Search for diabetes patient champions

One of the fastest growing diseases in Norfolk is being tackled through a new initiative designed to improve diabetes services, with greater patient involvement in the way services are provided.

As part of the new National Service Framework (NSF) for diabetes produced by the Department of Health, staff involved in diabetes care in central Norfolk are looking for people with diabetes who can help the NHS deliver services that more closely meet patients’ needs.

The Norfolk Integrated Diabetes Management Group (NIDM) is responsible for developing the Diabetes NSF locally and this group is looking for ‘Patients Champions’ to join the group and give an expert view on developing patient’ based diabetes services locally. The NIDM group is chaired jointly by a Consultant Diabetes Specialist and by a General Practitioner.

NNUH Consultant and NIDM group joint chairman Dr Mike Sampson: “Diabetes is a major health issue locally and we need to find two patients’ champions with diabetes to join the NIDM group and help us shape diabetes services with patients’ experiences at the centre of the service .”

If you are interested in being a Patients Champion, have diabetes, and live in Norfolk please contact Dr Mike Sampson (01603 287094) for more information.

For more information about the NSF for diabetes, visit the Department of Health website.

Background

There are two forms of diabetes. Type 2 diabetes means the person affected may still produce insulin but they are unable to use it properly to control blood glucose levels . Type 1 diabetes is where the person’s pancreas stops producing insulin and they need to control their blood sugar with daily injections of insulin. The number of children being diagnosed at the N&N with Type 1 diabetes has doubled over the past 15 years. Before the 1920s, Type 1 diabetes always proved fatal. It is thought that the onset of diabetes is caused by genetic factors and factors like poor diet or lack of exercise. There are about 12,000 people with diabetes in East Norfolk and a further 1000 are diagnosed each year locally.

Diabetes explained
Diabetes can affect babies, children, young people and adults of all ages, and is becoming more common. Diabetes can result in premature death, ill health and disability, yet these can often be prevented or delayed by high-quality care.

Diabetes is a group of disorders with many different causes, all of which include raised blood glucose levels. This is the result of a lack of the hormone insulin and/or an inability to respond to insulin. Insulin in the blood, produced by the pancreas, is the hormone which ensures that glucose (sugar) obtained from food can be used by the body. There are two types of diabetes: Type 1 diabetes and Type 2 diabetes.

Type I diabetes – About 15% of diabetics in England are people with Type 1 diabetes, the pancreas is no longer able to produce insulin because the insulin-producing cells (b-cells) have been destroyed by the body's immune system. Type 1 diabetes develops most frequently in children, young people and young adults. Although it is far less common than Type 2 diabetes, it is more immediately evident. The symptoms of Type 1 diabetes can develop very rapidly. These include increased thirst and urine production, weight loss despite increased appetite, tiredness and blurred vision. People with Type 1 diabetes need daily injections of insulin to survive.

Type 2 diabetes – About 85% of diabetics in England have Type 2 diabetes, where the pancreas is not able to produce enough insulin for the body's needs. The majority of people with Type 2 diabetes also have some degree of insulin resistance, where the cells in the body are not able to respond to the insulin that is produced. Type 2 diabetes is most commonly diagnosed in adults over the age of 40, although increasingly it is appearing in young people and young adults. Glucose builds up in the blood, as in people with Type 1 diabetes, but symptoms appear more gradually and the diabetes may not be diagnosed for some years. People with Type 2 diabetes need to adjust their diet and their lifestyle. Many are overweight or obese and will be advised to lose weight. Some will also need to take tablets and/or insulin to achieve control of their blood glucose level.

Effects of diabetes – Prolonged exposure to raised blood glucose levels damages tissues throughout the body by damaging the small blood vessels. The initial changes are reversible but, over time, prolonged raised blood glucose levels can lead to permanent damage. These complications occur only in people with diabetes and include:

• damage to the eyes, which can lead to visual impairment and blindness (diabetic retinopathy)
• damage to the kidney, which can lead to progressive renal failure (diabetic nephropathy)
• damage to the nerves (diabetic neuropathy). Damage to the nerves supplying the lower limbs can lead to loss of sensation in the feet, thereby predisposing to the development of foot ulcers and lower limb amputation. Damage to other nerves can lead to a variety of symptoms, including postural hypotension (feeling faint on standing up), abnormal sweating, gastrointestinal problems (such as diarrhoea), difficulties with bladder emptying and erectile dysfunction (impotence).
• People with diabetes, particularly Type 2 diabetes, are also at significantly increased risk of developing cardiovascular disease. This results from damage to the walls of the large blood vessels, which can then become blocked. Cardiovascular disease includes: coronary heart disease, which can lead to angina, acute myocardial infarction (heart attack) and heart failure, stroke and transient ischaemic attacks (cerebrovascular disease)
• blockage of the large blood vessels supplying the lower limbs (peripheral vascular disease) resulting in poor circulation to the legs and feet, which can cause pain in the legs on walking and can also predispose to the development of foot ulcers and amputation.