Type 2 Diabetes
For these patients, the diagnosis is often part of a more complex picture, with poor lifestyle habits, and hypertension usually present. With so many issues to address, it is often difficult to know where to start.
The patient’s understanding of the condition is crucial, in order to bring about concordance. Otherwise, a visit to the doctor or nurse can be a negative experience with neither party communicating fully with the other. There is good information available.
The Manage Your Health app, created by Keele University, the West Midlands Academic Health Science Network and Stoke-on-Trent CCG which is free to download, has useful information about diabetes, which patients can have on their smartphone.
NHS: Home is a reliable source of information.
Diabetes UK have a very extensive website full of helpful ways to manage diabetes:.
However, the diabetes community also have lots of information on their website, and this seems to be organised more from a patient’s angle.
Patients can also attend a series of talks known as a DESMOND course.
For lifestyle changes NHS: Home is a good place to start.
This has links to smoking cessation programmes – who have various platforms: an app, Twitter, Facebook, and YouTube videos.
There are also sections on alcohol reduction, diet, and exercise, many of which include apps for patients to have on their phones.
Flo can help with establishing better habits – checking blood glucose, reducing weight, stopping smoking, reducing alcohol. The videos below show how it works. There is an example of a Flo protocols to use when patients need to check their blood glucose regularly; other protocols for hypertension, weight management, smoking cessation etc can be found in the resources section.
Some patients like the approach of having regular messages, while others prefer their own ways of taking control of their condition. In this video below of Flo in use in Wales, some patients comment on how useful they found Flo for their glucose monitoring.
A number of blood glucose monitors store readings, so that patients can understand trends, and reflect on their food and its effect on their health. A new type of patch, which can be left on for two weeks, has a thin fibre permanently inserted into the skin, which monitors blood glucose, and is scanned by a mobile phone, producing more extensive information about trends in blood glucose, and enabling patients to see more clearly how their lifestyle affects their diabetes, without the need for a pin-prick each time. At present, in most areas, patients have to purchase the patches themselves, if they can afford the £93 per month.
Some patients with diabetes become very knowledgeable about managing their condition, and a closed Facebook group could work well for a group of practices. There would need to be clinical input, but the experience of clinicians involved in Facebook groups for other conditions suggests that patients are, on the whole, sensible people who want to enjoy as normal a life as possible, and would not follow advice about medication except from a clinician. However, learning from others in a similar position about having a suitable diet, or sharing experiences, can reduce the anxious phone calls that take up much of the clinician’s time.
Video consultations are a useful way of managing patients who don’t need to be seen in surgery. This video below of a specialist diabetes nurse using Skype is interesting, because she has data from Flo as well, and is then able to have a well-informed consultation with the patient, who can stay at home, instead of making a difficult journey to a central clinic.
There are a number of NHS approved apps to help with lifestyle changes, which can be found in. Also these from NHS: Home:
An introduction to Flo explaining what it is, how it works and the benefits of using it.
The DESMOND programme is a self-management workshop for patients with Diabetes.
Dr Rahul Nayar talks about how he has used Flo to manage patients with diabetes.
Chris Chambers and a newly diagnosed patient with diabetes discuss how the Manage Your Health app can help her to learn about and control her long term health condition.
Diabetes Nurse Specialist Theresa O’Shea of the East London NHS Foundation Trust and patient Yvonne, explain how they use a combination of Florence and Skype to increase the quality of care and convenience.