The details make the difference

Today’s guest post is by Arantxa Mugica, European Communications and Digital Public Affairs Manager at Lilly and 2017 Connecting Hearts Abroad Ambassador.

 

There are almost 200 million women living with diabetes around the world. Two out of every five women with diabetes are of reproductive age, and approximately half of all women with a history of gestational diabetes (GDM) develop type 2 diabetes within five to ten years after delivery[i].  

Pregnancy and diabetes clearly require greater consideration. Even more so in low and middle-income countries where access to maternal care is often limited.

I experienced this first hand when I visited Mexico City last summer as part of my assignment for Lilly’s Connecting Hearts Abroad Program. I had the chance to work with an array of Lilly colleagues as well as excellent healthcare professionals in Mexico to contribute to the NCD partnership between Lilly and the Carlos Slim Foundation  on GDM.

WDD blog 1

Our mission was to provide the NCD partnerships with a series of recommendations to improve the management and monitoring of gestational diabetes in Mexico. To do this, we designed and implemented a survey, with the support of the reference centers CIMIGEN and INPer centers, to understand the knowledge, attitudes and practices required to manage GDM from both the patient and health practitioner’s side. Our key findings included:

  • Some patients have to travel hundreds of kilometers for their pregnancy checkups, others cannot afford public transportation to go to the hospitals, and other women’s household responsibilities keep them from turning up to their doctor’s appointments.
  • Myths and false beliefs about diabetes are widely spread in Mexican society, which results in low levels of adherence to treatment and higher risk of comorbidities and negative consequences for mother and child.
  • They lack information and education about healthy nutritional habits and physical activity, making the self-monitoring and management of the disease difficult.
  • Healthcare professional operate with scarce resources; in some first level of care units, the patients per doctor ratio is higher than 10,000, they have scarce medical supplies and high bureaucracy leads to little time for the patients.

 

Our recommendations focused on simple, low cost but effective actions:

  • Telemedicine: cell phone adoption in Mexico is high and mobility is costly. Dedicating a telephone line for routine checkups, to address concerns and send reminders can be an efficient way to improve the consultation absence rate and ensure better follow-up for GDM patients.
  • Health education: “Education in diabetes is not part of the treatment, it is THE treatment” insisted an outstanding diabetes educator we met. High quality professionals working in the reference centers we visited offer very effective educational services and tools that empower patients to manage their condition. Why not extend these leaflets, videos, counselling models to other centers?
  • Understand, analyze, act!: the survey we created is a useful tool to identify disease management gaps; the NCD partnership leaders will consider standardizing it as a mechanism for identifying improvements in diabetes care in Mexico.

 

The small details make the difference. These recommendations, although simple, were very well received and already put in practice in some cases.

This year, the International Diabetes Federation’s theme for World Diabetes Day is Women and Diabetes and I am proud and excited to have contributed to a program that helps bridge the gap and move us towards more affordable and equitable access to care and education for women with diabetes.

 

[1] https://www.idf.org/our-activities/world-diabetes-day/wdd-2017.html

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