World Diabetes Day 2023

To mark World Diabetes Day 2023, we asked our Specialist Diabetic Nurse Practitioner Julie Parker to tell us all about this important day and why education is important in managing this condition.

“World Diabetes Day (WDD) is celebrated annually on 14^th November which is the birthday of Sir Frederick G Banting who was instrumental in the discovery of insulin in 1921.

He and his colleague J.J.R McLeod were awarded the Nobel prize for their discovery in 1923 and famously gave the patent away for $1 in the belief that insulin should be their gift to the world. Less well known but equally important are Dr Charles Best who as a medical student conducted many of the research experiments that led to the discovery of insulin and Dr James B Collip who refined insulin making it suitable for use in humans. They all deserve equal credit for their contribution to a discovery that has saved and changed the lives of millions of people worldwide.

Each year WDD adopts a different theme. The theme for 2023 is Knowing Your Risk of Type 2 Diabetes.

1 in 10 adults worldwide have diabetes. Over 90% have type 2 diabetes. Close to half are not yet diagnosed. The 2023 campaign focuses on the importance of knowing your risk of type 2 diabetes to help delay or prevent the condition and highlighting the impact of diabetes-related complications and the importance of having access to the right information and care to ensure timely treatment and management.  This year’s campaign also provides a useful online risk assessment tool where you can calculate your personal risk of developing Type 2 diabetes.

Why is diabetes education important?

A structured approach to diabetes education has been deemed the gold standard for many years for people with Type 1 and Type 2 diabetes.  The aim is to provide knowledge, skills and motivation to allow people to self-manage their diabetes more effectively, and to recognise when they should seek assistance with their diabetes management. It also enables people to meet others in the same situation to share knowledge, skills and support each other.

Structured education can be delivered on a 1 to 1 basis but research suggests that the education is more effective if it is done in a group setting. The benefits of discussing personal experiences with other people in a similar situation can be interesting, enlightening and often gives support and hope to those who attend.

Structured education is delivered by trained personnel with a consistent curriculum which is evidence based. Examples of courses offered in the UK are Desmond and X-pert for people with Type 2 diabetes and Dafne and Bertie for people with Type 1 diabetes.

Structured education for people with Type 2 diabetes was introduced to Gibraltar in 2010 when 2 members of GHA staff (myself and a colleague) attended a certified education course to become Desmond diabetes educators. We conducted research using blood test profiles before and after the education sessions which demonstrated that the education led to improved HbA1c results in every person who attended the course. The results demonstrated that the effects of education exceeded the effect of adding additional medication. Medication available at that time had the potential to reduce HbA1c by 5-11 mmol/mol. The results from our patient groups were 11-66 mmol/mol reduction 3 months after the education sessions were delivered. In addition to this patient satisfaction surveys consistently gave positive feedback about the Desmond course.

These sessions were well received by those who attended and gave them skills to improve their day-to-day diabetes management as well as introducing them to people in a similar situation to themselves.

I now provide this service at the Specialist Medical Clinic in Gibraltar sessions can be on a 1 to 1 basis, in small family or friend groups or in the workplace at a time and venue that suits the needs of the people involved. It is hoped that the delivery of group education will be attractive to people as well as making the service affordable to people who are uninsured.

Having a new diagnosis of Type 1 or Type 2 diabetes can come as a shock and can be a difficult time for many people. Effective management of Type 1 and Type 2 diabetes involves understanding the disease, adapting to the diagnosis and then making long term lifestyle changes to manage the condition effectively. Receiving care and support from an informed, well educated, supportive and proactive health professional can make the challenges much easier to cope with.

How I became a Specialist Diabetic Nurse Practitioner

I began working with people with diabetes in 2004 in my role as Nurse Practitioner at the GHA. My interest and desire to develop a better diabetes service prompted me to apply to move into a diabetes role full time in 2008. I undertook additional training to enable me to develop and deliver diabetes services and I studied at Kings College London to gain a Masters in Diabetes Clinical Management.

Patient education, support and empowerment have always been the most enjoyable aspect in my role as Diabetes Specialist Nurse. It is a wonderful feeling knowing that the information I have shared with individuals gives them confidence to move forward and improve their self-management of diabetes.

The information I share is always based upon clinical evidence and is delivered in a way that is easy to understand. It is based on the premise that we are all individual, we have different lives and different ways if dealing with issues. However, it is important that every person with diabetes understands that the complications of diabetes are largely preventable if their diabetes is managed effectively.

This is especially important as poorly controlled diabetes can lead to heart problems, stroke (CVA), kidney failure, depression, erectile dysfunction, lower limb amputation, loss of sight, Alzheimer’s disease and dementia. This is because high glucose levels associated with poorly controlled diabetes is harmful to the circulatory system.

Structured education is also available to Prevent Type 2 diabetes. The risk factors for developing type 2 diabetes are obesity, lack of exercise, family history of Type 2 diabetes in parents and siblings, long term steroid use, Asian and African heritage, being male and being over 40 years of age. Developing gestational diabetes (diabetes during pregnancy which usually resolved) and smoking also increases the risk of developing Type 2 diabetes. This year’s campaign provides a useful online risk assessment tool where you can calculate your personal risk of developing Type 2 diabetes.

Education sessions about how to Prevent Type 2 diabetes by improving your health, losing weight and becoming more active and smoking cessation are also available in the Specialist Medical Clinic in the ICC. They offer a complete diabetes service in Gibraltar including assessments, dietary and lifestyle planning and monitoring, regular insulin and glycaemic control monitoring and treatment, eye and renal checks and management of disease complications.

Please contact us for more information.