Discovery: Care and treatment
Care and treatment for diabetes
Diabetes care in the NHS is provided by GPs and specialist teams in hospitals. Most of the people we talked to were treated by the GP and/or specialist nurse, but others who had been treated in hospital as emergencies, or who had developed complications with diabetes were receiving specialist care in hospital. Those with other illnesses as well as diabetes used a combination of hospital and GP care.
Everyone with diabetes should have an annual check-up with the GP and specialist nurse at the GP practice. Each person will have a range of tests to check long-term blood glucose levels (the HbA1c test), blood pressure, kidney function and cholesterol. Patients also have their weight checked and BMI (Body Mass Index) calculated and recorded. The nurse or a podiatrist carries out an annual check of the feet and tests for loss of feeling in the feet and legs, to pick up early signs of nerve damage (neuropathy). Dietary advice is provided by nurses or by referral to a specialist dietician. It is important for all people with diabetes to have an annual eye check and this is normally done by a recall system for retinal photography carried out by designated opticians/optometrists.
The Department of Health has set out national standards for NHS organisations and professionals for diabetes care and prevention. The Diabetes National Service Framework
was developed by diabetes clinical experts and patients with diabetes. Good diabetes care includes:
- *Awareness of the risk factors for type 2 diabetes.
- *Advice and support to help people at risk of type 2 diabetes reduce that risk.
- *Access to information and appropriate support for people with type 1 and type 2 diabetes, including access to a structured education programme, such as DESMOND (Diabetes Education and Self Management for Ongoing and Newly Diagnosed).
- *An agreed care plan, helping all people with diabetes to manage their care and lead a healthy lifestyle, including a named contact for their care.
- *Information, care and support to enable all people with diabetes to optimise control of their blood glucose, maintain an acceptable blood pressure and minimise other risk factors for developing complications.
- *Access to services to identify and treat possible complications, such as screening for diabetic retinopathy and specialised foot care.
- *Effective care for all people with diabetes admitted to hospital, for whatever reason. (From NHS choices website.)
Many people talked about going to their local 'diabetes clinic' at the GP's surgery whenever they had any problems. Diabetes clinics, usually run by a specialist nurse, provided people with advice about medication, diet and weight control and also monitored when people needed their medication changed. Some people had been invited to diabetes workshops when first diagnosed.
Some of those working full-time said that diabetes clinics were always held on weekday mornings or afternoons and so were inconvenient. They wanted the chance to see their own GP at evening or Saturday clinics. Others who worked full-time said they preferred getting care from hospital clinics.
When people had used the internet to search for information about diabetes (see Looking for Information and Support) or when there had been a story about diabetes in the media, some people wanted better access to their GP for reassurance. Several wondered why GPs couldn't respond to queries with simple emails or text messages and help put their fears to rest.
Several people for whom English was a second or third language, said they valued being able to see a GP with an expertise in diabetes who could talk to them in their own language.
For more information on care and treatments see Diabetes UK and NHS choices.
Last reviewed November 2012.
Last updated November 2010.