As type 2 diabetes progresses and changes, the patient’s diet should change in accordance, often their insulin requirements may change throughout the term of the illness.

It is vital that a diabetic person has access to a specialist dietician who is able to provide individual support and guidance on the best diet to follow allowing the patient a normal and carefree life.

The NHS
Primary Care Trust
(PCT) is the part of the National Health Service that provides both primary and community services in a number of fortes in the medical sector, primarily they are responsible for spending around 80% of the total NHS budget.

Depending on the Primary Care Trust in which the individual lives, access to healthcare professionals will vary. The following section outlines the various healthcare professionals in the UK, and how they can help you.

Remember, you are the most important person in
diabetes care
and successfully managing diabetes, but your healthcare team can help to manage diabetes and maintain good health.

PCT categories

The Primary Care Trusts are categorised geographically around the UK and are managed locally.

Each PCT has their own specialised diabetes clinic and drop in centre to allow diabetics access to a team of highly specialised and dedicated professionals who offer education, support and advice to people with diabetes.

Diabetes Specialist Nurses (DSNs), also called Community Diabetes Specialist Nurses, are the backbone of diabetes treatment and care in the UK .

Practice nurses

Their primary goal is to help people self-manage their diabetes. Patients with

type 2

diabetes usually see both a practice nurse at their local GP’s in addition to a diabetes specialist nurse who will provide additional support and advice.

Best possible care

They are legally required to be constantly maintaining and expanding their knowledge of their specialised sector, as well as personally ensuring that they are qualified to undertake every duty or responsibility they are give, as such a diabetic patient can be sure they are receiving the best possible care.

General Practitioners continue to be a diabetic patient’s primary source of care; they are required to complete a full medical review upon diagnosis taking into account any other medical problems.

GPs and Primary Care Teams

They are also the key to ensuring all necessary members of the

primary care team

are informed and up to date on each patient’s progress both verbally and in writing.

Initial course treatments

Arguably more significantly, they are also required to instigate an initial course of treatment and review these annually incorporating any developments and lifestyle changes of the patient.

In addition it is the GP’s role to ensure any referrals made to external bodies abide to locally agreed criteria and are timely and appropriate.

Specialist nurses

In many cases the GP is also partly responsible for the care provided by the

specialist nurses

and therefore has to be satisfied with their competence and knowledge of their specialised forte including diabetes.

Digital healthcare can provide people with diabetes access to education, support and treatment interventions.

Self-supporting communities can help healthcare professionals with their most precious resource: time. Where they often struggle to have longer discussions with patients, forum users have all the time they need. When using forums like ours, people really learn about their condition. They are not just told what they should do and sent on their way.

By using digital media to improve diabetes health outcomes, we’re able to provide people with tailored interventions and unprecedented access to key information. Rather than working against the advice of doctors, we’re enhancing it.

Moreover, results show that people are improving their health through our digital solutions, reporting improved blood glucose levels, weight loss and better understanding of diabetes.

Building upon the foundations of togetherness and collaboration, the

Diabetes.co.uk Medical Advisory Panel

ensures Diabetes.co.uk is guided by leaders in their respective fields to aid in accomplishing our mission.

Diabetes Forum

The

Diabetes Forum

was launched in 2002; it is now the world’s largest community of people with and without diabetes alike.

The forum has over 351,823 members and welcomes people with and without diabetes, their friends, parents, carers and others. The forum enables the diabetes community to talk openly about their condition – especially regarding diet – and it is community feedback that makes it possible for us to keep positively affecting real-world health.

A recent survey found that:

• 77% of forum members improve their understanding of diabetes within six months
• 1 in 3 forum members improve their HbA1c within six months

Hypo Program

The

Hypo Program

was our first education solution: a free online program that helps people with insulin-treated diabetes improve their understand of hypoglycemia.

Upon completion of the Patient course:

• 88% of people reported knowing how to spot a hypo
  
  and
  
• 63% experienced fewer severe hypos after six months

At a conservative estimate, the Hypo Training Program has saved the NHS £1.4m in call-out costs. Following its success, we also created programs for Teachers, Parents and Healthcare Professionals.

CPD points can be earned for the Parents and Healthcare Professional programs.

Low-Carb Program

On World Diabetes Day 2015, the

Low-Carb Program

was launched. The program is a 16-week course was developed based on the latest research and with the help of 20,000 people with obesity, prediabetes and type 2 diabetes.

The Diabetes Forum played an instrumental role in the development of the Low Carb Program. Forum users have reported reversing their type 2 diabetes after adopting a low-carb diet, and results from the program have already been impressive.

Data demonstrates that:

• 82% of users report weight loss
  
  and
  
• 73% have improved/significantly improved their blood glucose levels after meals

Type 2 Testing Program

We launched the

Type 2 Testing Program

to help people with type 2 diabetes improve their blood glucose control through structured blood glucose testing.

Self-monitoring of blood glucose levels can empower non-insulin treated type 2 patients to reduce their HbA1c and the risk of developing diabetes-related complications.

The Type 2 Testing program provides diabetes test strips alongside full structured support. After 12 months of following the program:

• 96% of members understand the impact of food on blood glucose
  
  and
  
• The average HbA1c reduction after 6 months is 1.2%

By connecting and sharing data we are not only positive affecting real-world health, but also changing diabetes research and understanding for the better.

If you are looking for

posters

, they can be found here.

Many people express that when they go to see their diabetes team, although things have been ‘done’ –

HbA1c
discussed, feet and eyes checked, diet overhauled – they haven’t really felt heard.

Common experiences of relating to

healthcare professionals
that I hear from people with diabetes I work with are:

• Feeling scolded or like a ‘bad’ patient
• A pressure to lie about their blood glucose results or other health behaviour
• Feeling rushed
• Being patronised, unintentionally or otherwise
• Feeling misunderstood
• Not feeling free to talk about what is really of concern e.g. that
  
  diabetes is getting you down, how it is affecting your family
• Feeling that the healthcare professional is an “expert” and can’t be disagreed with
• Not attending health appointments at all and avoiding healthcare professionals entirely.

This isn’t a criticism of the diabetes team, quite the opposite.

Your healthcare team should be on your side

They are committed to helping you to gain control of your diabetes and remain in good health by assisting you to manage the delicate balance between food, insulin and activity so that your

blood glucose control
is just right.

But have you thought about the challenges that your healthcare professional or

your doctor
may have to operate within?

• Feeling pressure to be the ‘expert’
• Working within an environment (especially in
  
  NHS contexts
  ) with stretched resources
• Not having as much time to spend with patients as they’d like
• Feeling at a loss to know how to help
• Team conflict amongst their colleagues
• Working to meet government health targets which prioritise ‘hard’ data such as blood glucose control achieved over ‘soft’ data such as psychological wellbeing or quality of life
• Being aware that they can’t fully appreciate the lived experience of diabetes (being an ‘expert’ rather than an ‘expert by experience’)
• Having to maintain the caring role at work when experiencing personal challenges in their life outside of work

How does it feel to read this list? Do you recognise any of these pressures? Or do they perhaps surprise you? Just viewing the ‘doctor-patient’ relationship from another perspective can be insightful.

This is one of series of Psychology articles by

Dr Jen Nash, a Clinical Psychologist who has been living with type 1 diabetes since childhood.

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