How to have quality time with your healthcare team
People with diabetes only spend two or three hours a year with their healthcare team. Being prepared is key to getting the most from your consultations.
“It’s important to use the limited time the best you can,” said Dr Partha Kar, consultant in diabetes and endocrinology in Portsmouth.
“Consultations have become a bit of a box ticking exercise, and very few people come along with a clear idea of what they want to discuss.”
There are routine tests and checks that need to be carried out, but they shouldn’t dominate the consultation.
Preparation is key
Think about the three most pressing things and raise these at the start, Dr Kar recommended. In his Type 1 diabetes adolescent service, teenagers are given a short form to fill in before consultations. It gets the conversation started and sets it on the right foot.
Dr Kar said: “For these people, it might be drink, drugs or leaving home they are worried about – all these things can impact on your diabetes.” For people with Type 2, putting on weight may be a concern.
“Anything that is worrying you and is impacting on your condition can be discussed in the appointment – it is your consultation, not the consultant's,” said Dr Kar.
- Prepare: write down two or three things that you most want to talk about
- Raise the thing you are most worried about first
- You can talk about anything that is having an impact on your condition
- Take any relevant information with you, like blood glucose meter charts or graphs
Survey finds people prepared to challenge advice
Most people with diabetes felt able to challenge their doctor if they disagree with them.
A survey of 321* people who used a blood glucose meter “at least a few times a week” found 84% would be happy to question their GP about recommended treatment or equipment, if they had the facts.
This figure rose to 93% among those with Type 1 diabetes.
The survey, carried out between February and July 2015 by Morpace Market Research and Consulting on behalf of Roche Diabetes Care, found 64% of people whose healthcare professional had recommended a change of blood glucose meter had challenged the suggestion.
(*110 people with Type 1 diabetes, 114 Type 2 insulin users, 97 Type 2 tablet users.)
Supporting shared decision making
This updated guideline focuses on the importance of putting each person’s needs and preferences at the heart of joint discussions and decision-making.
New guidelines for doctors could lead to better support and clearer advice for some people living with diabetes. The National Institute of Clinical Excellence (NICE) has published new information on Type 2 diabetes care placing joint decision making at the core.
Sir Andrew Dillon, NICE Chief Executive, said: “This updated guideline focuses on the importance of putting each person’s needs and preferences at the heart of joint discussions and decision-making.” The guideline stresses the importance of education programmes in helping people to manage their condition. Managing blood glucose avoids complications such as tissue damage, premature heart disease or stroke.
What the advice should mean for you
- Regular blood pressure monitoring every 1-2 months
- A personalised management plan, with dietary/ physical activity advice or a weight loss plan
- Support for sticking with drugs
How often should you test?
Type 1 Diabetes
NICE guidelines say adults with Type 1 should test at least four times a day. Certain groups of people may need to test up to 10 times a day.
Type 2 Diabetes
NICE recommends self-monitoring of blood glucose if you use insulin or take tablets that may put you at risk of hypoglycaemia, are ill, drive, or have changed medication or your lifestyle.
David Hudson, 70, company director, Type 2 diabetes.
David manages his condition with medication, diet, exercise and careful blood glucose monitoring. He normally has good control but last January his blood glucose levels increased for no apparent reason.
"I decided to test more frequently to try and stabilise my blood sugar. My GP felt I was testing too often, worrying too much and putting myself through unnecessary discomfort.
"I dug my heels in. I explained that testing was an essential tool to my ability to manage my blood sugars and to be able to see what was having an effect. Once you start on an upward trend it’s hard to get back.
"I analyse everything in life – that’s me. I would feel far more worried if I didn’t test. I explained all this to my GP and he accepted my view."
People with diabetes recognised that finding savings for the NHS was important. They thought managing the condition proactively would be more cost-effective. In total, 86% felt treating long-term diabetes complications cost the NHS more than blood glucose meters and test strips, and 92% agreed it was better to spend money on testing than on dealing with complications later on.
Testing alone is not enough, you need to be able to correctly interpret your results and take action when needed. Structured education is a key part of diabetes care and can help you manage your condition more effectively.
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