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The case for diabetes self-management education

Trudi Deakin2Today’s guest post was written by Trudi Deakin who is the Chief Executive of the registered charity, X-PERT Health which specialises in the research, development, implementation and audit of patient structured diabetes education.

Diabetes is currently costing the NHS £1 million an hour and that is unsustainable. Not only that, but it is unnecessary.

It is largely due to the Diabetes Type 2 epidemic that is sweeping the UK. The key risk factors for Type 2 diabetes include age, ethnicity, family history and obesity, with obesity accounting for 80 per cent of the risk for developing Type 2 diabetes. Knowledge is power and if people at risk or newly diagnosed with diabetes had access the right information they would be able to manage and bring their condition under control to the stage where some might be able to give up prescription medication altogether.

However, thanks to the unique way medical services are managed and prescribed in the four nations, England, Wales, Ireland and Scotland it can be a lottery whether or not you get access to proper education or end up with a do it yourself and hope for the best approach.

There are currently 4 million people living with diabetes in the UK. Around 700 people a day are diagnosed with diabetes. That’s the equivalent of one person every two minutes. By 2025, it is estimated that five million people will have diabetes in the UK. On top of that there are an estimated 4.75 million people at risk of developing Type 2 diabetes at any minute.

Added to the financial cost is the fact that one in seven hospital beds is occupied by someone with diabetes, and in some areas it as much as 30 per cent, people with diabetes are twice as likely to be admitted to hospital and one in 20 victims will also incur social care costs; the figures are mind boggling and we are only scratching the surface.

We are campaigning for every person who presents as being at risk, or is diagnosed with the condition to be given access to a proper National Institute for Health and Clinical Excellence (NICE) compliant education programme to help them manage their condition more effectively.

There is a compelling case. Good diabetes management has been shown to reduce the risk of complications. Not only that but people experience a boost in confidence and wellbeing that is empowering and impacts positively on other aspects of their lives. 

Armed with the facts about food and diet, patients are able to manage their diabetes much more effectively. Trials conducted by X-PERT Health a decade ago demonstrated a clinical and psychosocial benefit with patients losing weight, reducing blood pressure, body mass, waist size, and improving cholesterol and lipid levels as well as having more energy.

When diabetes is not well managed it is associated with serious complications including heart disease, stroke, blindness, kidney disease and amputations leading to disability and premature mortality. There is also a substantial financial cost to diabetes care as well as costs to the lives of people with diabetes.

NICE recommends that all people diagnosed with diabetes are referred to an intensive lifestyle management structured education programme. Equipped with the right information people may be able to reverse the diagnosis of diabetes but even better, early intervention for people presenting at risk could avoid a positive diagnosis in the first place.

The time has come for a policy shift that will benefit the health of the nation and of the NHS.

The question is no longer can the NHS afford to invest in improving self management of diabetes but can it afford not to?

The views and opinions expressed herein are those of the author and do not necessarily reflect the views of the APPG.

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