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UK vs. Australia for good diabetes care

Today’s guest post comes from Linda Brodie, who speaks of her experience and compares the differences in her diabetes care here in the UK with that in Australia.  

I’ve been a Type 1 diabetic for 42 years, and I moved to Australia in 2009 for 5 years, so I’d like to compare their treatment with that of the UK NHS.

With regards to the UK, GPs and practice nurses I have encountered have a poor understanding of diabetes. Many of the truly informed staff are diabetic specialist consultants and nurses. 

Many Australian GPs, consultants, and Diabetes Specialist Nurses (DSNs) I have come across have better knowledge generally than in the UK.

Linda Brodie

Linda Brodie

After developing insulin sensitivity in 2011, I was offered an insulin pump by my Australian consultant, as Type 1 diabetics on private health schemes are moving onto pumps over there.

The reaction to my use of a pump on my return to the UK was “we’ve never seen one before”.

The failure to take regular HbA1c blood tests by my surgery and share these results with myself and the hospital have made my management difficult. This continues to be a frustrating situation and I am still waiting for a podiatry appointment almost two years after my return when it was a regular free treatment in Australia.

In Australia, the use of technology was very advanced. I was shown how to upload my pump data during an initial training, share it with the hospital team, and was contacted by email by my diabetic consultant to adjust my basal rates.

My first appointment to see a diabetic consultant on my return to the UK was upsetting. The current system means I need NHS funding to get the supplies from my pump manufacturer and told “If you want to be seen here, you’ll have to change that pump”; I’d only bought my pump 4 months earlier.I was gutted, although I was granted funding for supplies.  The hospital was offered free training by my pump manufacturer, but the offer was declined, which was a shame, considering many pumps work in a similar way.

I complained to my GP, contacted my pump manufacturer, on the advice of the charity Input, to help find supportive pump clinics within a 50 mile radius. I finally found one, but it all took time, perseverance, and long journeys. I was invited to pump training sessions, which were very well organized. I learnt a lot about diet, fat absorption, and exercise, but I’ve had to educate myself as to carb counting.  I highly recommend the visual Carbs & Cals app.

My Australian experience was such that my Diabetes Specialist Nurse was available on the phone at any time. This was particularly helpful as a novice pump user. Advice was texted straight back to me, with a follow up call later, just to check up on me. Brilliant service! In my experience my UK DSNs remain difficult to get hold of, and some have told me they are unable to reply by email, only
phone.

I moved again last year, and started at another diabetic pump clinic. The DSN stays in touch, and I’m happy to report they check my data uploads, and email me with any suggestions to basal rate changes. There is no phone contact available to me, but I hope this may be offered in the future. Doing your homework definitely pays off when trying to find a supportive pump clinic.

I’ve had two A&E admissions in the UK due to diabetic ketoacidosis, since going on the insulin pump. On my first admission, the A&E doctor demanded I remove my pump, whereas the second time, the doctor was happy for me to keep it connected. Neither of them asked about insulin sensitivity, which I think is vital, as diabetic ketoacidosis has a potentially fatal consequence.

A GP at my new surgery invited me in to talk about insulin pumps to visiting student doctors. They had little knowledge as to how the condition needs managing, but I think they all left with a much better idea of how diabetes affects you, and the health implications it has both daily and long term. I feel that doctors should spend time in a pump clinic training as part of their medical training.

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