In his Edmonton practice, diabetes specialist and Health Research Fund recipient, Dr. Philip Hardin has seen all too often the devastation of long-term diabetes. He knows, too, that for many diabetics, early diagnosis and prompt, constant management of the disease is the only way to delay or prevent its worst effects. Diabetes is one disease that requires attention and care from the patients themselves, with a vigilance that can come only from full knowledge of the disease.
Newly diagnosed diabetics receive vital information about diabetes management through special education sessions that, not too long ago, took the better part of a week to teach. Then diabetes experts concluded that the same information could be taught faster, often in a three-day course. Now, Dr. Hardin is researching diabetes delivery methods that might mean an intensive, but one-day session for patients.
He bases his research on the premise that too much information might not always be a good thing. "We started wondering, if someone has high blood pressure do they really need to know the physiology of stroke or of heart disease to get them to take their pills? Diabetes is a comparable disease. Does the patient need all the details?"
At the heart of Dr. Hardin's research project is a seven-hour education module that includes physiology, diet, blood monitoring, complications and more. He set out the parameters of the project as a blinded study; that is, he has no knowledge of which of his patients are receiving the seven-hour information module and which are taking the standard three-day course. The 200 people participating in the study have been recently diagnosed with Type II (non-insulin dependent) diabetes and have not had any diabetes education from any kind of educator, nurse, or dietitian.
All patients in the study are followed up a year later not only to look at their management of blood sugar monitoring, diet, and exercise, but to test their retained knowledge of diabetes. At the end of the two-year project, Dr. Hardin will have information that may change the way diabetics receive the initial education needed for proper management of the disease.
Testing a one-day class is a response to the busy lives people lead. "A lot of people with diabetes are working people. They have to take time off work to take the class. If they're married, they often want their spouse to attend as well, since so much of diabetes management requires careful attention to meals and exercise by the whole family. Often, spouses are working too, which adds up to a lot of time off for the class."
Shorter classes could also be beneficial to educators. "In a working week, the four Edmonton diabetes clinics can fit only one three-day class in. With a one-day class, you can fit two or three classes in and the waiting list goes down."
Described as epidemic by the Diabetes Association of Canada and requiring about one seventh of Canada's total healthcare budget to address, diabetes is on the rise. If Dr. Hardin's research can set a new standard for delivering crucial information that helps diabetics manage their disease optimally, then the savings in human and financial terms could be enormous.
Fighting diabetes with basic researchAHFMR scientists have made world headlines with basic research breakthroughs in the ongoing effort to understand and manage both juvenile and adult-onset diabetes. Nearly ten years ago, U of A Heritage scientists Dr. Garth Warnock and Dr. Norman Kneteman, together with colleague Dr. Ray Rajotte were the first in Canada to show that healthy islet cells, which produce insulin, could be transplanted into the livers of diabetics who could not produce their own insulin. Part of the liver then began functioning like a pancreas, enabling several patients to go off daily injections of insulin for several years.The islet transplant team and Heritage researchers Dr. Chris Bleackley, Dr. John Elliott, and Dr. Alex Rabinovitch brought in more than $3.5 million (US) for basic diabetes research over the past half dozen years. Colleagues and fellow U of A scientists Dr. Larry Guilbert and Dr. Tim Mossman also contributed to the U of A's diabetes research that, in 1992, was deemed by the Juvenile Diabetes Foundation International as one of six Centres of Excellence in diabetes research throughout North America. Heritage scientist Dr. Leigh Field at the University of Calgary drew the international spotlight not once but three times, with the discoveries of three genes implicated in juvenile diabetes. Another Heritage researcher at the U of C, Dr. Douglas Zochodne (see Nov/Dec '96 Newsletter) studies why diabetics are so susceptible to nerve damage and is developing treatments for it. |
Dr. Philip Hardin is an internist specializing in diabetes care, who practices in Edmonton's Westgrove Medical Clinic. He received project support from the Health Research Fund, administrated by AHFMR on behalf of Alberta Health.
Recently diagnosed Type II diabetics who have not had any diabetes management education, and who are interested in participating in Dr. Hardin's study, should contact him at(403) 452-1999.
Relevant diabetes websites:
- The Canadian Diabetes Association:http://www.diabetes.ca/
- Juvenile Diabetes Foundation Canada:http://www.jdfcure.com/
- Juvenile Diabetes Foundation Canada:http://www.jdfcure.com/
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