Diabetes - holistic approach

[Olive_Grace]

Good evening. My name is Judith and whilst a long term type 1 diabetic (58 years) - I am also a health professional having worked in general practice for over 25 years. As my retirement looms closer I do feel (and agree with the recent article on diabetes and mental health) - that the diabetic patient is not given psychological or indeed holistic recognition or support throughout their years of self management. It is not an easy journey but rather hard work amidst the possibility of developing a host of multi system associated problems along these patients journey. GP's now are under enormous pressure and are fighting fires with regards to their ever reducing workforce numbers. There simply is not enough time to afford patients with chronic diseases the luxury of the holistic approach to incorporate associated conditions including blood pressure monitoring and required medication titration. Having self managed my 58 years of diabetes I now find that I myself DO suffer from increasing associated conditions which often are barely touched upon during my medical reviews (2 yearly). This is not the intention of the expert practitioners & consultants. Time does not allow for reviewing of foot (including mobility) eye, cardiac or additional conditions such as coeliac disease monitoring. Last but not least is the mental health aspect mainly HOW is the patient coping with their condition both practically and emotionally and what might they be finding difficult to manage. That question has NEVER been asked of me in 58 years. It seems our precious NHS historically has not (and now cannot) include any reference or review of anyone's mental health (or even coping strategies) despite the understandable & often underestimated impact on the lives of these diabetic patients.

 

[Kittycat_7_]

Hi,
Welcome to the forum
I agree with you, more time is needed to give an holistic approach.
Thanks

 

[Guzzler]

Good evening. My name is Judith and whilst a long term type 1 diabetic (58 years) - I am also a health professional having worked in general practice for over 25 years. As my retirement looms closer I do feel (and agree with the recent article on diabetes and mental health) - that the diabetic patient is not given psychological or indeed holistic recognition or support throughout their years of self management. It is not an easy journey but rather hard work amidst the possibility of developing a host of multi system associated problems along these patients journey. GP's now are under enormous pressure and are fighting fires with regards to their ever reducing workforce numbers. There simply is not enough time to afford patients with chronic diseases the luxury of the holistic approach to incorporate associated conditions including blood pressure monitoring and required medication titration. Having self managed my 58 years of diabetes I now find that I myself DO suffer from increasing associated conditions which often are barely touched upon during my medical reviews (2 yearly). This is not the intention of the expert practitioners & consultants. Time does not allow for reviewing of foot (including mobility) eye, cardiac or additional conditions such as coeliac disease monitoring. Last but not least is the mental health aspect mainly HOW is the patient coping with their condition both practically and emotionally and what might they be finding difficult to manage. That question has NEVER been asked of me in 58 years. It seems our precious NHS historically has not (and now cannot) include any reference or review of anyone's mental health (or even coping strategies) despite the understandable & often underestimated impact on the lives of these diabetic patients.

Well put.

Welcome to the forum.

 

[Caeseji]

Good evening. My name is Judith and whilst a long term type 1 diabetic (58 years) - I am also a health professional having worked in general practice for over 25 years. As my retirement looms closer I do feel (and agree with the recent article on diabetes and mental health) - that the diabetic patient is not given psychological or indeed holistic recognition or support throughout their years of self management. It is not an easy journey but rather hard work amidst the possibility of developing a host of multi system associated problems along these patients journey. GP's now are under enormous pressure and are fighting fires with regards to their ever reducing workforce numbers. There simply is not enough time to afford patients with chronic diseases the luxury of the holistic approach to incorporate associated conditions including blood pressure monitoring and required medication titration. Having self managed my 58 years of diabetes I now find that I myself DO suffer from increasing associated conditions which often are barely touched upon during my medical reviews (2 yearly). This is not the intention of the expert practitioners & consultants. Time does not allow for reviewing of foot (including mobility) eye, cardiac or additional conditions such as coeliac disease monitoring. Last but not least is the mental health aspect mainly HOW is the patient coping with their condition both practically and emotionally and what might they be finding difficult to manage. That question has NEVER been asked of me in 58 years. It seems our precious NHS historically has not (and now cannot) include any reference or review of anyone's mental health (or even coping strategies) despite the understandable & often underestimated impact on the lives of these diabetic patients.

Far too true that is for sure. Welcome to the forum and this is experience we could all use.

 

[Olive_Grace]

Far too true that is for sure. Welcome to the forum and this is experience we could all use.

Good to hear Caeseji
Well done! Nice f you to reply.
Kind Regards
Judith

 

[Olive_Grace]

Well put.

Welcome to the forum.

Well put.

Welcome to the forum.

Hi,
Welcome to the forum
I agree with you, more time is needed to give an holistic approach.
Thanks

Hi,
Welcome to the forum
I agree with you, more time is needed to give an holistic approach.
Thanks

Thank you Olive

Hi,
Welcome to the forum
I agree with you, more time is needed to give an holistic approach.
Thanks

Hi,
Welcome to the forum
I agree with you, more time is needed to give an holistic approach.
Thanks

Thank you Olive...nice of you to respond. I know this is true and I wish I could predict a change for the better.
By the way....what a coincidence. My mother's name was Olive Grace AND I love cats (have 2).
Kind Regards
Judith

 

[Rachox]

I actually disagree to some extent. I am well aware of the pressures having worked for 36yrs until 2016 in the NHS, however earlier this week I had two twenty minute appts, back to back with the nurse practitioner at my surgery. One appt for my annual diabetic review the other for my annual asthma review. For my diabetes review I was sent in advance a document with all my recent blood, weight, BP and foot check results listed (these had been taken a fortnight before by an HCA). Beside each result was a space for me to write comments. There was also a list of mental health symptoms I may be suffering from which I could comment on too. The NP went through every section giving me the chance to discuss each point. The result of all this was a reduction in my BP meds, a phone appt made for four weeks to check how my home BP readings were and a six month review of HbA1c. I came away feeling cared for and happy
I feel for patients who aren’t getting the service they would like and for the NHS staff who are struggling at times in a system which in some places is on it’s knees

 

[Guzzler]

I actually disagree to some extent. I am well aware of the pressures having worked for 36yrs until 2016 in the NHS, however earlier this week I had two twenty minute appts, back to back with the nurse practitioner at my surgery. One appt for my annual diabetic review the other for my annual asthma review. For my diabetes review I was sent in advance a document with all my recent blood, weight, BP and foot check results listed (these had been taken a fortnight before by an HCA). Beside each result was a space for me to write comments. There was also a list of mental health symptoms I may be suffering from which I could comment on too. The NP went through every section giving me the chance to discuss each point. The result of all this was a reduction in my BP meds, a phone appt made for four weeks to check how my home BP readings were and a six month review of HbA1c. I came away feeling cared for and happy
I feel for patients who aren’t getting the service they would like and for the NHS staff who are struggling at times in a system which in some places is on it’s knees

We were diagnosed at roughly the same time, @Rachox but I have never even seen a DSN and I was diagnosed with an A1c far higher than yours. My GP is uninterested and my reviews have been perfunctory at best. I have never been asked how I am coping and I was not even asked why I refused to have a review for well over a year. Think yourself very, very lucky indeed.

 

[Rachox]

We were diagnosed at roughly the same time, @Rachox but I have never even seen a DSN and I was diagnosed with an A1c far higher than yours. My GP is uninterested and my reviews have been perfunctory at best. I have never been asked how I am coping and I was not even asked why I refused to have a review for well over a year. Think yourself very, very lucky indeed.

I do indeed consider myself very lucky and I’m sorry you have received such a poor service. I hope that this forum fills the gaps to some extent.

 

[HSSS]

And herein lies the problem, a huge disparity in service and care.

Genuine question, do all practices across the country get the same £ per patient or condition or appointment?
Why can one surgery manage such great service and another abject failure? Is is individuals? funding? Lack of cohesive criteria?

 

[Diakat]

Wow @Rachox - never experienced anything like that. In fact my blood was taken last Fri and apparently results still not back yet. Struggle to get results let alone discuss them or how I feel.

 

[Listlad]

Good evening. My name is Judith and whilst a long term type 1 diabetic (58 years) - I am also a health professional having worked in general practice for over 25 years. As my retirement looms closer I do feel (and agree with the recent article on diabetes and mental health) - that the diabetic patient is not given psychological or indeed holistic recognition or support throughout their years of self management. It is not an easy journey but rather hard work amidst the possibility of developing a host of multi system associated problems along these patients journey. GP's now are under enormous pressure and are fighting fires with regards to their ever reducing workforce numbers. There simply is not enough time to afford patients with chronic diseases the luxury of the holistic approach to incorporate associated conditions including blood pressure monitoring and required medication titration. Having self managed my 58 years of diabetes I now find that I myself DO suffer from increasing associated conditions which often are barely touched upon during my medical reviews (2 yearly). This is not the intention of the expert practitioners & consultants. Time does not allow for reviewing of foot (including mobility) eye, cardiac or additional conditions such as coeliac disease monitoring. Last but not least is the mental health aspect mainly HOW is the patient coping with their condition both practically and emotionally and what might they be finding difficult to manage. That question has NEVER been asked of me in 58 years. It seems our precious NHS historically has not (and now cannot) include any reference or review of anyone's mental health (or even coping strategies) despite the understandable & often underestimated impact on the lives of these diabetic patients.

A very good point and one I have tried to make for some time now. Coping strategy is an area I have felt can be an issue.

On a slightly different note, I am going to see how things look from the inside, next week. It could be illuminating.