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Diabetologist's core competence curriculum: A position statement of the amd (Italian association of medical diabetologists)

N. Musacchio*, R. Candidom, A. Cimino, A. De Micheli, A. Giancaterini, L. Monge, A. Ozzello, M.A. Pellegrini, M.C. Ponziani, M. Ragonese, S De Cosmo, G.T. Russo, C. Suraci, R. Zilich

Background: The management of chronic diseases requires integrated, patient-centered, medicine, technological and therapeutic innovation, as clearly explained in all chronic management models, such as the Chronic Care Model (CCM). The Italian association of medical diabetologists (AMD) started the project “Diabetes Intelligence” (DIA&INT), aiming at identifying and ranking major competences required by modern diabetologists to implement the CCM. Methods: A step-based approach was adopted: 1) identification of 25 activities 19 outcomes for optimal practice in diabetology, obtained from national guidelines for diabetes care; 2) ranking of the activities according to specificity, through digital questionnaires administered to a set of diabetes specialists; 3) assessment of the Social Return on Investment (SROI) of the activities to estimate their impact on the outcomes; 4) annotation of the knowledge and skills requirements for each activity, as reported by the Italian guideline for diabetes care; 5) evaluation of the collective degree of specificity and priority of each activity. Results: All results are based on the answers provided by 211 AMD diabetologists. The top 4 activities, educational therapy, personalized therapeutic plan, biomedical evaluation and assessment of fragility obtained excellent scores in terms of intensity and pervasivity showing a high sphere of influence. The activities judged as more specific were: the definition and management of personalized treatment plans, and the diagnostic and specialist evaluation - or the biomedical assessment. From these results, it emerges that the specific competence of the diabetologist is strongly associated with the ability to make patients participate and take charge of their own .condition. Conclusions: This project allowed the definition of a Core Competence Curriculum for diabetology specialists, formally approved as a position statement by the AMD. This effort highlights the relationship between assets/knowledge/skills and outcomes in diabetology, through the application of a rigorous scientific method, as required by the logic of the CCM.