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'Taking a whole practice approach to preventing type 2 diabetes'

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Over the past several years there has been a positive shift in how type 2 diabetes and impaired glucose tolerance are managed. 

elaine and company

elaine and company

Elaine Paisley (far left) and team

Rather than accepting that type 2 diabetes is progressive and will inevitably deteriorate over time, we are now in the fortunate position of being able to educate and empower our patients so that the opposite is true. In many cases it is reversible.

I am an advanced nurse practitioner based in a primary care four-partner GP practice in Southport, working with three practice nurses and two healthcare assistants.

I work with a dedicated team of nurses who are equally keen to spread the message that we can reduce the number of people being diagnosed with type 2 diabetes.

The NHS Diabetes Prevention Programme was introduced in Sefton in 2017 and is delivered locally by Living Well Taking Control (one of four providers of the service across England). This free service is offered to all patients who are considered at high risk of developing type 2 diabetes.

The programme involves weekly informal meetings for seven weeks (each lasting 90 minutes) addressing diet, physical activity, weight, stress and emotional wellbeing.

There are an estimated seven million people in the UK who have impaired glucose tolerance and the first step is identifying them.

As a practice, we ran our own searches to identify those patients who had an impaired glucose tolerance (HbA1C 42 -47 mmol/mol).

“A lack of contact could often make patients become demotivated and disinterested over a period of time”

The nursing team arranged retesting when necessary and onward referral was encouraged and facilitated to the NHS Diabetes Prevention Programme (NHS DPP), alongside recommendations for attending local activity programmes such as Access Sefton and Parkrun.

Previously, patients identified as having impaired glucose tolerance would have received brief intervention advice on lifestyle changes from a practice nurse, with recommendations for follow-up testing in six to 12 months. A lack of contact could often make patients become demotivated and disinterested over a period of time.

Now that we can offer the NHS DPP, patients have a much more in-depth, prolonged programme they can attend regularly; consequently making more nursing appointments available in the practice.

Patients are able and encouraged to take a friend or family member with them, and as the course is delivered in small groups, they have the opportunity to meet others with similar concerns and questions.

The team delivering the programme empower patients to take responsibility for their own health and provide the information they need to make small positive changes, which can make a big impact to their health.

It is really gratifying to see the reduction in HbA1C, blood pressure, cholesterol and weight – reducing not only the risk of type 2 diabetes but cardiovascular disease too.

“With an estimated £6bn per year being spent on diabetes and its complications, the NHS Diabetes Prevention Programme has got to be an investment in the long-term”

The latest national figures from the programme show that 154,000 people have already been referred to the programme with around 66,000 taking up the offer. Early outcome data also shows that more than half of those who attended the majority of sessions lost on average 3.3kg. When exuding those of normal body mass index (BMI) and weight, this actually rose to 3.7kg.

So these early indications show the programme is working and making an impact.

With an estimated £6bn per year being spent on diabetes and its complications, and one in six hospital beds taken up by preventing the onset of type 2 diabetes, programmes such as the NHS Diabetes Prevention Programme have got to be an investment in the long-term.

That’s why our practice will be taking part in #PreventingType2 as part of Diabetes Prevention Week, which takes place 16-22 April 2018.

Our team of doctors and nurses will continue to raise awareness using the free Diabetes Prevention Week toolkit, which includes posters, leaflets and other materials that we will be displaying in waiting rooms, and offering advice and testing as needed.

It’s true what they say – prevention is better than cure, and even more so when there is no cure.

Elaine Paisley is an advanced nurse practitioner working in Southport

Diabetes Prevention Week takes place from 16-22 April 2018. Free toolkits are available to order now from the Public Health England Campaign Resource Centre. Find out more about the NHS Diabetes Prevention Programme at www.england.nhs.uk/ndpp

 

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