Diabetes self-management education adapted for deaf communities

Educators at Leicester Diabetes Centre (LDC) have collaborated with Greater Manchester Integrated Care Partnership to adapt the DESMOND diabetes self-management education programme for the D/deaf population.

Established in 2003, DESMOND is a range of group-based and digital self-management programmes grounded in evidence and developed by LDC for people with or at risk of type 2 diabetes, and other long-term conditions.

The British Deaf Association estimates that 151,000 people in the UK use British Sign Language (BSL), but not as their first language. Of those, 87,000 who are deaf state that BSL is their preferred language.

SignHealth report (2014) showed that BSL users had worse health outcomes than the general population. 56 per cent of people with known diabetes had high fasting blood sugar levels, suggesting that their diabetes was not being properly controlled.

Julia Burdon, Education and Research Associate for LDC, explains: “The report states there could be several reasons for this but poor communication, poor access to information could be leading to medication errors, or inadequate patient education for diabetes self-management. Whatever the cause is, it suggests that more needs to be done to ensure that people from the D/deaf community fully understand their condition and how to manage it.”

The aim of the collaboration with NHS Greater Manchester Integrated Care was to identify what adaptations are needed to deliver the DESMOND programme for the D/deaf community to help them become more confident in the management of their condition.

An in-person discussion group with 10 people from the D/deaf community living with type 2 diabetes and two BSL interpreters was held with the support of the Manchester Deaf Centre (MDC).

Key areas of discussion included the need for DESMOND groups to be held in person within a local Deaf Centre and a toolkit to be created for accredited DESMOND educators, and BSL interpreters including top tips, such as the need to extend the programme duration to account for additional interpretation time.

Additionally, it was recognised that BSL interpreters require access to the general content of the sessions before programme delivery including a glossary of terms, to help with the BSL interpretation of some clinical information.

Following these discussions, two toolkits have been developed to support future rollout of DESMOND groups for the D/deaf community with type 2 diabetes across Greater Manchester and now the 105 other DESMOND providers around the UK and Ireland. The toolkits are now being shared with all DESMOND providers following Educators attending a DESMOND Academy session to learn more about this project and how to adapt the delivery of the DESMOND programme in their local area and work with their local D/deaf communities.

Feedback from the most recent DESMOND Academy session has been positive, with one colleague commenting: “The availability of the tool kits and resources has motivated me to pursue support for this group of participants and knowing the team is available for support is a huge help.”

Professor Naresh Kanumilli, Diabetes Clinical Lead for the Greater Manchester & Eastern Cheshire Strategic Clinical Networks commented “This is an important step forward in addressing some of the health inequalities that we know exist in Greater Manchester and we are delighted that the work is now being rolled out to other areas across the country.”

Julia added: “We have been working on this important project for the last 12 months and we are really pleased to now implement these toolkits to improve the accessibility of our programmes.

“We are now looking at what adaptions are needed for those living with type 2 diabetes and visual impairment.”

To find out more about DESMOND and Leicester Diabetes Centre, visit our websites: www.desmond.nhs.uk and www.leicesterdiabetescentre.org.uk