Diabetes

The 3 Parts

When your review is due, you will get a reminder

We request you click the link below and complete the Annual Diabetic Review Form

Our team will contact you to arrange the rest of the review.

Preparing for your Annual Review

Due to the current Covid-19 pandemic we have made some changes to how we carry out reviews of long term conditions. This is to reduce contact wherever safe and possible. The Diabetes Care Navigator will advise and guide you through how to get your relevant tests etc, ready for the clinical review.  The follow up review with the clinician will now be a telephone consultation. This is scheduled for 15-20 mins, so you may want to find a place to sit comfortably and you migh want to have someone else with you on the call.

Please have the following to hand – List of medication, any results you have been documenting, any questions or queries you have written down and a pen and paper (reading glasses if needed)

Some of the themes that you may want to discuss are: medication, diet, impact of covid-19, keeping active, losing weight, sex life, mental health.

Diabetic retinopathy

Diabetic Retinopathy is a complication of diabetes, caused by high blood sugar levels damaging the back of the eye (retina). It can cause blindness if left undiagnosed and untreated.

However it normally takes years for it to develop far enough to damage your sight. To minimise the risks of this happening the parameters of blood glucose, blood pressure and cholesterol should be controlled. Attend annual eye screening to pick up and treat problems early on.

Click here for more information on the NHS website

Click here for more information on the Diabetes UK website

The screening apoointments are so important for protecting sight that the service has become more flexible – They can offer evening and weekend appointments and you can visit any of their venues – not just your local venue, so you can work around other commitments.

Telephone: 01983 898700

Visit: www.desphiow.co.uk

Email: desphiow@nhs.net

Diabetes and heart disease

When you have diabetes, you’re more at risk of heart disease. This is also called cardiovascular disease (CVD) or coronary disease, and can lead to heart attacks and strokes.

Website:www.diabetes.org.uk/guide-to-diabetes/complications/cardiovascular_disease

Lipohypertrophy

Also known as ‘Lipos’, are hard lumps that can form if you inject in the same place too often. Some people don’t like how they look and they can stop insulin from working properly. They may even be responsible for causing hypos or hypers because of this. So make sure you rotate where you inject and choose a different spot each time. You also have to change to a new needle for every injection as repeat use of the same needle causes it to blunt making it more painful, more prone to infection and lipos.

Checklist for Injectable Medication – Insulin and GLP-1

Things you need to know about injections

Other Diabetes Complications

  • Skin conditions. Diabetes may leave you more susceptible to skin problems, including bacterial and fungal infections.
  • Hearing impairment. Hearing problems are more common in people with diabetes.
  • Alzheimer’s disease. Type 2 diabetes may increase the risk of dementia, such as Alzheimer’s disease. The poorer your blood sugar control, the greater the risk appears to be. Although there are theories as to how these disorders might be connected, none has yet been proved.
  • Depression. Depression symptoms are common in people with type 1 and type 2 diabetes. Depression can affect diabetes management.

Diabetes and Foot Care

Diabetes UK have a campaign to help address this and improve these figures- Putting Feet First  They have also got information on Keeping your feet healthy- Steps to Healthy feet

If you need to find a private podiatrist, look on the College of Podiatry website

To check your podiatrist is registered visit the hcpc-uk.org.

Diabetic nephropathy (kidney disease)

Diabetic nephropathy is the name given to kidney damage caused by diabetes. It develops slowly, over many years, and is also referred to as kidney disease.

Website: www.diabetes.org.uk/guide-to-diabetes/complications/kidneys_nephropathy

Diabetic neuropathy

Diabetic neuropathy is the name given to nerve damage caused by diabetes. It can affect different types of nerves in your body, including your sensory nerves, autonomic nerves and motor nerves.

Website: www.diabetes.org.uk/Guide-to-diabetes/complications/Nerves_Neuropathy

Sex and diabetes

Sex is important and part of some people’s relationships. This isn’t any different if you have diabetes.

Website: www.diabetes.org.uk/guide-to-diabetes/life-with-diabetes/sex-and-diabetes

Sick day rules - Type 1 Diabetes

View our poster on ‘What to do when you are ill’.

Sick day rules - Type 2 and DKA

View our poster on ‘What to do when you are ill’.

Hyperglycaemia

Hyperglycaemia is the medical term for a high blood sugar (glucose) level. It’s a common problem for people with diabetes.

Website: www.nhsinform.scot

Sick day rules - Type 2 Diabetes

View our poster on ‘What to do when you are ill’.

Hypoglycaemia

This is more commonly known as “Hypos” – Low blood glucose levels.

View our poster on ‘Why do I sometimes feel shaky, dizzy and sweaty?’

Helping to Prevent Illness

Staying healthy and attending your annual reviews will help prevent any periods of illness. Another way to protect yourself from disease is by ensuring you have all of the vaccines that you are entitled to. 

Website: www.nhs.uk/Conditions/vaccinations

Insulin

  • This is the first medication prescribed in Type 1 Diabetes
  • This can only be given by injection as it is broken down in the gut before it can be absorbed, so tablets are not of use.
  • There are different types and brands of Insulin (what you are prescribed may be different to other people). You will be given what best suits your needs.
  • The Basic categories are – Rapid-acting, Short-acting, Intermediate acting, Long acting and there are Mixed Insulins that are combinations with different durations of action.
  • Regular finger pricking to check blood glucose is required
  • There is a risk of Hypoglycaemia (Blood Sugar under 4) with this medication, you will need to know how to recognise it and how to treat it – See the Hypoglycaemia information on our website
  • You need to inform the DVLA if you are a driver – See the Driving information on our website
  • You will need to know how to correctly store your insulin for both daily use and travelling
  • You will need to follow some sick day rules if you become ill – See the what to do if you are ill section
  • it is important to not run out of your insulin as it may take a few days for the pharmacy to order it in and it is a medication that must be given daily
  • It is important to know the type of insulin you take and the delivery device you use as this will prevent Insulin drug errors – Some people use a disposable pen device and some people use cartridges that fit into a resusable pen device (The analogy of the difference between a biro or fountain pen).
  • There is also an insulin pump that can be used for the delivery of insulin instead of the pen injections, but this has to be assessed under the NICE Guidelines by the Diabetes team at the hospital

Please click here for more information on Insulin

Please click here for a chart showing an overview of the different types of insulin

Carbohydrate Counting

The video below can show you how to work out the carbohydrate content in the food you eat. This can help you better manage your diabetes and have more stable blood glucose levels.

Video: www.youtu.be/qDwLSFG38Ms

Healthy Eating

Enjoy Food is our healthy eating resource for everyone – whether you have type 1, type 2 or another type of diabetes. It’s also relevant if you are newly diagnosed or have been told you are at risk of diabetes.

Website: Diabetes UK: Healthy Eating

Reversing Type 2 Diabetes with a Low Calorie Diet

A very low calorie diet may help you to:

  • Lose weight and feel better in yourself
  • Reduce your risk of diabetic complications, such as damage to eyes, feet, nerves and kidneys
  • Reduce your blood pressure, and your risk of heart attack and/or stroke
  • Reduce your blood glucose (HbA1c)
  • Losing the weight around your middle can also help your pancreas and liver to work properly, and possibly put your diabetes into remission

There are lots of low calorie diets out there, below are just a selection

If you’d like to try this, we recommend that you talk to your GP or practice nurse first, just to check you’re safe to start

Metformin

  • If you have Type 2 diabetes, metformin is usually the first diabetes medication prescribed
  • It protects against heart disease in diabetes and keeps people well for longer
  • It is usually prescribed if a healthy diet and increased exercise have not been enough to control your blood sugar levels
  • Metformin lowers blood sugar levels by improving the way your body responds to insulin and it may support weight loss.
  • You may not be prescribed this if you have poor kidney function
  • You may need to follow ‘sick day rules’ with this medicine
  • You should avoid drinking alcohol whilst taking this medicine

Website: www.diabetes.org.uk

DPP-4 inhibitors (Gliptins)

  • Medication names include: Alogliptin, Linagliptin Saxagliptin Sitagliptin and Vildagliptin
  • DPP-4 inhibitors (Gliptins) work by blocking the action the enzyme DPP-4, a protein that destroys the hormone incretin, and in turn boosts the production of Insulin
  • Having more insulin in the blood stream moves glucose into cells and reduces the amount of glucose released by the liver
  • Gliptins slow digestion and reduce appetite – This can help with weight loss
  • DPP-4 inhibitors are usually prescribed for people with type 2 diabetes who have not responded well to drugs such as metformin and sulphonylureas.
  • They are a good choice for people who are overweight and for those who need to avoid hypo’s
  • Not suitable if you have ever had pancreatitis, as they can cause or worsen this condition

Website: www.diabetes.org.uk

Thiazolidinediones (Glitazones)

  • Pioglitazone is the only medication of this type
  • Pioglitazone lowers your blood sugar levels by improving the way your body responds to insulin.
  • It can reduce levels of triglyceride (a type of fat) in the blood
  • You may gain weight on this medication
  • It is not likely to cause hypo’s
  • It can cause fluid in your body which can increase blood pressure and worsen heart failure symptoms
  • It may increase the risk of fractures and bladder cancer – If you have any history of these illnesses this is not be suitable for you
  • You need to have good liver function to take this

Website: www.diabetes.org.uk

Insulin

  • Insulin is the hormone that is released from your pancreas which enables glucose (sugar) to be used effectively in the body for energy
  • There are many different types of insulin injections – you will be shown how to use the one prescribed for you – it is important you understand they type you are on and have it written down for reference
  • Insulin therapy in type 2 Diabetes may be used when the blood glucose levels are inadequately controlled despite dual or triple therapy with other medication
  • It is the medication that provides the most drastic drop in blood sugar readings
  • It is an injectable medication usually given daily to start with, but this may increase to gain better control
  • It can cause weight gain
  • You will need to finger prick to check your blood glucose regularly
  • you will need to inform the DVLA if you drive
  • There is a risk of hypoglycaemia ‘hypo’ with this treatment
  • You will need to follow sick day rules with this medication

Website: www.diabetes.org.uk

Sulphonylureas

  • Medication names include: Gliclazide, Glipizide, Glibenclamide, Glimepiride
  • They work by increasing the amount of insulin released by your pancreas
  • Can cause hypoglycaemia (“hypo’s”)
  • This is when your blood glucose drops too low. If you don’t recognise hypo symptoms, drive, or operate machinery as part of your job, these aren’t suitable for you
  • If you have a risk of falling over and harming yourself these medicines would not usually be a good choice
  • You will need to do regular pin prick blood tests to check your sugar levels
  • Can cause weight gain – if you are overweight they are usually avoided
  • They are particularly useful in treating diabetes brought on by steroid medication
  • Repaglinide and Nateglinide are Prandial Glucose Regulators, which are similar sulphonylureas.
  • They work much quicker than sulphonylureas, but only last for a short time, so are taken half an hour before each meal
  • As the drugs act for a shorter period than sulphonylureas, the side effects of hypoglycemia and weight gain are slightly less likely

Website: www.diabetes.org.uk

SGLT2 Inhibitors (Flozins)

  • Medication names include: Empagliflozin, Canagliflozin, Dapagliflozin.
  • Sodium glucose co-transporter 2 (SGLT2) inhibitors “Flozins” block the enzyme responsible to absorbing glucose in the kidney
  • This means that more glucose is left in your urine, which you then pee out
  • These medicines will promote weight loss and have been shown to help slow the development of kidney and heart disease
  • If you have early symptoms of these conditions they may be a good choice for you. They are less likely to cause hypo’s.
  • They need to be avoided if you already have poor kidney function
  • You should not use them if you have any signs of poor blood flow to your legs and feet as they may be linked to an increase in limb amputations.
  • You need to drink extra water if you given this medicine.
  • You will need to follow ‘sick day rules’ with this medicine
  • You may need to regular pin prick blood sugar tests if you take with other medication

Website: www.diabetes.org.uk

GLP-1’s (Incretin mimetics)

  • Medication names include: Exenatide, Liraglutide, Lixisenatide, Dulaglutide and Semaglutide
  • This medication mimics the effect of the hormone incretin, which helps the body to produce more insulin
  • They also reduce the rate the stomach digests food, and can reduce appetite
  • It is an Injection medication given daily or weekly
  • It aids weight loss and has a low risk of hypo’s
  • It can be protective against heart disease and may be an option for someone who has signs of heart disease
  • It is used when treatment with at least 3 tablets is not helping you to keep your sugars under control or you have risks starting insulin
  • Or if you are overweight (BMI over 35) or have other illnesses which are made worse by being overweight
  • After six months of use, it will only be contnued if you can see that your sugar levels have improved and have seen some weight loss
  • DPP-4 inhibitors (Gliptins) should be stopped if you start this medicine

Website: www.diabetes.org.uk

Home Workout Videos

To stay fit and healthy, you’re recommended to get at least 150 minutes of moderate physical activity a week, or around 20 to 30 minutes a day.

Website: https://www.nhs.uk/oneyou/for-your-body/move-more/home-workout-videos/

Steady & Strong Classes

Designed to help people over 65 to improve strength and balance, helping you to live independently for longer

The instructors have specialist training to deliver exercises proven to reduce falls.

Salvation Army Building Thursday at 10.00am and 11.15am. Cost: £3.50 or block of 4 classes for £14. Contact Kevin Nuttall 01256 302249

Monk Sherborne Village Hall Friday at 3.30pm. Cost: £4 per class. Contact Louise Lewis 07908 851570

Online Weight Reduction Programme

POWeR is a Positive Online Weight Reduction programme to help you lose weight. POWeR is only suitable for adults with a BMI of 25 and above.

Website: www.powerhants.lifeguidehealth.org/player/play/powerhants

NHS Weight Loss Plan

Download the NHS Weight Loss Guide. It’s a free 12 week diet and exercise plan.

Website: www.nhs.uk/live-well/healthy-weight/start-the-nhs-weight-loss-plan

Green Gym

Everyone is welcome to join the Green Gym. There is something to suit everyone, regardless of fitness or experience. You will have the satisfaction of improving the environment in and around the hospital site, while improving your own physical and mental wellbeing and meeting like-minded people.

Website: www.tcv.org.uk/southeast/volunteer-south-east/day-projects/basingstoke-hospital-green-gym

Advice Videos

Check out the NHS Weight Management videos:

  • Health eating tips
  • Energy balance & fad diets
  • Fats, sugars & simple swaps
  • Food labels
  • Goal setting
  • Portion sizes
  • Recipe & menu planning
  • The eat well guide

Website: www.healthandcarevideos.uk/hld/59677

Glucose Meters

Information on how to use your glucose meter can be found on the manufacturer’s website below. This includes:

  • How to set up
  • How to perform a test
  • Trouble shooting and error messages
  • Information on ordering batteries (some companies will supply you or send vouchers for them)
  • Downloadable glucose sheets and software options.

If you cannot find what you are looking for on there, then the customer service numbers supplied on the website usually provide a good response.

How to test your blood sugar levels

How to test your blood sugar levels in 7 simple steps.

Video: www.youtu.be/NUskHl7APHE

Blood Sugar Monitoring Chart

View, download and use our Blood Sugar Monitoring Chart.

Smokefree Hampshire

They’re here to help you. We understand that different types of support for work different people.

Website: www.smokefreehampshire.co.uk

Call a Samaritan

When life is tough, Samaritans are here to listen at any time of the day or night. You can talk to them about anything that’s troubling you, no matter how difficult Call free on 116 123 or visit the Samaritans website.

CALM Webchat

Free, anonymous webchat with trained staff.

Website: www.thecalmzone.net/help/get-help

MIND Mental Health Clinic

Book in with a mental health support worker at Holmwood, for 16+ years old suffering from anxiety, lower mood and depression.

Telephone: 0118 981 4166

Website: www.andovermind.org.uk

Relate

Family and relationship counselling.

Website: www.relate.org.uk

Domestic Violence Helpline

Are you experiencing domestic violence or know of someone who is?

Website: www.nationaldomesticviolencehelpline.org.uk

Community Connect Service

Whether you are feeling lonely, or are looking to become physically active but need help with motivation, want support to find out how to take part in activities in your community then the British Red Cross can help

FREE service, receiving up to 12 weeks support, tailed to each person’s needs and goals

  • Lonley & isolated
  • Need to reconnect with the community
  • Would like carer support & signposting to groups, days centres & benefits
  • Advice & signposting about keeping fit & healthy
  • Have anxiety but would like to get out more
  • Tracey has 20+ years experience with people with learning disabilities

Make an appointment via reception 0118 981 4166 or Contact Tracey on 07885 804 25.

Email: TraceyPowell@redcross.org.uk

Text Shout

Shout offers confidential 24/7 crisis text support for times when you need immediate assistance.

Text “SHOUT” to 85258 or visit Shout Crisis Text Line

iTalk Physchology Therapy

iTalk provides free treatment to people 16 and over, suffering from a range of common mental health problems.

Website: www.italk.org.uk

YPI Counselling

A registered charity for 11-25 year old for counselling.

Website: www.ypicounselling.co.uk

Basingstoke Counselling Service

Counselling is a ‘talking therapy’. It helps many people with a wide range of problems through periods of distress or difficulty.

Website: www.basingstokecounselling.org.uk/counselling

Mental Wellbeing Audio Guides

For low mood, sadness and depression, anxiety control training, low confidence and many others.

Website: www.nhs.uk

Mental Health Apps

Apps that may help in times of need.

Website: www.nhs.uk/apps-library/category/mental-health

What is Diabetes Mellitus?

Diabetes is a long term (chronic) condition caused by too much glucose (sugar) in the blood.

The word Diabetes comes from the Greek word for siphon (or to pass through) and the word Mellitus is Latin, meaning honeyed or sweet. This was because in ancient times Diabetes was diagnosed when too much sugar was passing through into the urine of those affected

There are 2 main types of Diabetes: Type 1 and Type 2.

Watch the ‘What is diabetes’ video by Diabetes UK for more information.

Type 2 Diabetes

The most common type (90% of all Diabetics)

Diagnosis occurs most frequently in mid to later life – but can occur in all ages

In Type 2 Diabetes the body becomes resistant to the hormone insulin (which controls blood sugar levels)

This can present with vague symptoms that can be difficult to identify (up to 25% of those with Type 2 diabetes don’t know they have it)

Treatment may start with lifestyle changes and tablet medication but insulin injections may be necessary with time

Type 2 information from Diabetes UK

Type 2 information from NHS.uk

Type 1 Diabetes

The less common type (10% of all Diabetics)

This is an autoimmune disease, where the body mistakenly destroys the insulin producing cells in the pancreas

Insulin is a hormone that regulates blood sugar (glucose) levels and Type 1 diabetics need Insulin injections to control blood sugar levels

This is generally diagnosed in childhood, adolescence and young adults. However it is now known to occur in older people

Type 1 information from Diabetes UK

Type 1 information from NHS.uk

Prediabetes

Where blood sugars are higher than normal, but not high enough to be diagnosed with Type 2 diabetes

Prediabetes doesn’t have any symptoms but people with it have a high risk of developing Type 2 diabetes

Being at risk doesn’t mean you will definitely develop Type 2 diabetes and it’s a great time to start making healthy changes to your lifestyle to reduce your risk of Type 2 diabetes

Eating a healthy diet, being more active and losing weight are great ways of reducing your risk of diabetes

Prediabetes information from Diabetes UK

Know your Numbers and Terms

A guide to all the jargon!

View our page for information. 

Lilly Diabetes

This website is intended for UK residents who have a current prescription for Trulicity.

Website: www.lillydiabetes.co.uk

Diabetes UK

Find out lots to do with Diabetes.

Website: www.diabetes.org.uk

Diabetes Education

What can I do to take care of my diabetes?  What should I be eating?  I know I need to change some of my habits – how can I get motivated?

You’ll find the answers to these questions and more in this series of short education videos.

Website: www.southernhealth.nhs.uk

Health and Care Videos

Health and Care Videos about Diabetes.

Website: www.healthandcarevideos.uk/diabetes

BERTIE Type 1 Diabetes Education Programme

There is a lot of useful information here to help you to understand and manage your diabetes in a way that suits you and your lifestyle.

Website: www.bertieonline.org.uk

Diabetes UK Youtube

Diabetes is a serious, lifelong condition where your blood glucose level is too high. Watch the videos to find out more.

Website: www.youtube.com

Official Gov.uk Recommendations

Check with your nurse or doctor if you don’t know what type of medication you’re on.

Website: www.gov.uk/diabetes-driving

Driving and Transfer Assessments

Sometimes medical conditions, accidents or disabilities may mean that you are restricted when it comes to driving, or that you may need to stop driving for a while. When you are ready to return to driving, an assessment provides you with the information and advice you need to start driving again.

Website: www.wessexdriveability.org.uk/assessments

Diabetes UK

DVLA rules for a Group 2 driving licence (large vehicles and lorries) based on how you treat your diabetes.

Website: www.diabetes.org.uk/guide-to-diabetes/life-with-diabetes/driving/driving-licence#g2

Diabetes and Driving

If you take Insulin or Sulphonylurea tablets, your ability to drive safely may be affected because you are at risk of Hypos.

Because of this, there are laws and guidlines that cover diabetics to make sure the roads are safe for themselves and others.

Laws affecting Group 2 vehicles (Buses and Lorries) are stricter than those affecting Group 1 (Cars and Motorbikes)

Remember “5 to drive” – If you take drugs that can cause a Hypo, blood glucose must be 5 mmol/l or above (taken within two hours of setting off) for any journey longer than two hours.

If you are driving and have a severe Hypo (one where you need help and can’t treat it on your own) you must stop driving and inform the DLVA by visiting the Gov.uk website below or calling 0300 790 6801.

If you have two Hypos whilst awake within one year you must stop driving and inform the DLVA.

If you have diabetic complications affecting your driving (e.g. eye/nerve damage) you must inform the DVLA.

Below are links to the gov.uk official guidlines and helpful information from Diabetes UK.