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Diabetes: a lifetime of choices

Welcome to my first blog of 2012. How many of us, or our patients start the New Year by making one or a number of resolutions? How easy is it to actually stick to these?

Diabetes demands a lifetime of choices, once diagnosis has been made, be it type 1 or type 2, and our responsibility as healthcare professionals is to help in making these choices and then supporting our patients as they try to live them out. I believe that we need to supply our patients with the right amount and quality of information from the time they first receive their diagnosis for them to make the best possible choices. I do not believe it is our role to tell them what they must do and then make them feel awful when they don't manage to. How would we cope if we spent our appointments with our GP or nurse being told off, how would we feel, and would we want to keep going back for more of the same possibly.

I hope you have good relationships with your patients, so that they feel they can trust you and are confident in your expertise. How do you keep up to date with changes in the world of Diabetes? I knew about Bydureon, the once weekly form of Exenatide, but had not seen it demonstrated in practice, until a patient of mine came in very keen to try it out. He was a classic patient and fitted the required criterion and had previously been taking twice daily Exenatide. He was also sadly not a good attender at appointments before this; but so keen was he to use this option that he came for blood tests, then to discuss the result and receive his script for Bydureon and has been back twice to review progress (in the space of less than 2 months). It became apparent within a week or two that this drug suited him, as his blood sugars had improved beyond imagining, although due to his size, he had to take it every six days otherwise his blood sugars shot up on day seven. Has anyone else had any experience with Bydureon, good or bad?

During the past year there have been changes to the DVLA driving regulations, which may seem more restrictive to patients who may have hypoglycaemic episodes.  In March 2011, NICE published a 13 point quality standard for managing Diabetes in adults as well as a guideline to prevent the development of Type 2 diabetes. This standard clearly states the care those with diabetes should be receiving and we should be giving. If you have not seen this, take a look at the NICE Quality Standard for Diabetes. The guideline on prevention gives practical actions that community support and other non-medical parties can participate in.

It looks like I've used up my allotted number of words, so Happy New Year and please let me know what you think, and any topics you would like to see included here.