March 24, 2023 Breaking down barriers to diabetes education

Every day, Canadians all across the country are working to make life better for people who have diabetes or to prevent the condition from affecting the next generation.

Pharmacist Nafisa Merali is one of them. She comes from a family of pharmacists, so it is no surprise she is committed to improving the health and wellness of Canadians. More than 25 years ago, Merali co-founded Naz’s Pharmacy group, a chain of pharmacies within Vancouver’s Lower Mainland that serve communities with large immigrant populations.

Seeing the high rates of diabetes among her South Asian and Asian patients (and even among her own family members), Merali wanted to educate these communities about their increased risk and about strategies to help them manage their health. That meant working to break down cultural and language barriers.

“Many of our patients are from cultures where there isn’t a widespread understanding of diabetes or its long-term consequences,” says Merali, who is also a certified diabetes educator. “I want to help them understand that diabetes is a serious, progressive disease.”

For many years, Merali has offered diabetes education presentations and clinics at local mosques, temples, and community centres. She also appears regularly on multicultural television and radio programs to talk about diabetes, cholesterol, and heart health.

Merali and the other pharmacists in her stores offer one-on-one diabetes consultations, diabetes screenings, education sessions, and at-home visits in English, Hindi, Punjabi, Cantonese, and Mandarin to help patients make informed decisions about their health. For her contributions to improving the quality of life of people living with diabetes, Merali received Diabetes Canada’s 2018 Charles H. Best Award.

Franca Lattanzio, Diabetes Canada’s community fundraising and events program development coordinator, nominated Merali for the award. She says, “Through her work in Naz’s Pharmacy group, Nafisa has become a recognized community leader and champion in supporting the health and wellness of her patients. She works to remove the barriers that many higher-risk communities face to access healthcare services and resources.”

The role of pharmacists is an important one in the management and treatment of diabetes. During the pandemic, we were the most accessible and trusted frontline healthcare professionals. Today our role is more important than ever before, due to not only the number of patients with diabetes but the vast number of medications available to treat them.

We also support other healthcare providers by recommending the appropriate drug treatments available,” says Merali.

She has taken her commitment to supporting people with diabetes to a new level by volunteering as a board member with Diabetes Canada for the past three years, and is currently serving as a member of Diabetes Canada’s Governance & Nominations Committee. “My experience as a frontline pharmacist opened my eyes to the issues most communities face in getting access and care,” says Merali. “I sit on the board as a trustee working on behalf of Canadians, and want to share my knowledge to help improve the quality of life for the 11.9 million Canadians living with diabetes. I am passionate about Diabetes Canada’s vision statement of a ‘world free of the effects of diabetes.’”

How can your pharmacist help you live well with diabetes?

Pharmacist and certified diabetes educator Nafisa Merali offers these four ideas:

1. Determine if you are at risk of diabetes. At Naz’s Pharmacy group and some other pharmacies, pharmacists utilize the CANRISK (Canadian Diabetes Risk Questionnaire) tool as well as other tools such as random blood sugar screening and A1C screening (which measures your average blood sugar levels over the past three months). Your pharmacist can play an active role in referrals to other healthcare professionals as needed, and in educating individuals on how to reduce the risk of developing diabetes in the future.

2. Take action to live with and manage your diabetes. If you are diagnosed with diabetes, pharmacists can provide education on the disease and its complications. We show you how to monitor your blood sugar levels and how to prevent or delay the complications of diabetes, and help you set individualized targets. We also provide education on lifestyle modifications, such as physical activity, that will help manage diabetes. Pharmacists can also educate about self-management through the use of continuous blood glucose monitors and blood pressure monitors. Knowledge is power: an empowered patient will always have better outcomes and may be able to avoid diabetes complications.

3. Get the most out of your medication. This is perhaps the most important role a pharmacist can play. We encourage medication adherence—helping people take their medication as prescribed so that they get the most benefit from it—by explaining what a medication is expected to do and what its side effects are, so you are not surprised or worried and stop taking it. We also help our patients understand side effects such as hypoglycemia (low blood sugar) and teach them how to treat this. Adherence to taking medications has been shown to improve blood sugar control.

4. Manage your drug costs. Pharmacists are very familiar with drug formularies in their province, and because of this we can help our patients contain costs while recommending therapy based on the Diabetes Canada Clinical Practice Guidelines. We help select medications that maximize efficacy, minimize side effects, and may even have a beneficial impact on any other disease you may have, such as heart or kidney disease. 

Did you know?

March is Pharmacy Awareness Month. Pharmacists are an important member of your diabetes care team. Learn more about how you can prepare for your diabetes care by visiting Me, My Health and My Diabetes Team.

This article originally appeared in Diabetes Dialogue.