The glucose guardian

2024 National Credentialed Diabetes Educator of the Year Julie Kha MPS loves collaborating to deliver better outcomes for her patients.

What led you to pharmacy?

Pharmacy was an exciting choice, enabling an understanding of how medicines can affect us, which can then be communicated to patients to ensure they are informed how to best achieve their shared health goals.

As a profession, pharmacy also offers incredible flexibility with an increasingly specialised workforce.

For example, pharmacists or credentialed pharmacists have now extended into various practice settings such as general practice and aged care – with a continual expansion of scope of practice for those who undertake additional training.

Why did you decide to become a credentialed diabetes educator?

During my formative years, I was fortunate to work alongside the first Australian pharmacist credentialed diabetes educator (CDE) Kirrily Chambers.

I noticed the impact she had on the lives of people with diabetes and their families as they exited the consult room where she worked in private practice and I wanted to generate that same impact from each patient interaction I had.

I was also fortunate to have come across another pharmacist CDE, Cindy Tolba, who was working in a diverse community where English is not the primary language.

Here, she utilised family members and even generated her own resources in the patient’s own language to better convey the workings and impact of diabetes.

Not too surprisingly, my Asian heritage played a role with our increased risk of diabetes. Dr Chris Verrall, an advocate for individualised patient goals, encouraged me to complete my accredited pharmacist requirement and then become a CDE.

How do you support patients who have been newly diagnosed?

Collaboration with the patient’s GP is where we work best. During the early stages, the patient may require time to navigate their new diagnosis and have many questions, or none at all. This takes time that GPs, who are underfunded and in short supply, don’t always have.

Establishing a person-centred approach is also of utmost importance. From this, an individualised plan can be generated to provide personalised education and support with resources and tools to empower the person with diabetes to be in a position where they are able to self-manage this chronic condition.

I had one patient whose glycated haemoglobin (HbA1c) remained elevated despite the addition of insulin.

Following a discussion about injection technique, and more importantly injection site rotation, it was discovered that the abdomen had developed areas of lipohypertrophy as ‘these areas didn’t hurt as much’.

After collaboration with the GP, the person with diabetes was just as excited to hear their insulin dose would be decreasing with a follow-up review scheduled soon thereafter.

How will pharmacists’ roles evolve in chronic disease management?

I was delighted to hear about the partnered prescribing models in our South Australian public hospitals.

With the right education and collaboration, I believe we can develop a similar model to our Canadian pharmacist colleagues, who provide structured chronic disease management programs in collaboration with GPs, practice nurses and other allied health to improve patient outcomes.

I believe one of the first steps would be to incorporate pharmacist CDEs into the hospital system, both public and private, to encourage greater interprofessional collaboration.

I’m proud to be part of pharmacy in this era of change and excited for our pharmacists of the future.

Advice for pharmacists looking to specialise in diabetes care?

Pursue your passion with a group of like-minded colleagues and mentors.

This way, your continuous learning will ensure the outcomes of each person with diabetes, and their families, are improved via an individualised approach and collaboration with the
best evidence-based practice.

A day in the life of Julie Kha MPS, Credentialed Diabetes Pharmacist, Adelaide, SA.