Understanding Diabetes Q4 Nov-2019

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Understanding Diabetes HEALTHAWARENESS.CO.UK

INTERNATIONAL DIABETES FEDERATION “Globally, one in two people currently living with diabetes remain undiagnosed.” » p2 DIABETES UK “Innovative technology is changing the way we monitor and manage diabetes.” » p4-5 Henry Slade shares his own diabetes journey and how it hasn’t stopped him playing international rugby. » p6

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One in ten people are living with diabetes The global increase of diabetes prevalence is a major wake-up call. The huge social-economic impact of the condition cannot be ignored. Acting now will protect individuals and their families.

Globally, one in two people currently living with diabetes remain undiagnosed.”

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ew figures released today to mark World Diabetes Day estimate that the number of people with diabetes globally will increase to 578 million over the next decade. One in ten people are now living with diabetes, making the condition a concern for every family.

With the rising healthcare and societa l costs associated w it h d iabetes – USD 76 0 bi l l ion i n direct medical costs alone in 2019 – we must think about how the increasing prevalence of diabetes, Type 2 in particular, can be slowed down, and, hopefully, reversed.

The unknown enemy Around 10% of people living with diabetes have Type 1 diabetes. This type has to be treated with insulin and there is currently no way to prevent it. This leaves around 90% with Type 2 diabetes, which can often be prevented. This gives us

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hope that the growing epidemic can be halted. The challenge, however, lies in the relatively low awareness of the condition.

Despite its rising prevalence, Type 2 diabetes often flies under the radar. Onset can be slow and the warning signs and symptoms mild or absent. Globally, one in two people currently liv ing w ith diabetes remain undiagnosed and many are diagnosed late when complications are already present.

When diabetes is left untreated, or people with diabetes are not adequately supported, they are at risk of serious health issues.

Diabetes is a leading cause of blindness, lower-limb loss, heart attack, stroke and kidney failure. In the UK alone, it is estimated that nearly half a million people living with diabetes are undiagnosed and are therefore at risk of these lifethreatening complications.

Anyone could be at risk Diabetes impacts all age groups, r e g a r d l e s s o f g e o g r aphy a n d income. Any person can develop the condition, but some people are more susceptible than others. That is why we are urging people to learn about their risk of Type 2 diabetes and seek the advice of a healthcare p r o fe s s i o n a l i f r e q u i r e d . B y answering a few simple questions about yourself and your lifestyle, such as dietary and exercise habits, you can quickly discover whether you could be at risk of developing Type 2 diabetes.

Greater awareness of the risk factors and an increased focus on education is key to help individuals take action to reduce their risk of Type 2 diabetes and avoid serious health issues.

We all have a role to play in protecting ourselves and our family members from developing Type 2 diabetes. To mark World Diabetes Day today, we encourage everyone to learn more about diabetes and the simple action that can be taken to protect the health of individuals and families.

WRITTEN BY: PROFESSOR NAM H. CHO President, The International Diabetes Federation

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Read more at worlddiabetesday.org

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Exciting breakthroughs in diabetes research

Western diets are causing an epidemic of Type 2 diabetes, and UK research expertise is in demand more than ever.

Exciting breakthroughs in the field are being made — with more on the horizon.

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here has been an explosion of Type 2 diabetes cases in recent years, says Steve Bain, Professor in Medicine (Diabetes) at Swansea University Medical School.

Wales is particularly affected, with the highest prevalence of diabetes in the UK at 7.4% of the population.

In the UK as a whole, 6% of the population are living with the condition.

“But it’s not just happening here,” says Professor Bain. “The US also has extremely high levels of Type 2 diabetes, and countries such as India, Iran and Saudi Arabia — which are beginning to adopt western diets — are seeing a rise in childhood obesity, leading to early onset Type 2 diabetes.”

On the plus side, the UK does well in the field of Type 1 and Type 2 diabetes research. “Many clinical trials take place in this country,” says Professor Bain. “And in the last two or three years, the UK has been an early adopter of new medicines and technologies.”

INTERVIEW WITH:

STEVE BAIN Professor in Medicine (Diabetes), Swansea University Research breakthroughs making a difference for patients Certainly, big breakthroughs have been benefiting people with Type 2 diabetes which, in the mediumto long-term, could help take some pressure off an overcrowded NHS. “UK-international diabetes studies are under way, led from Swansea and Cardiff,” explains Professor Bain.

“India, Iran and Saudi Arabia — which are beginning to adopt western diets — are seeing a rise in childhood obesity, leading to early onset Type 2.”

“For example, there’s activity around improved screening for diabetic retinopathy, and a big focus on exercise and diabetes. Plus, we’ve been involved in international studies introducing new medications for Type 2 diabetes.”

That’s critical because, 20 years ago, there were only three treatments for Type 2 diabetes, two of which actually caused weight gain. However, today’s therapies — both oral and injectable — promote weight and blood pressure reduction while reducing the risk of heart disease and stroke for people with the condition.

“Some patients who had to inject insulin up to four times a day can

now have a once weekly injection of medicine,” says Professor Bain. “That injection is now available in a trial setting as a once-daily tablet, which was recently given approval in the US and is currently going through European regulatory approvals.

Also, there are interesting studies into immune therapy for people with Type 1 diabetes. So, things are moving rapidly.”

WRITTEN BY TONY GREENWAY

Sponsored by

Swansea University Swansea University Medical School is also leading the way in training the workforce required to deal with the growing number of people living with diabetes in the UK. Their Master’s course in Diabetes Practice has been specifically designed for healthcare professionals wanting to specialise in the field of diabetes.

To find out more visit https://direc.to/cKcf

Read more at direc.to/cKcf

Tim’s journey with diabetesrelated foot ulcers Tim Newman was diagnosed with Type 1 diabetes at 14 years old. Despite managing his diabetes, he had to face complications caused by diabetes, including foot ulcers.

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im Newman, 49 years old, is a company director. His journey with diabetes started on his 14th birthday. Despite doing his best to keep active and manage his diabetes, it caused him to develop complications, including foot ulcers.

Bet ween 2011 and 2018, T im developed si x d iabetes-related foot ulcers (DFU). His first severe episode with DFU occurred in 2012, following training for a 10k charity race Tim joined after his uncle was diagnosed with cancer.

Losing a toe to diabetesrelated foot ulcers He damaged two of the toes on his right foot but didn’t notice due to the loss of sensation in his feet caused by diabetes, commonly known as neuropathy. The ulcer became infected, the infection spread to the bone, and ultimately caused him to lose a toe to amputation.

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Having a DFU massively impacts patients’ quality of life. Treatment includes having to off-load all the weight on the foot, making any activity more challenging.

An ulcer from ill-fitting shoes saw Tim in intensive care Tim’s more recent DFU was lifethreatening. After wearing ill-fitting shoes at a friend’s wedding, he developed another foot ulcer. This time, he ended up in the intensive care unit, with life-threatening sepsis and pneumonia in October 2017. He was 47 years old, and the medical staff was not sure he was going to survive.

A we ek a f ter b ei n g told he wouldn’t survive, Tim was offered a new treatment. The infection cleared, and he was given a new type of interactive dressing. He says he could see improvement happening in the wound right away, with the

UrgoStart would appear to be a ‘no brainer’ based on my experience when it came to rapid recovery and therefore cost effectiveness.

It’s made a huge difference to my life and I certainly hope it will be the same for many others.” skin around it looking healthier and an apparent better blood supply in the wound bed. The size of the ulcer decreased more and more rapidly, until healing completely.

Experiencing that progress had a tremendous impact on Tim’s quality of life. He shares: “[The new dressing] did not require any additional padding on the foot and I could wear normal shoes. It didn’t need changing as regularly as the previous dressings, yet the results were more noticeable”. Keeping

TIM NEWMAN Diabetes Patient active is important to Tim, and he was able to resume his usual activities, such as walking his husky dog, Sika.

The dressing could save NHS time and money Tim also believes the technology could have a positive impact, not only on patients like him, but also on the NHS as a whole. He says: “There was an obvious time and cost- saving for the NHS. I had fewer hospital and community podiatry appointments.

Urgostart would appear to be a ‘no brainer’ based on my experience when it came to rapid recovery and therefore cost effectiveness. It’s made a huge difference to my life, and I certainly hope it will be the same for many others now that this great product is available.”

UrgoStart Tim was given UrgoStart dressing, which was still undergoing a clinical trial at the time. In January 2019, interactive wound dressing range UrgoStart was recommended by the National Institute for Health and Care Excellence (NICE) for treating diabetes-related foot ulcers and venous leg ulcers.

Sponsored by

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Finger prick tests were disruptive and always painful WRITTEN BY: ROSEY EDWARDES 14 year old living with Type 1 diabetes

I was first diagnosed with Type 1 diabetes when I was 17 months old. One of the biggest challenges of having diabetes, for me, used to be checking my blood glucose levels at least eight times a day by finger prick, which always left my fingers very sore.

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hecking my glucose levels also known as blood sugars could be at any point, from the early morning to the middle of the night, when my parents would need to wake me up and do a finger prick test to make sure I wasn’t about to have a hypo.

A hypo is when your blood glucose level is too low. If I have a hypo and don’t sort it out quickly, I could start feeling confused and drowsy – and there is also the risk of becoming unconscious or having a fit so making sure my blood glucose levels are fine is really important.

Which leads me to one of the other difficulties: trying to control my blood sugar levels. Even though my parents have always helped me, it can be really hard, especially as a teenager.

access to Flash, a life-changing glucose monitoring device.

Using this technolog y really improved my diabetes control and allowed me to finger prick less often.

My sugar levels have been much better and my fingers no longer hurt from the constant testing.

Now, I no longer have to miss out on anything at school to check my sugar levels, I can simply scan the sensor on my skin and I get the reading on my phone. My parents don’t have to wake me up every night to check my sugar levels either; they just scan the sensor using the scanner or my phone. Plus, when I am at a friend’s for sleepovers, I can scan myself and my parents can check on their phone that I am well, which stops them worrying so much.

My Flash glucose monitor changed my life An important change, however, came after campaigning with my mum and Diabetes UK when I got

Glucose readings connected to mine – and my parents’ – phones Most impor tant ly, it g ives me the opportunity to do what I love

without having to take breaks over and over again – I can now do gymnastics and simply swipe the sensor on my arm if I need to check my sugar levels, rather than stop and finger prick.

Data from Flash also allows the Children’s Diabetic Team looking after me to review all the information about my glucose levels during my check-ups. My mum uploads the data from the sensors every week and then we all discuss it and correct my insulin doses if needed.

This helps everyone to do everything possible for me to manage my diabetes and to help prevent any long-term complications.

Read more at healthawareness.co.uk

Pricking our baby’s fingers and toes was really upsetting WRITTEN BY: KIRSTY EDWARDES Coffee shop owner and Rosey’s mum

Rosey was a 17-month old baby when we found out she had Type 1 diabetes. She had been very poorly and had lost a lot of weight quickly, so we went straight to the hospital where they diagnosed her with the condition. It was a stressful time for us. She was so tiny and it was really upsetting to prick her fingers and toes constantly to make sure her blood glucose levels were fine.

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osey’s been most bothered by the finger pricking as her fingers (and toes) would get really painful – she was also told by the doctor she had begun to have nerve damage.

But, one day, Rosey saw the Flash sensor on – then prime-minister – Theresa May’s arm; a technology helping those with diabetes check their glucose levels and better manage their condition. That was when we looked at whether Rosey would be able to access one herself and found out that, in our area, that wasn’t possible.

We realised such a sensor would be life-changing so Rosey – brave as she is – sent a letter to Mrs May explaining the importance of people having access to this technology.

And Rosey didn’t stop there; she lobbied until people with diabetes in our area who could benefit from Flash were able to access the same technology.

Flash monitors weren’t available in our area, until we lobbied for them It just shows that you can get great results if you stand up to something you feel strongly about, and Rosey was incredibly determined to help others manage their diabetes effectively.

This technology was a life-changer

It just shows that you can get great results if you stand up to something you feel strongly about.” for us all – for Rosey, as well as for me and my husband. As parents, it was hard to know that our kid was in constant pain from finger-pricking.

Knowing that, now, this is no longer the case and seeing how it has dramatically improved Rosey’s diabetes control has been wonderful.

She ca n now do g y m nast ics without constant interruptions because she can easily swipe her sensor, whereas she used to have to stop to do a finger prick test. It’s the same in lessons. She can scan at her desk rather than go to the school office to get her test kit out. When she’s out and about with friends she can scan using her mobile phone and I can check sugar levels. This takes away a lot of the worry when she’s away on school trips or on sleepovers. It seemed unfair that she had to miss some of her lesson to do a check that is vital for anyone living with diabetes. It all made a huge difference to Rosey’s life.

Read more at healthawareness.co.uk

YOU CAN DO IT

WITHOUT LANCETS1

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Do you know the difference between Type 1 and Type 2?

WRITTEN BY: EMMA ELVIN Senior Clinical Advisor, Diabetes UK

Diabetes is a serious condition where someone’s blood glucose levels are too high. There are two main types, Type 1 and Type 2. They are different conditions, but they are both serious.

There are some other, rarer, types of diabetes too.

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f you’ve got Type 2 diabetes, the insulin you make either can’t work effectively, or you can’t produce enough of it. When you’ve got Type 1 diabetes, you can’t make any insulin at all and we all need insulin to live.

For many people with diabetes, technology can be a really important part of how they manage their condition – for example, technology can help people take their insulin or check their blood glucose (sugar) levels.

Rosey (right) with elder sister Milly and their puppy Sooty.

Tech can make managing diabetes much easier There are lots of different types of diabetes tech, like insulin pumps and continuous glucose monitors (CGM).

Depending on how their diabetes is treated, people with the condition might already be using things like insulin pens and blood glucose monitors.

Options to manage diabetes are growing as technology starts to develop, which is an important step forward as the benefits of such technology could be endless.

People with diabetes, their families, the healthcare professionals who

support them and researchers, all make the case that technology can really help manage diabetes and, in turn, significantly improve quality of life and reduce the risk of serious complications.

As far as current technologies are concerned, there are three broad themes: tech for checking blood sugars and ketones, tech to help manage diabetes like carb counting apps and tech for taking insulin. There’s also the growing research around the artificial pancreas or closed loop technology.

Flash and CGM devices can help people with Type 1 diabetes manage their condition better as they help monitor glucose levels.

Flash glucose monitors mean fewer finger prick tests Many people with diabetes, including those who treat their condition with insulin or certain other medications, need to self-monitor their blood glucose levels. This is usually done with a finger prick blood test using a meter that indicates the glucose level at the time of the test. People with diabetes who use insulin often need to

test many times a day.

In contrast, Flash uses a small sensor that people wear on their skin that records and stores the last eight hours of glucose readings, and can be read by scanning the sensor whenever needed. Although Flash measures the amount of glucose in the fluid that surrounds cells, rather than the glucose levels in the actual blood - and there is a small delay when checking this fluid, the device can free people from having to test by finger prick as frequently. This makes it easier to keep on top of their glucose levels.

Crucially, because Flash helps people test more frequently, and gives them much more information, it in turn supports people to manage their condition better.

This can then reduce the risk of serious diabetes-related complications, such as amputation, sight loss and stroke, as well as improving quality of life, and saving the NHS muchneeded funds.

Read more at healthawareness.co.uk

Digital health tools that work together for seamless diabetes management

Learn more at FreeStyleLibre.co.uk 1. Scanning the sensor does not require lancets. © 2019 Abbott. FreeStyle, Libre, and related brand marks are trademarks of Abbott Diabetes Care, Inc. in various jurisdictions. ADC-16696 v1.0 10/19.

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Being a comedian with Type 1 diabetes can be a bit of a joke Ed Gamble was a typical 13-year-old going about his daily life, blissfully unaware of the Type 1 diabetes bubbling away beneath the surface. Now 33 and a successful stand-up comedian, he discusses his battle with regulating the condition that has, at times, been at odds with his hectic career.

Q: How did you find out you had Type 1 diabetes?

A: I was constantly thirsty and drinking a lot of water, which is a common consequence of having high blood sugar levels. I’d then be going to the toilet a lot, which is when my mum noticed something was up. I’m glad she did as I’ve always been a bit useless at spotting things like that! Luckily, she had been a nurse and knew what to be looking out for.

Q: How did that affect your day-to-day?

A: Being diagnosed when I was 13 was something of an advantage, as I could adapt my life to being a Type 1 diabetic. Being diagnosed at 33 would have been tough, as getting used to what is a 24-hour job, in terms of keeping track of your blood sugar levels, would be much harder with all that life behind you.

There are so many environmental factors that can affect your blood sugar levels. I can inject exactly the right amount of insulin for a meal I’ve just eaten, yet one day I’ll be fine and the next day my levels will go crazy high or crazy low.

Q: How do you keep track of your blood sugar levels?

A: I am very lucky in that I’m no longer forced to take blood samples for readings manually. Hammering a pin into the end of my finger 10 times a day or more is less than ideal.

Now though, I use a constant blood glucose monitor by which a sensor in my stomach sends readings via a transmitter in my skin directly to an app on my phone.

That gives me my readings so I can alter my insulin and food intake.

This one change has made such an enormous difference to me personally, as someone whose job doesn’t involve much routine. I really think this should be available on the NHS - it’s made my life so much easier.

Q: What affects your diabetes most in your life as a stand-up comedian?

A: Adrenaline can affect my blood sugar levels, which is obviously a bit of a pain in my line of work.

Before a show, my blood sugar level

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Adrenaline can affect my blood sugar levels, which is obviously a bit of a pain in my line of work.” might be quite high and then, due to the adrenaline of going out and performing, it’ll often be two hours after the show finishes and then it’ll just plummet.

I also have to make sure I’m looking after myself far more than I used to. I went through a stage when I was younger of binge eating and drinking, not really focusing on what I was doing to my body and my diabetes suffered as a result of that.

Now, I have a much better quality of life because I’m more focused on my diabetes. Yes, it’s more work, but I feel a lot better about it.

WRITTEN BY: JAMES ALDER INTERVIEW WITH:

© ED GAMBLE

ED GAMBLE Comedian

Ed Gamble is touring the UK with his show Blizzard, including a performance on 20th December at O2 Shepherd’s Bush Empire. For tickets and more info please visit edgamble.co.uk. You can also catch Ed’s stand-up special on Amazon Prime Video, as well as hear him co-host the Off Menu podcast and Sunday mornings on Radio X.

© EXETER RUGBY CLUB / JMP UK

My Type 1 diabetes doesn’t stop me playing international rugby

Twenty-six-year-old international rugby player, Henry Slade, developed Type 1 diabetes at the age of 18 – but doesn’t let it affect his performance on the pitch.

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lade has now adapted to life with diabetes. However, there was a moment he thought his career may have to come to a premature end because of his diagnosis. He says: “All I could think was: ‘I want to be a rugby player’ and I was questioning: ‘Can I do that?’”

For t u n ately, Sl ade w a s told his rugby career would not be jeopardised, providing he was able to control his diabetes – which proved to be a steep learning curve.

Learning how to manage his diabetes Slade had to quick ly g rasp the complexities of his blood sugar levels and how playing rugby would affect the medication t hat he needed. It ’s different going from training to matches and that’s probably the thing that I had to trial and error with the most.”He sought advice from professionals as well as a peer in a similar situation: “Chris Pennell, from Worcester Warriors, also has Type 1. He spoke to me and said he injects before a match, so I’ve recently started doing that.”

It can really be a balancing act, and understanding how ot her factors, such as adrenalin, may affect the body’s blood sugar levels, is very important. This is particularly prevalent for a sportsman whose adrenalin levels are likely to be heightened before a match.

“My blood sugar was often higher because of adrenaline. If my blood

It’s frustrating having diabetes, but it doesn’t stop you doing anything.” sugar was 7 or 8 mmol/L before I went out for a training session, I’d have to up it with a couple of jelly babies, which would last me up to an hour and a half. But, if I was to do that before a match, I’d come in with a higher blood sugar.”

Type 1 diabetes doesn’t have to change your life Slade has not let his diabetes hinder his ambitions and was selected for the England squad for the 2 01 9 Ru g by World C up in Tokyo.

S o, h a s b e i n g diagnosed w it h T y pe 1 diabetes has changed h i m?

It has

changed my life, but I’m still able to do everything I want to. The way I look at it is you can’t change what’s happened to you. I’ve got diabetes and it’s something I just have to live with.

“It’s frustrating having diabetes, but it doesn’t stop you doi ng anything. You can do whatever you want, it’s just about having control.

“It shouldn’t limit you any way physically. It’s not going to affect how fast you ca n r u n or how strong you are. It’s just a matter of controlling it. If you can do that, then there’s nothing you can’t do.”

People just don’t know enough about diabetes People with Type 1 or Type 2 diabetes may attest that awareness of the disease can be generally poor, which Slade himself has also found out.

“When people ask about how you developed diabetes, they often think you’ve eaten too many sweets. Then there are people that think now I can’t eat any sugar at all.”

“The Dexcom G6 has enhanced my control enormously as it is constantly measuring my glucose levels. It’s the easiest device I have ever used as I’m able to constantly check my levels, and get a warning when I’m close to the limit.”

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Technology that can help prevent hypos and how to access it Karen Baxter, Country Director at Dexcom UK, Ireland, and Belgium talks about the incredible advances in diabetes technology she has seen in the last decade, with real time glucose monitoring revolutionising management for those patients who experience frequent, severe hypoglycaemic episodes.

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hen I started working in the diabetes space t h i r t e e n y e a r s a g o, the standard method of glucose measuring for people with Type 1 d i a b e t e s w a s w it h a b l o o d g luc o s e me ter. I’ve s e en t h i s industry evolve in myriad ways but the most exciting thing has been seeing patients – who were relentlessly pricking their fingers t o d r aw blo o d a nd te s t t he i r glucose – transition to wearing a continuous glucose monitoring system (CGM) and being able to glance at their glucose numbers on their compatible smartphone or smartwatch.* Giving patients choice is at the heart of what we do here. My hope is that every person with diabetes (PWD) has a choice of diabetes technology and can access it without barriers; whether they’re using our device or another.

How to choose the appropriate technology In order to find the best solutions for patients, we must collaborate with diabetes charities, leading clinicians w ithin the diabetes space, and our colleagues in the industry. One such project is the T y pe 1 Diabetes Tech Pathway

which is a fabulous step towards making healthcare professionals within the NHS feel empowered to guide their Type 1 patients to the appropriate technology to meet their needs.1 However, of the three arms of technolog y available – continuous subcutaneous insulin infusion (CSII – insulin pumps), flash glucose monitoring (scanning), and real-time continuous glucose monitoring (RT-CGM) – it is only RT- C G M t h at l ack s m a nd ate d funding. This is despite growing evidence of its efficacy in improving outcomes; particularly for those PW Ds who have impaired hypoglycaemic awareness and/or are experiencing severe hypoglycaemia, which requires t hird-par t y assistance. I want this to change.

I feel strongly that we need to better serve this group of PWD who are experiencing these kinds of serious issues with hypoglycaemia.”

Reducing hypos with RT-CGM Clinical trials, such as HYPO DE, demonstrate that using RT-CGM reduces hypoglycaemic episodes by an incredible 72% in a cohort of patients vulnerable to severe hypos.2 Furthermore, using predictive low alert features with a CGM device has been shown to reduce the amount of t ime t he pat ient spends in hypoglycaemia. This is backed-up by real-world data that shows that this kind of alert is allowing people to meet the globally agreed upon target for Time in Range relating to hypos.3 Preventing hypos through technology I feel strongly that we need to better serve this group of PWD who are experiencing these kinds of serious issues with hypoglycaemia – as many as 80,000 in the UK and Ireland alone. 4 Re c ent ye a r s h ave show n a massive improvement in access to technology for PWD, but there is a risk that this group of vulnerable patients could be left behind. It is this group who are most likely to re qu i re a n a mbu la nce c a l l out and hospital admission for a hypoglycaemic event at a cost to the NHS of approximately £1800. 5 A focus on prevention through

WRITTEN BY: KAREN BAXTER Country Director, Dexcom UK, Ireland, and Belgium

Giving patients choice is at the heart of what we do here.

My hope is that every PWD has a choice of diabetes technology and can access it without barriers.” investing in technology will have life changing benefits through helping to prevent these severe hypoglycaemic events.

How to access this technology If you are struggling to gain access to this technology, there is help available from our charity partner, JDRF-INPUT who can support and guide you through the process of accessing CGM technology.

Find out more at www.dexcom.com/ worlddiabetesday2019

Dexcom CGM is a form of Real Time Continuous Glucose Monitoring that shows the patient their glucose value, where it’s heading, and how quickly, supporting their treatment decisions. Using customisable alerts and alarms, patients are empowered to achieve better outcomes for their diabetes management.

Sponsored by

SIMPLIFY DIABETES MANAGEMENT WITH DEXCOM G6 The Continuous Glucose Monitoring (CGM) System offers: • Real-time glucose readings straight to your compatible smart-device† • A predictive warning up to 20 minutes before a severe hypo • Zero fingersticks or calibrations* • Real time data sharing with up to 5 followers‡

*If your glucose alerts and readings from the Dexcom G6 do not match symptoms or expectations, use a blood glucose meter to make diabetes treatment decisions. †For a list of compatible smart devices, please visit www.dexcom.com/compatibility. ‡Internet connectivity required for data sharing. Following requires the use of the Follow App. Followers should always confirm readings on the Dexcom G6 App or Receiver before making treatment decisions.

Dexcom and Dexcom G6 are registered trademarks of Dexcom, Inc. in the U.S., and may be registered in other countries. © 2019 Dexcom Inc. All rights reserved. LBL018417.

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I’m taking control after my Type 2 diagnosis “I make sure I get all my checks and by taking that control myself, that responsibility, I’m reducing my risk of developing these complications.”

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was diagnosed with T ype 2 diabetes in May 2014. But I’d been getting what I now know as the symptoms for around six to nine months before that.

I’d become incredibly thirsty all the time and was drinking gallons of the wrong stuff, like bottles of sugary, fizzy drinks.

So I was going to the toilet a lot to pass urine, and then developed bad thrush. I’d constantly wake in the night to go to the toilet and would then end up falling asleep in my chair. I could barely sit down due to the pain so visited my GP in a desperate state.

Sarah [pictured] at the support group she set up in Newport to help those living with diabetes

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I was in a desperate state by the time I was diagnosed My doctor (GP) had a specialist interest in diabetes and made me come back the following day for blood tests. When I phoned for the results I was told, “We can’t tell you the results over the phone, but we’ve made an appointment for you to see the nurse in the diabetic clinic.”

B et we en b ei ng told t h i s on the T uesday and attending my appointment on the Friday, I’d read every horror story you can find on Google and was incredibly worried and upset.

I was in there around half an hour with my mum, and all I can remember is them saying it was a lifelong condition and I needed to make lifestyle changes.

I lef t t he app oi nt ment a nd went straight to do my normal weekly shop. I remember picking everything up and reading the labels of all the stuff I’d normally buy and having to put the food back on the shelves.

In the end, I burst into tears in the middle of the supermarket, abandoned my trolley and went home. I was in shock.

Speaking with a diabetes specialist changed my life My turning point was when I was sat in my doctor’s surgery and saw a

WRITTEN BY: SARAH Living with Type 2 Diabetes

I burst into tears in the middle of the supermarket, abandoned my trolley and went home.” postcard for a Diabetes UK event.

That was the day that completely changed my life. I spoke to dietitians, diabetes specialist nurses, consultants – everyone was there to do their bit.

After the event, the message hit home that, with good management, I can do something to avoid serious diabetes complications like sight loss, kidney problems or needing an amputation.

I needed more support and I sometimes feel isolated It was at the same event when they asked who would like a support group in Newport (the area I lived) and 200 hands went up.

Not long after that, I started the group. I started it because when I was first diagnosed, I wanted someone to say to me: “It’s not the

end of the world, come and have a cup of tea and a chat.”

I can sometimes feel isolated. My kids are amazing and very supportive, but there are times when I get frustrated because they don’t understand what it’s like as they don’t have to live with it.

Speaking to others with diabetes helps enormously When I’m feeling down, really down, it can feel like it’s the end of the world. There are times when I don’t know how I’m going to carry on, but it’s at those dark times that I pick up the phone and speak to someone from the group or send them a few text messages. This really picks me up.

When I was first diagnosed, I was in a bit of a rut and felt really sorry for myself because I was unwell.

But I now feel that my diagnosis has given me a purpose – to spread my knowledge and raise awareness with as many people as I can.

I hope my work is making a difference, as so many people are now being diagnosed with diabetes and just don’t know what to do next.

Read more at healthawareness.co.uk

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Tips for the newly diagnosed Enrol on a diabetes education course

Diabetes courses are available for free on the NHS and equip you with a rounded understanding of your diabetes from diet to medication.

Ask your doctor which diabetes courses are available to you.

Start a food diary

Diet has a strong influence on blood glucose numbers. Keep a food diary for a week or more and you can review where you’re going right and what can be improved.

Talk to others with diabetes

A forum, such as the Diabetes.co.uk Forum, is a great way to see how others have made great strides in getting their diabetes under control.

Pick an activity to get you moving

It can help with motivation if it’s something you enjoy, like dancing, has an achievable target or is a game

10 HEALTHAWARENESS.CO.UK

Know the health targets to aim for

These i nclude you r HbA 1c, cholesterol and blood pressure targets.

Be aware of all the health checks you should have each year

There are up to 15 health checks that people with diabetes should receive each year. Making sure you are regularly checked will ensure you are best protected from complications relating to diabetes.

Build up a good rapport with your doctor

It’ll work to your advantage if you can work with your doctor as a partner in your health.

Everyone on my timeline seems to be slimmer than me, running more marathons than me, spending more time in their target range and getting better HbA1cs.

I don’t think I need to explain why that is not a healthy view of the world; as soon as you start to feel hopeless, you lose the most crucial part of your ability to self-manage determination.”

Why I’d rather be positive than perfect WRITTEN BY: NATALIE BALMAIN Founder, Type 1 Clothing

Natalie Balmain is a designer with Type 1 diabetes. Known for her line of adapted fashion for T1Ds - Type 1 Clothing - Natalie counts Barack Obama and Tom Cruise among her famous followers and is realistic about the difficulties of managing Type 1.

L

ike any T1D, I’ve learnt a lot about diabetes over the years; from understanding the research to the arsenal of skills required to self-manage. But I think one of the hardest, and probably most important things I’ve learnt is to be positive, even when T1D is kicking my butt (which it does - regularly)!

Now, while I’m all for those uplifting ‘you can achieve anything’ posts on social media (after all, I’ve been the author of many of them, and the message absolutely is true) I think it would be remiss to leave it at that - this is real life after all. And real life, as much as Instagram wants you to believe otherwise, is not perfect.

Nor are we – and, dare I say it, nor should we be. Perfection, I’ve learnt, is a paradox. It is simply not realistic to expect perfection in everything we do, all the time.

In the glossy world of social media it’s easy to believe that perfection exists, and that it is easy, because everyone else seems to be doing it.

It is simply not realistic to expect perfection in everything we do, all the time.”

Everyone on my timeline seems to be slimmer than me, running more marathons than me, spending more time in their target range and getting better HbA1cs. I don’t think I need to explain why that is not a healthy view of the world; as soon as you start to feel hopeless, you lose the most crucial part of your ability to self-manage - determination.

You have to be determined to self-manage; and that’s hard Don’t get me wrong, I want to share my picture-perfect moments as much as anyone: that occasional ‘flat line’ day, the days I’ve finished a hike without turning into a sweaty hypo mess (thank goodness for my monitor, or those days simply wouldn’t happen).

These are things we want to share because we are proud of them. But those perfect moments are just that - transient moments of greatness in an otherwise pretty average life.

Sometimes it’s hard to remember that the same is also true of others, especially when your timeline is made up of a few hundred T1Ds all sharing their own perfect moments!

Yes, I probably could work a bit less and establish more of a routine so that I have flat lines more often, spend more time in target and get a better HbA1c, but I would have to change my life to achieve that. There’s nothing wrong with anyone making that their priority, but personally, I want to live the life that I love - with all the stress, chaos and irregularity that comes with it. If that means I have to be positive about not being perfect, then sorry Instagram - we just aren’t meant to be.

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NICE RECOMMENDED. A LIFE-CHANGING DECISION FOR PATIENTS WITH DIABETES-RELATED FOOT ULCERS OR VENOUS LEG ULCERS.

REDUCE HEALING TIME. IMPROVE QUALITY OF LIFE. SAVE COSTS. NICE now recommends the UrgoStart range of interactive dressings for the treatment of diabetes-related foot ulcers and venous leg ulcers.1 UrgoStart range dressings are proven to reduce healing time for patients, improving patients’ quality of life, and are associated with significant cost savings for the NHS compared to non-interactive dressings. 2–5

1. UrgoStart for treating leg ulcers and diabetic foot ulcers, https://www.nice.org.uk/guidance/mtg42, January 2019; 2. Münter KC, Meaume S, Augustin M, Senet P, Kérihuel J.C. The reality of routine practice: a pooled data analysis on chronic wounds treated with TLC-NOSF wound dressings. J Wound Care. 2017; 26(2): S4-S15. Erratum in: J Wound Care. 2017; 26(3): 153; 3. Meaume S, Truchetet F, Cambazard F et al. A randomized, controlled, double-blind prospective trial with a Lipido-Colloid Technology-Nano-OligoSaccharide Factor wound dressing in the local management of venous leg ulcers. Wound Repair Regen. 2012; 20: 4, 500-5114; 4. Meaume S, Dompmartin A, Lazareth I, Sigal M, Truchetet F, Sauvadet A, Bohbot S. Quality of life in patients with leg ulcers: results from CHALLENGE, a double-blind randomized controlled trial. Journal of Wound Care. 2017; 26: 4, 368-379; 5. Edmonds M, Lázaro JL, Piaggesi A, et al. Sucrose octasulfate dressing versus control dressing in patients with neuroischaemic diabetic foot ulcers (Explorer): an international, multicentre, double-blind, randomised, controlled trial. Lancet Diabetes & Endocrinol. 2018 Mar;6(3),186-196; Always read the Product Information Leaflet before use.

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