A Vision takes shape and grows
St. Joseph's Diabetes Education Centre marks 40 years of groundbreaking excellence.
It began with two visionaries and a hospital led by the forward-thinking Sisters of St. Joseph, who were open, always, to the possibilities.
The visionaries were Dr. Wilson Rodger and Dr. Gerald Tevaarwer, who recognized that medical treatment wasn't enough to manage diabetes. Patients needed to be partners in their care. They needed education that would help them to take charge of their health.
At the time, St. Joseph's Hospital was still testing its wings as an academic hospital and there was a zeal to explore new projects, new ways of caring for patients.
Together, and through the hard work of many, they created one of Canada's first diabetes education centres. The year was 1973. Until then, "patients learned what they could from their family doctor, did what they were told and hoped for the best," recalls Dr. Rodger.
The St. Joseph's Hospital Diabetes Education Centre, as it was first called, opened on the second floor of the hospital after five years of planning. It was initially funded through private donations with the hope of government funding to follow. The main sponsors were the Hon. and Mrs. Ray Lawson; local branch of the Canadian Diabetes Association; and Associated Physicians Services. The May Court Club would also become a valued donor. The first medical directors were the industrious Dr. Rodger and Dr. Tevaarwerk, and the first coordinator was nurse educator Dorothy Gibson, a pioneer in her own right. Dorothy was the first person with insulin-dependent diabetes to be accepted into nursing and she had a well-known motto: "The diabetic that knows the most, lives the longest."
Having arrived to begin his career at St. Joseph's 1967, Dr. Rodger came from Montreal which had the first diabetes education centre.
"I visualized something like that here because of the number of people with diabetes and how it would contribute to self care," says Dr. Rodger.
He also saw a need for an investigation unit to accommodate the special tests needed to evaluate endocrine problems. "These things came to mind and in those days everyone was very approachable. The hospital allowed the wheels to turn."
A four-bed inpatient clinical investigation/research unit was created and became a success. When the head nurse in the unit - Fran O'Brien - began giving diabetes lectures to the patients in1970, the seeds for an education centre were planted.
"That was the first sign of diabetes education in the hospital," says Dr. Rodger. "We developed a case for diabetes education centre for outpatients and the hospital identified a space where we could do this."
Dorothy was hired, along with a dietitian, a curriculum was developed and classes began. The centre would grow quickly and eventually moved to Mount St. Joseph where there was space to accommodate the growing demand. There, it would be renamed the Lawson Diabetes Centre.
The clinical investigation unit ran parallel to the education centre, as did the Diabetes Day Care Centre for individuals newly diagnosed with diabetes and starting on insulin. The Diabetes Day Care Centre would eventually amalgamate with the education centre.
Insulin pumps became part of the program in the late 1970s with a trial headed by Dr. Rodger and Dr. John Dupre at University Hospital. They would have the first pump patients outside the United Kingdom.
"It was complicated in those days," recalls Dr. Rodger. "The pump was the size of a small cigar box. It was primitive but effective. Patients were able to give themselves a little more insulin with each meal by simply activating the pump and would let the pump do its thing between meals."
Dr. Rodger, Dr. Dupre and their patients would play a key role in research and the evolution of the pump as an effective treatment shown to reduce diabetes complications.
Subsequent advances in diabetes care over the years have changed the care journey and quality of life for patients, from surgical innovation such as islet transplants, to the technology boon, to various apps that guide patients in their self care.
But the opening of the Diabetes Education Centre remains one of the most significant milestones for London, says Dr. Rodger. In 2008, the centre moved back to St. Joseph's Hospital as part of the new Centre for Diabetes, Endocrinology and Metabolism, which brings together education, treatment and research in one, purpose-built area. With this move, the name became the Diabetes Education Centre (DEC) of St. Joseph's Health Care London.
Today, about the DEC sees about 7,000 patient visits annually and boasts a dedicated staff of 11 certified diabetes educators of which five are registered nurses and six are dietitians. There is also an advanced practice nurse.
"The DEC is still at the forefront," says Dr. Rodger. "The wheels are still turning."