REVIEW OF 2006

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The following reports give you an idea of what the Group got up to in 2006:

Over the summer we had stalls, collections etc. at quite a few local events, including the 50+ event at Ponds Forge, Sheffield Fayre in Norfolk Heritage Park and several local fairs and carnivals.

SHEFFIELD ON SEA  SUNDAY 20 AUGUST 2006

WALK IN THE PARK Fundraising Event, 16 July 2006: CLICK HERE for report and photos

DIABETES WEEK 11 - 17 JUNE 2006

Thanks to everyone who helped at the street collections and Information Stall at the beginning and end of Diabetes Week. We handed out leaflets and Newsletters and spoke to lots of people with diabetes, some newly diagnosed and some who had been living with diabetes for many years. We raised over £330 in collections.

Hello to you if you're one of those we met, and we hope you are finding any information you picked up useful. Do get in touch with us if we can be of any further help.

SUPERMARKET COLLECTIONS

The collections at Supermarkets over the year raised over £2600.

  DONATION TO CHILDREN'S WEEKEND

In 2006 the Group voted to donate £1600 to the Sheffield Children's Diabetes Team who planned to take a group of children with diabetes on an educational / activity weekend break to Edale. This gives the children the opportunity to meet and befriend others with the same condition and helps them gain the confidence to manage their own personal care away from the home environment. The donation includes £616 raised by Sue Sayles from her parachute jump last year. (Well done, Sue!) This picture and a short report appeared in the Sheffield Star Newspaper on 6 April 2006.

MONTHLY GROUP MEETINGS:

Diabetes related medicines and their interactions.
 

At our last meeting of 2006, held on 16 November, we had a very interesting presentation by a Clinical Practice Pharmacist, Hilde Storkes and Joy, a Medicine Management Technician, covering the following points:

When two or more drugs meet it often affects how they work. This can sometimes be beneficial e.g. some diuretics are combinations of different drugs. In a small proportion of other cases the results can be harmful, or some drugs knock out the actions of others.
Drug companies do extensive tests, but there still may be interactions that are not known of and so it is important that any occurrences are reported. Any cases of interactions reported to a doctor are sent to a national database. The GP computer system alerts of any known interactions.
One problem is that interactions are not always predictable and individual people vary in their reactions to drugs due to genetic reasons etc. An interaction is most likely when starting on a new medicine, and some drugs need to be carefully adjusted in order to get the exact dose which is right for the patient. Another problem is that medicines are more widely available today than they have ever been, due to the Internet etc. You should always tell your pharmacist or prescriber what medicines you are buying from all sources. This includes herbal remedies which can also interact. Your doctor will be able to work out any possible risks as well as benefits brought about by taking medicines which may potentially interact with each other. Rather than increasing the dose of a particular drug it is sometimes better to add another drug which acts differently to achieve the same results.

There is a Yellow Card Scheme for reporting interactions, and you should ask your pharmacist or doctor about this if you experience any.
Or visit www.mhra.gov.uk (the website of the Medical and healthcare products Regulatory Agency)

Diabetes care in hospital

At our October Group Meeting, Cathy Stocks, a Diabetes Specialist Nurse from the Northern General Hospital, gave some advice about how best to manage your diabetes if and when you have to stay in hospital. In the case of acute illness (e.g. serious infections, immediately following surgery etc) a sliding scale of medication is used with insulin being administered intravenously. Blood sugar is checked every hour, although this can be elongated to two hours during the day if the patient is more stable. This is necessary as other drugs such as strong painkillers can mask the symptoms of a hypo. However, once you are back to eating normally and feel you are stable enough and able to cope with managing your diabetes yourself you should be allowed to request to do so.
It is probable that you know more about your own personal diabetes management than the medical staff in the hospital, and so Cathy advised that anyone who was stable and felt able to do so should take on their own diabetes care and decide themselves how often their blood sugar should be tested and what doses of insulin to take. It is best to stick as closely as possible to your usual routine. Hospital meal times may differ from your meal times at home but you should be able to work out a suitable regime. You should ask to keep your diabetes medicines in your own bedside drawer.
If you are at all concerned about your diabetes management whilst in hospital, you should ask to be visited by a specialist Diabetes Nurse. This applies to both the Northern General and the Royal Hallamshire Hospital.

The DAFNE Programme
 

At our June meeting Carolyn Taylor, a Diabetes Specialist Nurse and DAFNE Co-ordinator, spoke to us about this programme (Dose Adjustment for Normal Eating) for people with Type 1 Diabetes.She began by looking back to the 1970's when people who took insulin had to weigh all their food and if they went into hospital had to follow a strict diet. It was not until the 1980's that nurses started to specialise in diabetes care and Diabetes Education Centres began. The introduction of pens instead of syringes gave people more flexibility, although they was still an inclination to be strict over carbohydrate counting.
In 1998 a group of people from Sheffield and other parts of the country went to Dusseldorf to look at a Diabetes Treatment and Training Programme being used in Germany. People on the scheme had less long term health problems but there were doubts over whether it would work in this country. With the help of a grant from the British Diabetic Association (now Diabetes UK), a 5 day teaching programme was devised and in 2000 the first DAFNE course took place. The basic philosophy is that people with diabetes should be able to eat a normal diet by working out the needs of their pancreas and then taking the appropriate dose of insulin. Course Tutors (Diabetes Nurses and Dietitians) are given training and courses are inspected for quality assurance. The people on the course record their blood sugars, insulin intake and carbohydrate levels and learn from each other. Meal times etc. can become much more flexible.
The first Centres to offer DAFNE courses were in London, Sheffield and Northumbria. By 2002 there were 10 Centres and there are now 41 with another 17 opening soon. The scheme also operates in Australia. 520 people have completed the course in Sheffield, and the waiting time is now about 18 months. The programme has proved very successful.
Although the scheme is for those with Type 1 Diabetes, some members with Type 2 pointed out that they also found it useful.

PRESIDENT AND VICE PRESIDENT'S EVENING

We had a packed programme at our Monthly Meeting on 18 May when our President and two Vice Presidents each gave their own presentations.

Dr. Colin Hardisty began by giving us his personal views on "A Changing NHS : implications for Diabetes Care". He explained the reasons for the expected changes in the way the National Health Service is run. The NHS budget accounts for 17% of public expenditure and has risen from £43.9 billion in 2000 to £76.9 billion in 2005/6. This large increase has enabled Accident and Emergency waiting times to be considerably reduced and 98.2% of people are now seen within 4 hours. Waiting lists are also down and very few now wait over 6 months on the surgical waiting list. In spite of these improvements results from Focus Groups and Surveys show a continuing dissatisfaction with the NHS and the public want choice, better information, improved access and more services locally. An ageing population will increase the demand for hospital beds. Because of these considerations and the fact that the amount of money allocated to the Health Service will not increase by as much in future the Government is anxious to improve efficiency and ensure value for money. Some of the main changes will include the use of non NHS providers such as surgical treatment centres encouraging NHS hospitals to improve their services in order to compete. All NHS patients will be individually costed and the same fees will apply nationally without taking into account the quality of service for each episode of care. Practice based commissioning will apply. The implications for Diabetes care are that all costs will have to be looked at, including what workforce is needed. There will have to be some way of assessing the quality of care and it needs to be asked who will oversee any changes. It is possible that non NHS providers will be offered.

Dr. Nuala Creagh spoke about "Changing goalposts in Diabetes Care: risk factors for cardiovascular disease". She outlined the new guidelines recommended by JBS2 in 2005 (the Joint British Societies include Diabetes UK, Heart UK, British Cardiac Society, British Hypertension Society, Primary Care Cardiovascular Society and the Stroke Association). These guidelines recommend how to assess who is at risk and set thresholds for intervention. For example, the optimal Blood Pressure target is 140 / 85 and the optimal total cholesterol target is less than 4 mmol / l (in Sheffield treatment begins at a level of 3.5 mmol / l). Statin treatment is recommended for all those over 40 years of age with diabetes and for 18 to 39 year olds who have other complications such as retinopathy, nephropathy, poor glycaemic control, family history of CVD etc.

Prof. Solomon Tesfaye spoke on "Involving you in Diabetes Research". There was some discussion about appropriate terminology for people who get involved- Should they be referred to as patients, users, the public, lay members, service users etc.? He stressed the importance of active participation in the research process at all levels and quoted the North Trent Cancer Research Network who had set up a Consumer Research Panel as a good example. At the moment there is not much involvement in Sheffield for those with diabetes, but this could change in the future.

APRIL 2006 MEETING : Food, Fads and Favourites

At our April Meeting Val Naylor, a Registered Dietitian from the Royal Hallamshire Hospital, made a welcome return visit to the Group to talk about food and diet. She addressed the increasing problem of obesity which is an issue for about 80% of people with diabetes. As we have seen in recent television and newspaper reports, the number of obese children is rising. Today's lifestyles result in people being less active and eating more pre-packaged foods. Portion sizes of many packaged food products have increased alarmingly over recent years (for example in America research has shown that chocolate chip cookies have increased by 700% in the last 30 years) and so it is easy to eat more without realising.. A person who eats just 100 extra calories in a day can put on 10 pounds in weight in a year.
Val went on to examine various "fad" diets and to look at their advantages and disadvantages:-

Meal replacements (such as Slimfast): These can give a good kick start to a weight reduction plan. They are easily fitted into a busy schedule. However some people feel hungry and the lack of fibre can lead to constipation. They don't help in teaching a person how to switch to a healthier overall diet, so it's difficult to achieve lasting results.

Atkins Diet: This involves eating lots of protein and cutting down carbohydrates. Fat is allowed but no starchy vegetables or fruit. It is popular with meat lovers. In some parts of the country, but not Sheffield, it has been used successfully by dietitians working with people with Type 2 diabetes but it shouldn't be tried without medical supervision. It is not regarded as safe for those with Type 1 diabetes. Problems can arise such as the production of ketones, poor bone health and poor renal health.

G.I. Diet: The Glycaemic Index ranks carbohydrate foods according to how quickly they raise blood sugar. Low G.I. foods, such as porridge, muesli, granary bread, baked beans, pulses, pasta, basmati rice and vegetables, raise the blood sugar slowly and some should be eaten with each meal. This has the advantage of steadying the appetite and fits in well with diabetes care. However, in order to achieve weight loss, calories also need to be taken into consideration.

USEFUL CONTACTS:
www.bda.uk.com  The website of the British Dietetic Association
www.hpc-uk.org  Check that your dietitian (or other health professional) is Registered.

Comments on User Involvement conference on 7 March 2006

by Mollie Hickman

I attended the conference along with Annette, which was held in the Barbican, London. This was also very interesting to me as I have never been there before the Barbican that is, it turned out to be a huge rambling place with very good facilities for the disabled and able bodied. 100+ people attended the conference from all areas of the community; these included Health Care Professionals, carers of people with diabetes (adults/children), people with diabetes and user representatives. The Chairman of the Steering Group, Prof David Coates opened the day, followed by Douglas Smallwood the Chief Executive of DUK talking about “making involvement a success”. Three presentations followed by Alan Charlton who talked about his role as a user representative, Roopham Carroll whose talk was about “Starting from Scratch” and Peter Shorrock talking about “Bringing the health professionals and people together”. These talks were interactive and many questions were asked.

The delegates were then split up for a number of workshops, the particular one I was in discussed ways and means of getting information to the ethnic minorities and getting them to attend meetings etc. it was noted that hospitals and health professionals needed to become more involved, what was interesting though was that we all experienced the same problems although we came from various parts of the country. Lunch followed this and during Lunch there was an Art Project taking place by the artist Paul Digby who drew a number of things on the windows and the delegates were asked to go and add their views on “what being involved in planning as a health professional or a person living with diabetes means to you”. After lunch there were a number of seminars which you had to put down for in advance, unfortunately I was allocated to the one related to children with diabetes which I have no real knowledge of, although I was a bit disappointed in this particular choice I did learn about the difficulties to experienced by the parents.

Overall though the day was excellent, very interesting meeting all the delegates from round the country as well as the excellent speakers.

PSYCHOLOGICAL HEALTH IN DIABETES CARE

At our March 2006 meeting Dr. Nick Robinson spoke about his work at the Northern General Hospital and about how clinical psychology fits into overall health care.

CLICK HERE  for a more detailed report of the meeting.

SHEFFIELD DIABETES EYE SCREENING PROGRAMME

 In February we had an informative and interesting presentation by Mary Freeman, Nurse Consultant, Royal Hallamshire Hospital about the new eye screening programme which was launched at the end of 2005.

CLICK HERE for a more detailed report of Mary Freeman's presentation.

Those running the scheme are keen to receive feedback from patients. If you have had recent experience of eye screening and would like to make any comments, please contact us and we will pass them on (Whether it's a praise or a grumble !)

If you need any further information about eye screening, please contact: 0114 2711821 or 0114 2713959