are a very promising initiative.

Finally, Dr Kylie Mosely (BodyMatters Australasia) gave an excellent presentation on motivating lifestyle behaviours in people with pre-diabetes. She provided background on the important role psychology plays in how people with pre-diabetes can modify their lifestyles to prevent, or at least delay, the onset of type 2 diabetes. Dr Mosely highlighted existing research on effective strategies such as goal setting, reviewing goals, relapse management and information provision, which exist amongst a behaviour change taxonomy of 94 techniques. She went on to discuss some research (under review) she has been involved with in partnership with the ACBRD, which demonstrates that simple positive reinforcement techniques, such as praise and encouragement are associated with meeting or exceeding the recommended physical activity guidelines. In particular, praise of the behaviour (i.e. efforts to be active) appears more effective than praise of the outcome (i.e. weight loss or glucose levels). Overall, this session was both informative of the science behind behaviour change, and also practical, with take home messages that the audience could connect with and apply in their daily clinical practice.

Well done to all of those who presented at the #19ADC!

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