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Blog: Diabetes prevention


Many of you will no doubt have heard of the 13year old boy in Cardiff Wales who was admitted to hospital on New Year's day and died early in January, due to a chest infection and virus, which masked the symptoms of Type 1 diabetes. His parents have launched an appeal to raise awareness of Type 1 diabetes and to help fund more research into the condition.

But how many of you knew that this appeal has raised £10,000 for Diabetes UK, which is to be used by the region? Out of a very tragic situation, where a family have lost their teenage son, it seems there will be a great opportunity to turn this into something good. It is a challenge to all of us, in the face of any type of difficulty, to look for the good in the situation.

It is also a reminder to all of us involved in diabetes care in some way, to be alert to the signs and symptoms of both Type 1 diabetes and Type 2 diabetes, and how they should be treated. Anyone diagnosed with Type 1 diabetes in primary care, within a surgery, needs to be admitted to hospital immediately. Complications from Type 1 diabetes, which may be out of control, are extremely serious, not least DKA. These people need to be treated with insulin and closely monitored to get the condition under control quickly.

Have any of you come across patients with Type 2 diabetes, who once they have started using insulin therapy think they now have Type 1 diabetes. It seems to be something that does crop up quite frequently, and underlines the need for us to explain clearly what happens with the each type, and how because Type 2 diabetes is progressive, it may well require treatment with insulin at some point.

There are just so many things to consider when caring for people with diabetes, and there is just no way we can have all the answers. All the time we work in the field of diabetes care, we will find there are things we do not know. Early 2014, I attended a diabetes network meeting near where I was working, with particular interest. The subject our speaker was talking about was oral hygiene and dental health relating to diabetes. This was the first time in over 14 years of working in diabetes care that I had heard anyone speak on the significance of this to someone with diabetes.

Perhaps you are already aware of this, but by improving someone's oral hygiene, and then seeing a dentist and or hygienist, someone with diabetes can improve their blood glucose control. This is an issue we ought to be making our patients more aware of; there is so much they could do for themselves to prevent/reduce gum disease and gingivitis.

Gingivitis is reversible if caught at an early stage, and can be prevented from deteriorating, by using a good brushing technique. However, if the damage progresses to periodontitis, this is irreversible, and may ultimately lead to someone losing all their teeth, which then affects food choices even more. Apparently diabetes increases the risks of all this by 3 times. Also improving oral health leads to a reduction in Hba1c and subsequently a reduction in renal disease.

Flossing between the teeth and using inter dental brushes is not rocket science, but could help improve outcomes. Attending the dentist more regularly may well be an issue, especially if there is not an NHS dental in the person's locality. We do not need to be experts in dental health, but we can point patients in the right direction, and then who knows what benefits they might experience?

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