Establishing a System for Health Professional Training and Certification in Diabetes Self-Management Education in the Caribbean

Abstract

The Caribbean includes not only the islands in the Caribbean Sea, but also South and Central American countries (e.g., Guyana, Suriname, and Belize) as well as islands in the Atlantic (e.g., The Turks and Caicos Islands), which have strong historical, political, and social links. The region, predominantly comprising low- to middle-income countries, has been adopting a more “westernized” lifestyle, which has resulted in an increase in the prevalence of chronic noncommunicable diseases, including diabetes. Diabetes is estimated to affect ~ 9% of Caribbean adults, disproportionately affecting women and occurring at an earlier age than in many developed countries.1 The region has also reported some of the highest rates of diabetes-related amputations.2 In Jamaica, the prevalence of diabetes ranges from 65 years of age.3 Type 2 diabetes is the most common form of diabetes in adults. Although type 1 diabetes remains the most common form of diabetes in young people, a recent study4 found that type 2 diabetes affected 16% of adolescents. With an aging population and a high prevalence of obesity in women, the Caribbean is expected to see one of the largest increases in diabetes prevalence in the next 20 years.5 Diabetes self-management education (DSME) is crucial in addressing the coming epidemic. DSME equips patients with the skills to become active participants in their care and make informed choices that can improve outcomes and prevent complications. Although DSME is a well-established clinical skill in developed countries, there have been few efforts in the Caribbean and Latin America to develop this area of expertise and incorporate it as part of standard clinical practice.6–8 Clinicians receive much of their diabetes education while in training. Although conferences and continuing medical education opportunities …