Managers working in diabetes don't have to be gurus in diabetes but it is important for managers to know that Type 1 and Type 2 Diabetes are very different. Sometimes I wish they were called something different so that commissioners did not lump them together.
"In type 1 diabetes, the body's immune system attacks and destroys the cells that produce insulin. As no insulin is produced, your glucose levels increase, which can seriously damage the body's organs. If you're diagnosed with type 1 diabetes, you'll need insulin injections for the rest of your life. It usually develops before the age of 40, often during the teenage years.
Type 2 diabetes is where the body
doesn't produce enough insulin, or the body's cells don't react to insulin.
This is known as insulin resistance.
If you're diagnosed with type 2 diabetes, you may be able to control your symptoms simply by eating a healthy diet, exercising regularly, and monitoring your blood glucose levels.
However, as type 2 diabetes is a progressive condition, you may eventually need medication, usually in the form of tablets/injections."
If you're diagnosed with type 2 diabetes, you may be able to control your symptoms simply by eating a healthy diet, exercising regularly, and monitoring your blood glucose levels.
However, as type 2 diabetes is a progressive condition, you may eventually need medication, usually in the form of tablets/injections."
For me,
as a non clinician, the most useful things to know as a Manager are:
· It’s not you. Commissioning Diabetes is
complicated. The pathway covers public health, prevention, primary care,
community care, specialist care in DGHs and sometimes tertiary care (i.e. Islet
transplants for type)
· In the UK, around 90% of all
adults with diabetes have type 2
·
You
cannot prevent or delay type 1 diabetes (so the new NHS Diabetes Prevention
Programme is for the prevention or delay of type 2 diabetes) https://www.england.nhs.uk/ourwork/qual-clin-lead/diabetes-prevention/
·
A person with type 2 diabetes does not become a type 1 if they move on to insulin
injections.
·
Many
commissioners are redesigning diabetes patient pathways so that patients can
"safely" be discharged from secondary care
services to primary care services. (Care Closer to Home).
In my personal opinion don't discharge your Type 1
patients. The reason being that, type 1 only accounts for 10% of
your diabetic population and is managed very differently. Get your Type 2
diabetes patient pathway right first. By right, I mean that the
redesigned pathway has evidenced that patient outcomes have been at
least sustained and hopefully improved. Then you can get more ambitious
and look at discharging stable type 1 diabetics.
There are
many other things I could probably add (and please send me ideas and I can
edit) but I hope this is a good starting point.
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