Confidence growing in delivering personalised care to people with diabetes

[DCUK NewsBot]

Diabetes educators are becoming more confident in delivering personalised care to people with diabetes, a US survey reports. The survey findings were presented at the American Association of Diabetes Educators (AADE) annual meeting this week. A total of 66% of healthcare professionals indicated they were very confident in promoting person-centred care, with 29.7% reporting feeling somewhat confident. The survey was designed to assess confidence in person-centred diabetes care, such as how comfortable they were encouraging integration of strategies designed to focus on behavioural health, using technology to improve health outcomes and maximising health experiences for people with diabetes. It was conducted by Gwen Klinkner, diabetes clinical nurse at the University of Wisconsin Hospital and Clinics and the Inpatient Management Community of Interest (COI) chair for the AADE. The majority (77%) of the 75 respondents were nurses, 16% were dietitians and 2.7% were pharmacists, all of whom were members of the COI. Earlier this year Diabetes Digital Media's Chief Medical Officer Campbell Murdoch spoke about the importance of personalised care in treating type 2 diabetes, an approach "which is now widely accepted across healthcare". Personalised care involves focusing on the needs and goals of people, providing them with options for treatment and augmenting their health journey. There have been calls to harness technology to personalise care for older people with diabetes, which could provide people with better support to improve their health. Klinkner said of the survey: "Survey results suggest that members […] are embracing the call to learn more and expand their role and expertise. These survey results give us a baseline; it'll be exciting to see where we are in the next few years."

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[ickihun]

I hv a fantastic diabesity consultant. He regulates my insulin with me. He prescribed bariatric/ weight loss programme 4yrs ago and I've taken their education as prescribed but not all type2 relevant. Main eating core advice is still not very low carb. Maybe low carb to heavy carb eaters but I'm not.
Some lost before education classes so it muddled the waters. I was distracted from what I was doing to lose weight. Surgeon complained I'd lost on low carb but now readded. I told him I had been doing a so called "faddy diet". I was put on 800cals (Newcastle diet). I lost but then bgs went mad with IBS meds and sugary milkshakes.
Yes.
We definately need individual plans.
This low calorie with low carb helps me lose weight. No hunger due to the Roux-en-y op.

So.... they need to invent a med with low side effects which blocks hunger for morbibly obese insulin type2s or provide more Roux-en-y operations. Low carb with heavy insulin use still insights hunger! Even if its being reduced.

 

[bulkbiker]

they need to invent a med with low side effects which blocks hunger for morbibly obese insulin type2s

"They" have its called a ketogenic diet. Satiety and weight loss for most.

 

[Brunneria]

'Personalised care' is such a loose term, isn't it?
But what does it mean?
- a personalised cocktail of drugs?
- a personalised education on low carb and lifestyle changes?
- an expensive way to use health insurance to fund the latest technological developments in flash glucose monitoring, CGMs and pumps? (this is a US survey, after all)
- a quick referral to Virta, using that same health insurance to pay for it?

So many different interpretations of the term 'personalised care'...

 

[ickihun]

"They" have its called a ketogenic diet. Satiety and weight loss for most.

Not all heavy insulin takers get satiety as insulin overrules leptin response. Some who are on less insulin units and especially men don't hv other hormones to contend with hv a great chance BUT we are not all the same so I'd advise try it for yourself to see if it works for you. We'll not you @bulkbiker but readers.

 

[Tophat1900]

'Personalised care' is such a loose term, isn't it?
But what does it mean?
- a personalised cocktail of drugs?
- a personalised education on low carb and lifestyle changes?
- an expensive way to use health insurance to fund the latest technological developments in flash glucose monitoring, CGMs and pumps? (this is a US survey, after all)
- a quick referral to Virta, using that same health insurance to pay for it?

So many different interpretations of the term 'personalised care'...

That's just it... who knows what it means. If the focus on diet is poor or ignored, then it's just a flashy new paint job over the same old house. It reads a bit like a politician running for office. I'm going to do this and that and make things so much better and run more efficiently.... but no details on how any of this will happen.

 

[ickihun]

'Personalised care' is such a loose term, isn't it?
But what does it mean?
- a personalised cocktail of drugs?
- a personalised education on low carb and lifestyle changes?
- an expensive way to use health insurance to fund the latest technological developments in flash glucose monitoring, CGMs and pumps? (this is a US survey, after all)
- a quick referral to Virta, using that same health insurance to pay for it?

So many different interpretations of the term 'personalised care'...

We are forever watching how it works well in the U.S.
I've had personalised care from the start but it 99% has to come from you.
Any decent specialist would ask what has happened so far. Which mine did as I transferred from the South and an endocrologist near Brighton. Both very knowledgeable.
They both were familiar with MY health problems with conditions I manage. Their advice and knowledge is worth alot to me. After all they've studied the thyroid and blood test results for decades. They definitely know more than me. Ok I know more about my body currently but they know what CAN be avoided and should be avoided. They all know what insulin does. Dont think they don't, they do.
It's a tool to avoid imminent blindness in some or loss of limb. Or worse. Far cheaper and easier than losing an infinitely useful part of the body. When these specialist get a patient they are in huge danger. Not all diabetics need a specialist. They tottle along on their diet and exercise and some on metformin or more. With no damage, visible or detected.
Some need more than lettuce or low calorie soups when their body weight is in survival mode and trying to protect the organs.
Ever wondered why fat cells collect more around certain organs? Because they are being put under attack.
Stress mode protects the most at risk!
No amount of 'care' can fix everything but if you and a well knowledgeable assistant alongside has the same aim. What can go wrong?
Isn't that the whole purpose of this forum?
We can challenge all we know is inaccurate but ultimately we DO need assistance when the job at hand is overwhelming.
There is no 'I' in Team.
Yes even using a regular monitor relies on replacement batteries and test strips. Even monitor cannot work alone to provide a number. How many are needed for a hba1c result?
I'm independant in reducing my insulin and knowing when I'm not endanging my life but sometimes a knowledgeable person has to interpret how well my management is working; as weight loss alone doesn't stop blindness.
Everyone is different so of course we need individual care (assistance). If we want improvements or kept safe from everything diabetic.
Only a fool would be deaf to knowledge of diabetes.
I'm no fool. I listen and try it on my body as long as its not giving me warning signs (palpitations or severe thrush; for example).

 

[ickihun]

That's just it... who knows what it means. If the focus on diet is poor or ignored, then it's just a flashy new paint job over the same old house. It reads a bit like a politician running for office. I'm going to do this and that and make things so much better and run more efficiently.... but no details on how any of this will happen.

I think the answer is a team which listens to what hasn't worked. Maybe core questions so assistant's can get a true grasp of where that patient is at in their 'journey'.
Some sterio type people in U.S as oversensitive but not me. All any country needs are good listeners. As frustration is very distructive.
Type2 diabetes has been labelled due to greed. Myself it aways points to fat or famine.
Stress can turn this theory upside down. Hormones are complex not a simple as we can first think.

 

[Redshank]

Two issues
1. What is personalised care
2. The 75 respondents said they were "confident in promoting personalised care". This doesn't mean they are delivering it. To find that out you would need to define personalised care and then check with patients to see if it is being delivered.

 

[Tophat1900]

I think the answer is a team which listens to what hasn't worked. Maybe core questions so assistant's can get a true grasp of where that patient is at in their 'journey'.
Some sterio type people in U.S as oversensitive but not me. All any country needs are good listeners. As frustration is very distructive.
Type2 diabetes has been labelled due to greed. Myself it aways points to fat or famine.
Stress can turn this theory upside down. Hormones are complex not a simple as we can first think.

What hasn't worked for 50 years is the dietary advice.... if they are to persist with the same dietary advice then not much will change. Let's hope progress is made.

 

[ickihun]

What hasn't worked for 50 years is the dietary advice.... if they are to persist with the same dietary advice then not much will change. Let's hope progress is made.

Yes carbs encouraged for a balanced diet. After Roux-en-y I was/am encouraged to eat my carb portion last. Protein first. I'm able to eat fish and meat now but only a few flakes or ozs. Previously yogart and milk was only protein. I still enjoy a small yogart in solid protein's absence.
I love the no hunger part. I could robotically feed myself, if need be. I still enjoy my food but a lot less of it satisfies me. I still cook and make anything to satisfy my family.
Yrs ago I was encouraged to hv brown rice, seeded bread and green pasta. Of course potatoes too. Hence I lived off jacket potatoes and flat wholemeal bread or heavy seeded sandwiches as I could not stomach brown rice or wholemeal bread. I bought steamed veg to eat it undrr grudge. I still only like iceburg lettuce and no other lettuce or green salad. I still cannot face plum tomatoes as in skint days all I could afford with cheap dry pasta when financing a new home. I've seen a huge increase in my food bill as cheap food is mainly carbs. I'm feeding us all differently as only little one likes veg and I'm only lover of fish or seafood. Oh its fun and games doing our monthly food shop.

 

[Listlad]

Patients helping patients is however, taking a foothold. Those that have found the dietary solution can, through the NHS, help those that are struggling to come to terms with the dietary changes.

 

[Tophat1900]

Yes carbs encouraged for a balanced diet. After Roux-en-y I was/am encouraged to eat my carb portion last. Protein first. I'm able to eat fish and meat now but only a few flakes or ozs. Previously yogart and milk was only protein. I still enjoy a small yogart in solid protein's absence.
I love the no hunger part. I could robotically feed myself, if need be. I still enjoy my food but a lot less of it satisfies me. I still cook and make anything to satisfy my family.
Yrs ago I was encouraged to hv brown rice, seeded bread and green pasta. Of course potatoes too. Hence I lived off jacket potatoes and flat wholemeal bread or heavy seeded sandwiches as I could not stomach brown rice or wholemeal bread. I bought steamed veg to eat it undrr grudge. I still only like iceburg lettuce and no other lettuce or green salad. I still cannot face plum tomatoes as in skint days all I could afford with cheap dry pasta when financing a new home. I've seen a huge increase in my food bill as cheap food is mainly carbs. I'm feeding us all differently as only little one likes veg and I'm only lover of fish or seafood. Oh its fun and games doing our monthly food shop.

Sounds like you are making some good progress and yeah, I also eat differently to the way everyone else does in our household, so I understand how that all pans out. Shopping, cooking, likes and dislikes and other reasons etc.

 

[Tophat1900]

Patients helping patients is however, taking a foothold. Those that have found the dietary solution can, through the NHS, help those that are struggling to come to terms with the dietary changes.

Best advice you can get at times is from those who share the same condition, that have achieved what is said couldn't be achieved by experts who do not share the same condition.

 

[LittleGreyCat]

75 respondents isn't really that significant, especially if drawn from a pool of people already highly engaged.

Personalised care sounds like actually asking the patient how things are going instead of just saying "Blood results are acceptable, here is your repeat prescription, see you in a year.".

Not earth shattering news; at least it shouldn't be.