Diabetes Care Pathway
We started with the call to develop a Northamptonshire Diabetes Care Pathway involving commissioners and stakeholders in 2009. We explored the complexity of the pathway development that evolved with the realisation of the different aspects of diabetes care that needed to be considered. This process enabled the service provision that crossed organisational boundaries to be identified and the responsibilities of the different service providers, this informed the development of the Northants Diabetes MDT – the glue between primary and secondary care and made clear the responsibilities of each service. You can find out more here
Engaging Young People with Type One Diabetes in Self-Management and Proactive Care.
Oxford Terrace and Rawling Road Medical Group (OTMG-RR) is a GP practice, situated in Central Gateshead, with a predominantly deprived population and high numbers of refugees and asylum seekers. Our effort recently focused on frail elderly people with complex care needs.
However, as part of some work on the quality and productivity indicators on ambulatory care sensitive conditions we started to observe a theme over two years of young people with type one diabetes, using A&E as their main access to clinical care. We found that young people were not attending clinical appointments in primary or secondary care, then being admitted through A&E with DKA. Whilst small in number (9 out of 15,200), this group of patients was overrepresented in attendance and admissions though A&E. See how they did it here
Carbohydrate counting course for diabetes patients
Carbohydrate counting and insulin bolus calculation is recommended in the management of Type 1 diabetes (NICE 2015).
Studies have looked at the effects of carbohydrate counting on indicators like HbA1c, however the currently available literature does not provide sufficient evidence to definitively determine the effects of carbohydrate counting on HbA1c.
For every 10% reduction in HbAc1 there is a marked reduction in complications over time, some evidence also suggests that the sooner this reduction occurs in the person’s life with diabetes the greater the benefits and also more cases of complications are prevented by the same degree of improvement in glycaemic control at higher levels of HbA1c. You can find out about the course here
This Future Hospital case study of how Newham University Hospital improved its Transitional and Young Adult (TYA) diabetes service.Key recommendations
• Patient Champions and peer-to-peer support are crucial to success.
• Support services suitable for 16-19 year olds may not necessarily be suitable for 20-25 year olds; where possible these services should be separated.
• Collaborative working among all partner organisations (including local employers, leisure industry, etc) is essential and requires a high level of commitment and support from staff.
• Flexibility of service is key to engaging 16-25 year olds, as is increased use of digital and social media
Find out more here