Siva Sivapalan, MPharm. R.Ph. CDE.
Community Pharmacist, Clinical Preceptor, and Certified Diabetes Educator
Siva Sivapalan practices as a community pharmacist in the small town of Beamsville, Ontario. Initially an international pharmacy graduate from the University of London, Siva became a pharmacist in Canada in 2011, and in 2013 he decided to further his education by becoming a Certified Diabetes Educator (CDE). The certification provides health care professionals with practical knowledge on diabetes care, management, and education processes.
“I am a pharmacist, and like all pharmacists in community settings they probably provide diabetes care on a daily basis,” said Sivapalan. “You don’t have to be a diabetes educator to make really important contributions to diabetes patients, but with that being said, having the certifications gave me the confidence to be more involved and provide more in-depth advice to get my diabetes patients closer to target and live longer.”
According to Diabetes Canada, 29% of Canadians are living with diabetes or prediabetes.1 Although many Canadians are likely to know someone with the disease, a study commissioned by Diabetes Canada found that less than 50 per cent of all Canadians can identify less than half of the early warning signs of diabetes.2 There has yet to be a cure for diabetes and with more individuals being impacted by the disease, pharmacy professionals are in a poised position to provide education and support patients with adherence to therapies. The Certified Diabetes Educator (CDE) certification and programs such as the Comprehensive Diabetes Education empowers health care providers to be well versed when educating diabetes patients and delivers a thorough overview of the disease and therapies for management.
As part of a diabetes care team, pharmacy professionals can help guide treatment processes and improve management of the disease. Sivapalan shared that half of the medication reviews he completes on a weekly basis are diabetes follow-up reviews. The landscape of diabetes treatments has evolved significantly since insulin discovery, and new developments and research continue today.
“The paradigm shifts towards pharmacotherapies with GLP-1 and SGLT2 inhibitors have dramatically improved the outcomes in our patients. Pharmacists, particularly pharmacists that are diabetes educators play a critical role in ensuring optimal drug therapy is prescribed through prescriber recommendations.” Sivapalan continues, “Also, important studies clearly show that pharmacists’ interventions with in-depth counselling improves adherence to these life-saving therapies dramatically, so without pharmacists, I doubt the full clinical utility of these newer therapies would be realized.”
Siva Sivapalan, working in Beamsville, Ontario.
Although there are various therapies available to help manage diabetes, access is not equal for all. The financial burden is heavier for some people living with diabetes. The survey by Diabetes Canada also highlights the challenges of accessing treatments, with 71% of respondents (those living with diabetes or caregivers) stated they feel it is difficult to pay for health care bills related to diabetes.1 Sivapalan discussed some of the trials of being on the frontlines, working closely with diabetes patients, and having to navigate assisting patients from varying financial and economic backgrounds.
He says, “barriers to drug coverage are the biggest challenges, so I find when working with patients the knowledge that pharmacy technicians and pharmacists have is so valuable to our patients as well as our healthcare system as we’re able to help patients access the right and most effective drug therapies.”
With the challenges of helping patients with diabetes, also come rewards. It can be easy for an individual with diabetes to feel overwhelmed as the disease requires monitoring and lifestyle changes, but patients can benefit greatly due to the accessibility of pharmacy professionals, MedsCheck reviews, and other follow-ups. Considering the number of people impacted by diabetes and the growing number of therapies, the pharmacist’s role in diabetes management is more important than ever.
Siva Sivapalan, in his pharmacy in Beamsville, Ontario.
Sivapalan shared how he was able to witness the benefits of diabetes therapy adherence firsthand.
“Everything that pharmacists do on a daily basis is quite rewarding. I did a home Med Review on a patient and initially, they could hardly hold their pen to sign the consent form due to the peripheral neuropathy from diabetes. Knowing that I can help patients to prevent or slow down the disease process, thereby giving them a better quality of life is extremely rewarding.”
About the 100 Years of Insulin
This year marks 100 years since the Canadian discovery of insulin. OPA is commemorating this life-saving momentous medical achievement in collaboration with BD and Ascensia Diabetes Care. The 100 Years of Insulin campaign provides a series of educational resources, tools, and online programs. It also strives to highlight the importance of how pharmacy professionals transform the lives of those living with diabetes through medication therapies, adherence, and counselling.
To read more about the 100 Years of Insulin and discover upcoming events visit, opatoday.com/100yearsofinsulin.
1 Diabetes Canada. (2020, February). Diabetes in Canada Backgrounder. https://www.diabetes.ca/DiabetesCanadaWebsite/media/Advocacy-and-Policy/Backgrounder/2020_Backgrounder_Canada_English_FINAL.pdf
2 Ipsos. (2018, 6 November). Six in Ten (60%) Canadians say they Would be More Likely to Support a Political Party that Would Implement a National Diabetes Strategy. https://www.ipsos.com/en-ca/news-polls/support-party-implement-national-diabetes-strategy
All photos were provided courtesy of Siva Sivapalan.