糖尿病患者の在宅ケア向上をめざした徳島市糖尿病サポーター（TCDS）育成の試み

The Tokushima City Medical Association has cultivated the talented persons of nursing care profession by both the education of diabetes and the instruction of medical treatments to secure the quality of home care for increasing diabetic patients. They are certified to be the Tokushima City Certified Diabetes Supporter（TCDS）. In Tokushima Prefecture, the rate of aging and the certification rate of care need are ranked high in Japan, and the medical measures should be provided for the aged diabetic patients utilizing team nursing care as well as team medical care, because many of these patients are obliged to receive home medical care owing to the introduction of community-based integrated care systems. Tokushima Prefecture kept the worst of age-adjusted diabetes mortality and also the worst of crude diabetes mortality in recent years. Therefore, the program for the TCDS was arranged by the staffs composed of board certified fellows of the Japan Diabetes Society, certified diabetes physicians of Tokushima, and Tokushima local certified diabetes educators （Tokushima LCDEs）. The program includes the lectures of diabetes and medical treatments, the practical training, and the group work by the World Café system collaborated with the medical staffs across many different fields, using the dramatic skit presented by the medical doctors and the LCDE staffs after narrating the scenario for the blood glucose control of diabetic patients to be treated. The persons who have completed the training course are certified as the TCDS by The Tokushima City Medical Association. The workshop is held twice a year and the certification is renewed every three years without examination. In conclusion, it is suggested that the development of TCDS leads to the improvement of the ability of nursing care staffs to support diabetic treatments and the advancement of the quality of home medical care for the aged diabetic patients.