Which aspects of diabetes complications worry you the most? What area do you feel we need to put in more effort to engage with our patients? Is it that care and treatment are sadly lacking in these areas or are there other reasons?
Is there even one that you could single out? When I am seeing someone who has had a foot amputated, I really want to see more resources in the area of foot care. In a similar way, when I meet someone who has gone blind as a result of poorly controlled diabetes, I feel so very sad for them and wish they had been persuaded to attend their retinal screening when invited, and had been more engaged to keep their blood sugars under control. Of course let’s not forget those who progress to having chronic renal failure and need dialysis or even possibly a renal transplant. How can we hope to prevent these complications, how should we try to get the message across more effectively?
Returning to the topic of retinopathy, who’s aware that if someone with diabetes has active retinopathy and is encouraged to improve their blood glucose control, this can in fact cause deterioration in the condition, if it happens too quickly? In the past few years I have dealt with a young man who had previously not engaged with having Type 1 diabetes, and whose blood glucose had consistently run at high levels for some years, due to taking drugs and smoking. Then something changed in his life; he found girlfriend, someone who cared enough for him to encourage him to look after himself, and gave him the incentive to manage his diabetes. Sadly in the process of suddenly changing direction and working hard to lower his blood sugars, his eye sight deteriorated rapidly and now he has very limited vision.
Just the other week, I met another man of similar age who hadn’t always looked after himself, in particular his diabetes, but who was now wanting to improve this. I was able to advise him that, as he was currently having treatment for his eye damage, he must not rush into his desire to reduce his overall blood glucose control. I feel sure there will be others of you out there who have encountered similar situations, and we need to be wise in the advice we give our patients.
Talking of those who have problems with their sight, there is a blood glucose meter now available, which talks to the patient, telling them what to do, and what their blood glucose is. Advertising a particular product is not appropriate in my blog, but if you wish to find out more, try and get hold of a copy of the Diabetes UK “Meds and Kits”, which lists out all the meters currently available, and you will find that meter and then be able to check it out, if you have not already heard of it.
Like everything else in the world of diabetes care, there are always new products coming out, and it can be a massive challenge to keep abreast of these changes. If you know of a new drug or product that is available and could be of real help to people with diabetes or healthcare professionals, write to us, so that others can benefit. We need to support each other to provide the best possible care.