This site is intended for health professionals only

Diabetes and the festive season

It's almost Christmas time now and for those with diabetes of either of the main types this can be a very difficult time of year. So much of what happens around Christmas revolves around food and drink. For those on insulin, over-indulgence in alcohol will more than likely trigger a hypoglycaemic episode. Mince pies, Christmas pudding and Christmas cake are all loaded with sugar, and so should only be eaten in small quantities by anyone with diabetes.

I have just read a publication from the Insulin Dependent Diabetes Trust, where they give practical advice on how to enjoy Christmas festivities, but restrict intake in a reasonable way; there's even a recipe for a Christmas pudding that is much more suitable for those with Diabetes, and probably better for the rest of us as well. They also produce a four week menu plan for diabetics to help decide what is right to eat and how much, as the latter is often more of a problem.

If you were listening to the news or read the newspaper on Wednesday 14th December, we learnt that up to 24,000 people were dying each year unnecessarily, due to diabetes and its' complications. It was suggested that insufficient monitoring, along with poor diet and lack of exercise are the main contributory factors. Whilst most of these deaths are in the over 65 population, two younger people are dying every week as a result of avoidable causes.

How should we respond to the suggestion that there are huge variations in the care provided by general practice in different parts of the country? What can we do to improve the care that is offered? We have a duty of care to our patients and must ensure that we are competent to carry out the work that we are required to do, and that we do it to the highest level possible. Many of us are aware that patients with chronic conditions are sadly rather poor at following advice, but even so, do we need to work harder with them, encouraging them to take more responsibility for their own health needs? It can be an assumption with some patients that medications will sort everything out for them, whereas we know only too well that is not the case.

Enough on that issue, but linked with that, how many of us get adequate appointment times to carry out an annual review and change any necessary medications? I am very fortunate in my place of work; I am given 30 minutes to carry out annual reviews, but for some of you that may not be an option. Diabetes is increasing rapidly and we may find ourselves under increased pressure to expend more time and energy caring for our diabetes patients. At some point in the future, there may be insufficient funds available in the NHS to equip additional staff in competencies to provide the appropriate standard of care as recommended by NICE, for this numerous patient group.

As we come to a New Year, how will we manage? Let's aim to keep ourselves well informed and competent so that we can provide good quality care on all occasions.