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Diabetes in the young

How many people under 40 with type 2 diabetes do you see in your practice? Did you know that it appears that the consequences of developing type 2 diabetes if you are in this age range are far more serious than if you are older?

This was something I learnt about in more depth, whilst attending an introductory weekend for an online Diabetes Postgraduate Diploma. In fact, most of the 30 or so of us in attendance were shocked by this revelation, especially as more youngsters are developing type 2 diabetes now than ever before.

We were also challenged that our treatment of this group needs to be aggressive, if we are to limit complications, especially cardiovascular ones. In fact, the outlook is bleak and we are likely to see a rise in mortality due to these complications in the younger generation.

As this is a relatively recent phenomenon, there is little evidence on which to base our management, however, there are trials going on right now which will hopefully shape the care we provide in the future.

I would be delighted to receive feedback concerning things I said in any of my blogs. I would be happy to discuss anything controversial that I may have mentioned as we all need challenging in our practice. The monthly blog could be a learning experience for readers and writers alike.

This week I had a telephone interview for a role on the Diabetes UK Council of Healthcare Professionals. One question I was asked was that if I was to represent practice nurses across the country, how would I find out what are their issues when caring for the Diabetes population? In the course of answering, I realised that social media of various kinds were possibilities, but also this monthly blog is a potential source of information, which I could pass onto Diabetes UK, who could maybe find ways to address some of them.

What are the challenges that we have in caring for those with diabetes? Where do we find support in general practice for providing appropriate care, and preventing the development of complications in our patient group? What interaction is there between primary and secondary care in the areas where you work?  In Portsmouth, where I work, the hospital diabetologists also seek to help those of us in the community as well as those in secondary care; two community diabetes specialist nurses are available to assist us in general practice.

How easy is it for you to access training in clinical specialities such as diabetes - is it shortage of time, money or both perhaps? How supportive are your GPs and practice manager of your learning needs? How much time we are given to keep ourselves up-to-date with new developments in the diabetes world, are equally important as the amount of time and resources we are provided with to look after our patients within the surgery setting. How many of us read the very informative journals we are sent, particularly those that we don't have to pay for, and attend updates that are free also?

I want to encourage all of us who work in primary care and spend some time helping people with diabetes. Please, please let me know your issues or even problems or good practice initiatives. Let us share experiences and learn together from them.