Diabetes UK Professional Conference

At the Diabetes UK Professional Conference, which takes place this week, health workers, doctors, nurses and researchers will join with policy makers and business leaders to look at the major issues which will make a difference to how we combat this condition in future.

The number of people with type 2 diabetes has doubled in the last 20 years and this is having a serious impact in terms of health complications and disability. This trend, which is linked to the obesity epidemic and sedentary lifestyles, is also a major financial burden on the NHS.

The cost of dealing with diabetes, which occurs when the body is unable to control blood sugar levels properly, is over £1.5 million an hour or 10 per cent of the entire NHS budget for England and Wales.

Certainly, telemedicine is going to be on the agenda at the conference which takes place at ExCel in London. This will allow many more people to take ownership of their own care and to feel like equal partners with doctors when it comes to medical management. Of course, telemedicine, which includes remote monitoring, is not for everyone and many people prefer to stick to traditional care, but there are many ways where it is already being used to great effect.

In terms of technology, there are now continuous glucose monitoring systems, rather than the usual finger prick blood tests which have to be done several times a day. The flash glucose monitor, which is now available on the NHS, measures glucose at intervals in the interstititial fluid that bathes the cells, using a small sensor implanted inserted just underneath the skin. The sensor is scanned to read the blood glucose level. Another type of glucose monitoring is Continuous Glucose Monitoring, or CGM, when glucose is measured constantly, again through the interstitial fluid. The blood glucose level is sent automatically to an insulin pump or hand held device, without the need for scanning. CGM also has an alarm which will alert you when you need to treat a low blood sugar level or take insulin to get back to the normal range. CGM is particularly useful for people who aren’t very aware of changes in their blood sugar level. NICE guidelines recommend CGM for certain people with diabetes who have difficulty managing their blood sugar levels, but some people who fit the criteria have found it difficult to access CGM technology. It is a very expensive resource and funding is not always available.

I’m sure there will also be plenty of discussion about how we can ‘reverse’ type 2 diabetes with diet and lifestyle alone. As far as Diabetes UK is concerned, we don’t talking about ‘reveresing’ diabetes. Instead, we talk about putting it into remission. Reversing suggests that it goes away and stays away and evidence actually suggests that symptoms can quickly come back of if diet changes or activity levels drop for whatever reason. There is also the difficulty that people may believe that their diabetes has gone for good and stop attending yearly checkups. This can mean it can come back without being noticed. And type 2 diabetes does not just affect blood sugar levels. It can also have long term effects on organs like the kidneys and heart and symptoms are not always obvious. So the yearly checks are still absolutely crucial.

Footcare is something that is a vital part of looking after people with diabetes because the condition can affect the blood supply and damage nerves that supply the feet. So people with diabetes can easily damage their feet without feeling discomfort, causing them to damage the area further. Poor circulation means that wounds take longer to heal, potentially leading to infection or ulcers. If this happens, a foot amputation may be necessary. We know that, if we catch foot damage early, we can greatly reduce the risk of needing an amputation. Diabetes UK’s ongoing campaign, Putting Feet First, aims to raise awareness in people with diabetes of the need to check their feet everyday and seek help at specialist clinics when they have a problem. It also highlights the need for healthcare services to provide immediate access to specialist foot care services
We look forward to welcoming our speakers and delegates this week and hope to come away with new ideas and solutions for improving diabetes care.