Attending a diabetes conference, especially one as scientifically focused as EASD, is always an interesting juxtaposition for a lay person. I do not have diabetes and I do not boast a medical degree. My credentials to attend such a conference fall solely within the realms of “mother of a child living with diabetes” and my ability to attend such a conference is reliant upon invitation and support from industry who are trying to engage with diabetes communities and learn from a vast array of experiences.
My aim from attending is therefore to share the sorts of discussions that evolve from everything a conference like this provides. From highlighting differing uptake rates of a multitude of therapies and devices used in the treatment and management of diabetes, and how these may differ widely across different countries, to reviewing just how relevant the research being conducted is to a person or a family living with and around diabetes.
So what have been the hot topics at this year’s EASD?
There was much discussion around empowering a person living with diabetes, and how they must be educated. Now, I wholeheartedly agree with the empowerment part. And the education part. But these are often presented as something which has to happen to a person. Educational literature or a programme is compiled, a format and delivery model are decided, and only then at that point is the person who needs to benefit most from that information informed how they will be educated. This needs addressing.
Learning is most effective when delivered at a point a person is most receptive to acquiring a new skill or knowledge, and crucially, in a format they find accessible. They need to see and understand a purpose in developing that particular skill set. Ensuring that it is acknowledged that people have different learning styles is pivotal to this too. Producing educational content that can be readily adapted to the seven learning styles is key to success. Almost all the current forms of educational resources that are in mainstream use favour the Verbal (linguistic) learner. Some programmes incorporate the Social learner too, but there is still a long way to travel if we are to meet the needs of those people whose learning styles favour Kinaesthetic, Visual, Aural, Logical and even Solitary. In Berlin, there were a couple of presentations and current initiatives which reflected the success that can be achieved with this more holistic approach to education.
And I think it is also important to note, that success cannot be solely judged on the clinical, bottom line HbA1c result. Quality of life is by far the most important gauge with which to measure the success of such educational approaches. If the education is delivered in an accessible manner, which lands the messages it needs to, then the person living with diabetes will feel far more empowered to live the life they want, without self-imposed limitations.
It is well researched and documented that a person living with diabetes has a greatly improved quality of life if they are knowledgeable and well supported in their management. I was greatly encouraged to finally see and hear some presentations addressing the above issues (albeit in venues tucked far out of the main space and poorly promoted), looking at the merits of a tailored approach for the individual. These sessions recognised the importance of working in a manner which is collaborative and allows the person living with diabetes to be the conductor of their care, so it may continue to work at its most optimal for that person. This is the main key. Listen to the person. Hear what they are telling you. Then together, it becomes possible to facilitate the learning that will empower that person with diabetes.
Another interesting subject, that is an ongoing, recurring theme at conferences, is the uptake of the latest technologies and the variations in care that it highlights across different countries. This year’s EASD provided the latest snapshot of the picture across Europe. What emerges is a picture where management, when judged on factors such as HbA1c and time in range, is greatly improved in the countries where there is large uptake of this technology. In countries where the uptake of technologies is high, there comes, by nature of the treatments supported and the familiarity with tech devices, far higher levels of expertise from supporting HCPs about how to make the most of technology to support management of diabetes. This is important to note, as the support a person living with diabetes is given will be far more beneficial when given with a multitude of experience and expertise. The more clinicians initiate the use of devices and technologies when working with people with diabetes, the more everyone learns about the capabilities and functionality of this tech.
Experience breeds confidence, and people living with diabetes benefit enormously from care and support delivered by clinicians they know and trust when embarking on new therapies and treatments. In countries where a self-funding model is more commonplace for accessing new technology, then you will find the expertise lies not with the HCPs supporting a person with diabetes, but from the person themselves. Their economic wherewithal to support their tech use, their independent research into learning about the different technologies available, and their decisions about which to invest in, all culminate in a level of understanding and education that an HCP who has had little to no diabetes tech exposure can only dream of.
Engaging clinicians and investing in training for the HCPs tasked with supporting people living with diabetes, even in territories where self-funding is the main source of sales, will result in the overall experience of people living with diabetes being enhanced. Encouraging a collaborative approach to using technology and devices will be beneficial to everyone involved in diabetes management.
Diabetes research also came under what could be considered long overdue review, with some grass roots initiatives on show that were designed to question the research projects scientists and researchers propose to pursue. Academic research can, at times, feel remote and irrelevant when compared to the realities of living with diabetes. I have lost count of the amount of times I have been aghast at a research project that has not only been proposed, but funded and taken to its conclusion. The relevance of the project could be questioned when scrutinised next to the fundamental realities of living with diabetes. The initiative that was started at this year’s EASD aimed to pair researchers to PWDs who had experience, knowledge or interest in the topic they were proposing to research. It is no surprise that the genesis of such a project had its roots firmly placed in the diabetes community. What is refreshing is the willingness now of all invested parties to collaborate to ensure all efforts within this field make a difference and are not just filling time.
EASD is a fascinating conference. Being very scientifically driven, it has been slow to pick up on how important the language used in and around diabetes is, and the impact poorly chosen words may have on a person’s ability to address the endless and relentless diabetes tasks they must perform every day. This, coupled with what at times feels like sidelining the important work being undertaken by those working on the psychosocial impact of chronic conditions, results in a conference that at times feels like it has forgotten there are real people, with real lives, on the receiving end of the case studies and scientific research that are presented to great fanfare. It is my hope that the organising committee learns from the strong programme they hosted this year, with many global leading experts on psychosocial impact of diabetes, and recognises the importance of keeping at the heart of the conference the reason why everyone is gathered there. The one person who should be the focal point of the entire conference. The person living with diabetes.