Improving diabetes care and outcome
14 November 2012

On World Diabetes Day (14 November) a world renowned expert on diabetes from Tameside Hospital has offered tips on improving the outcome for diabetes patients.
Dr Edward Jude, Tameside Hospital’s Consultant in Diabetes, Endocrine and General Medicine, said that although the focus on diabetes has been increasing, up to 24,000 people with diabetes in the UK are dying unnecessarily each year from causes that could be avoided through better management of their condition.
In diabetes mellitus there are reduced or absent levels of the hormone insulin that helps regulate glucose sugar. Type 1 diabetes, where the body does not produce any insulin at all, typically affects children and young adults. Type 2 diabetes, where the body produces less insulin or is resistant to its effects, tends to affect older patients and, increasingly, overweight younger patients.
Diabetic emergencies come down to having either too much glucose in the body (hyperglycaemia) or having too little glucose in the body (hypoglycaemia). If left untreated, both can be life-threatening.
Dr Jude said: “The long-term consequences of poorly-controlled diabetes are numerous. Patients can develop eye problems resulting in reduced vision or blindness, kidney problems resulting in the inability to filter waste products and can lead to kidney failure.  Another serious consequence is neuropathy, where nerves in the feet are damaged, causing reduced sensation and sometimes leg pain.
“This combined with poor circulation can lead to foot ulcers and even amputation, with the risk of diabetic amputations being 23 times that of non-diabetics. Although these consequences may seem extreme, they are common and so the importance of understanding how patients can reduce their risk must be emphasised.
“By checking their feet regularly or having them checked by healthcare professionals, diabetic patients can decrease their risk of foot ulcers or receive treatment for them quickly should problems occur, further reducing the risk of amputation.”
Diabetes UK has estimated that foot care accounts for 20 per cent of total diabetic care cost to the NHS; however one NHS study has determined that with dedicated foot care teams this cost can be dramatically reduced and improve outcomes including preventing amputations.
Dr Jude added: “Despite the serious consequences of diabetes, patients can truly make a difference to their own care and outcome. Diabetes is not curable, but can be treated successfully in most people and the more involved and informed a patient is about their condition the better they can manage it.”

Dr Jude’s Top tips for diabetic patients:
▪ Write down your blood glucose readings and what time you take them. By noticing patterns of high or low blood glucose, you can have a better idea of what has caused these changes and also keep your medical team informed so they can help adjust your treatment.
▪ Learn the warning signs for low blood glucose (hypoglycaemia) and high blood glucose (hyperglycaemia) and what to do.
▪ Keep up with your regular diabetic appointments. If you do not have a diabetic team, be sure to inform your GP so you can get the assessments you need. You MUST have regular feet, eyes and blood pressure check ups
▪ Follow the advice given by your doctor or nurse and take your treatment regularly.
▪ Eat healthily. As your body cannot deal with glucose normally, and much of what you eat is converted to glucose, you can make a huge difference to your own health simply by changing what you eat. Speak to your GP or diabetic specialist about what food is best for you.
▪ Exercise regularly and try to get to your ideal body weight (or as close to it as possible)
▪ Inform your GP or the diabetic foot team immediately if you notice a problem with your feet. You must be seen by a foot care specialist in the diabetes foot clinic straightaway if you have a new ulcer, redness, swelling or deformity in your foot.

Dr Jude added: “Together we can give better care to people in Tameside with diabetes and reduce heart attacks, strokes and amputations and people with diabetes can then have a better quality of life”