I've seen a lot of changes in diabetic care, both in treatment and how the treatment is provided... As the NHS/HCP's struggle to keep up with demand..
The reality in the main it's the diabetic that's generally there own worst enemy not the HCP's,
If we look at different things introduced by the NHS/Government to improve the out come for the diabetic!
GP lead care... Well if you'd been diabetic when we all trotted off to the hospital clinic and the consultant you would see the benefit in this, as it actually does give better access to diabetic care.. Hospital clinic's were packed to the brim and getting appointments were horrific and few and far in between!
GP Incentives... The incentive carrot was brought in not for the GP benefit but because somehow they had to entice the diabetic into clinic, because they weren't bothering!
My hospital did in the late 90's tried a drop in clinic for diabetic's but ending closing it down, because no-body used it! They tried a 'phone-in' service but again, ensuring that the phone was manned, wasn't cost effective having a DSN twiddling her thumbs for a couple of hours just in case somebody phoned... So now e-mail access, and phone when needed if somebody is available it be answered! Because as well as various clinic's including out-reach clinic's, ward rounds etc everybody pretty busy!
Eye Screening was brought in purely because diabetic's weren't doing what they were supposed to be doing? That was ensuring that they went for a yearly Eye Test at their opticians! The lack of interest of the diabetic to look after their eyesight themselves, the NHS has been enforced to do something to counter react the impact by implementing an expensive screening program! If this actually saves money in the long run by picking up problems early, how many diabetic's didn't bother to look after their eyes! after all there's nothing in those photo's that can't be picked up by a simple Eye Check by an optician!
Dietary side..
It isn't what they say but again more down to two factors of the diabetic, firstly how the diabetic interprets information being given but also which is probably the most damaging one, is whether the diabetic has any intention in actually following information given!
What we have to remember, when it comes to diabetics, we (on the forum) are pretty pro-active about our own diabetes, determined to do the best we can to take control of our diabetes so we lower the risk factors of long term complications to our best advantage! If every diabetic the HCP saw were like us... Then the world of diabetes would be a lot different indeed but alas the HCP see's the 'Reality' of the diabetic world, where those like us are a very small minority! So they have to come up with ways and means to not only to get the diabetic in clinic, but get the diabetic to take control of their condition!
Which when it comes down to dietary advice, yes they work with dietary advice based around a normal healthy diet, because they know the difficulties and reluctance for the majority of diabetics to follow this! Can't you imagine what would happen when you tell an already reluctant patient that you'll going to turn their diet upside down for their best interest!
I know what happens, you end up with 3 groups, the first group and the biggest, will just stick their head further into the sand, the second much smaller group, will be so shocked and scared that they take the advice on board. The you get the 3rd group a very small group, who come from the second group, who can actually find the motivation to follow the new regime for any length of time! As this is what happens with currant advice given!
That's the sad fact about the diabetic world... The HCP do their best but are constantly let down by the diabetic themselves!
Now I know somebody who will blame the advice given to their husband by his team, why he's suffer major complications now... But then say in the next breath,Oh clinic he didn't bother going half the time, said they didn't do anything!
