Anna Carling is a registered dietician leading Freedom4Life within Wiltshire for a selection of local PCTs and health organizations with specific responsibility for diabetes care.
Freedom4Life focuses on diet and lifestyle changes in order to improve blood sugar control but also for greater quality of life for the people who take the course.
Freedom4Life within Wiltshire
Anna explains how she became involved in the courses, saying, "I work closely with Becky Hannan, a specialist diabetes nurse. We were aware of various diabetes education courses, and looked at some in detail, such as the BERTIE course at Bournemouth, and decided we too wanted to offer something similar. Our initial course was a great success so we then undertook to get funding to be able to offer more."
Freedom4Life course over five weeks
Each Freedom4Life course covers five weeks where the group meets once a week for three-and-a-half hours.
There are two courses a year that take place in the evening, two that take place in the afternoon, and two that take place in the morning - in this way fitting around people’s different commitments with jobs or family.
The courses are free to attend, with likely candidates either being recommended by consultants and diabetes specialist nurses in the area, or who contact the course organizers directly.
Each course has six attendees, although they can bring a partner along if they wish. Among the events are a meal out and a supermarket tour.
Says Anna, “Before coming on the course, candidates are asked to commit to attend every session of the course. We find that the group gets to know each other and very often keep meeting up even after the end of the course, to offer each other support . They seem to really benefit form meeting others in the same boat – they realize that they are not alone, they are not the only ones struggling to hit the right numbers, and not the only one to get some wild blood test results sometimes. This sharing is important.”
Assessing the benefit of Freedom4Life
Some standard questionnaires are currently used within the NHS to assess the benefits of courses such as these, one of which looks at frequency of hypos for those who undertake the course and another asks them about their perception of their quality of life.
In addition, Hba1c readings are used to assess success.
She says, “HbA1cs are taken at the start of the course, then checked again at three months, six months and again after a full year from taking the course, and we see distinct improvements, but we’ve seen the most dramatic improvements in people’s views of their own quality of life. Its’ not just about the HbA1c results, though they are an important factor, it’s about giving people the skills and confidence deal with their diabetes.”
Sometimes, Anna admits, there is ‘slippage’, where a patient may not maintain an improved HbA1c, which she says, “Even if the results may not be as good, the patients tell us that they know they have the skills to improve their control, it’s just that it can be tough and a bit? A big commitment, but they feel capable of doing it with the education they’ve taken on board. They still mention that while the numbers might have slipped, their anxiety levels about living with diabetes have lowered.”
Anna is confident that the courses will continue and is hoping to find funding for more in the local area. Her enthusiasm is based not only on the feedback of course attendees, but her own enjoyment of the process. As she says, “I love the fact that I learn something on every course.”
The course is also being recommended for those who want to be able to go on an insulin pump.
This level of education is considered an excellent pre-pump undertaking that ensures the best possible skills are learned before going on a pump to make the transition as simple and efficient as possible, as good pump skills include being able to assess carbohydrates in the diet and adjust insulin doses accordingly.
- Contact Anna Carling on 01249 456512
Written by Diabetes Expert: Sue Marshall.