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Diabetes and the NHS

I am sure many of you have heard or seen the news about diabetes and the cost it is to the NHS. Diabetes takes up one tenth of the NHS budget - £10 billion. The vast majority of that money is spent on treating the complications, which are largely preventable. Not only that, but one-in-six patients in hospital beds, have diabetes.

How should we be dealing with this? How can we work with the general population, to prevent type 2 Diabetes? At present there seems to be great encouragement to pick up those with impaired fasting glycaemia or “pre-diabetes”, but what do we do with them after? What materials can we offer them, how can we motivate them to make lifestyle changes, either dietary or physical activity?

How do you feel about the challenge to try and reduce the incidence of type 2 diabetes? Where should we start and how do we tackle this enormous issue? What do we think the government can do to tackle the problem? Do we think the government should be funding more resources into screening for complications? It is hard to reach all people with type 2 diabetes when there are insufficient staffing levels and not enough podiatrists to refer patient who have foot problems including ulcers?

During appointments patients need to receive advice on how to manage their diabetes and particular complications. But due to GPs and practice staff being asked to do more and more huge time constraints are placed on these appointments, not making it possible to cover all the areas needed.

Several articles have appeared in the newspapers in the past week or two, with Diabetes UK in the forefront - it might be worth reading these articles and seeing if you agree with them?

Take a look at:

http://www.thetimes.co.uk/tto/health/news/article4538019.ece

http://www.thetimes.co.uk/tto/health/news/article4537389.ece

Over my years of working with Diabetes I have become passionate about helping people to manage their own diabetes more effectively. More of what we do has got to be about enabling patients to do this; we can only be with them for very short periods of time, mainly it is up to them. We should never give up on trying to motivate those who are reluctant to change either, but keep on encouraging them.

At one surgery where I now work, I have been encouraged by the simple changes one patient has made. A middle-aged man has been coming to the surgery for years about his diabetes and weight issue. The GPs and nurses felt they had tried everything they could to convince him to improve his diet and lifestyle and take control of his diabetes. In summary, having seen me twice, he came back today and said how he had made significant changes; I weighed him, and he has lost 8 kg or 17lbs in little more than a month and has finally found some motivation. When I told the relevant GP, he could hardly believe it after all this time. It can be hard often to think that we can make a difference, but let's try and be patient and remain compassionate.