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DSN Forum newsletter – March 2020

Susan Mason-Cave
DSN Forum newsletter for March 2020, with news on the latest position statements and guidelines, diabetes devices and some thought-provoking content from the Diabetes Online Community.

It’s March already, and the days are getting longer! January and February have been a bit grim weather-wise, so it’s nice to see the snowdrops showing their little heads, the daffs coming up, a few lambs already and the Hawthorn starting to bud – new life.

My job
Cancer and diabetes continues to be one of the most rewarding jobs I have ever done in the past 33-plus years. It’s acute, it’s chronic, it’s happy, it’s positive and it’s also sad because there is end-of-life and death. People share so much of themselves when faced with a cancer diagnosis and treatment.

My colleague and diabetes lead, Louise, and I are supporting the EDEN and LOROS Hospice teams on 9 March in Leicester. The conference is titled Getting it Right: Diabetes and Palliative Care, and includes workshops. We are looking forward to some shared learning.

iDEAL feet – ACT NOW!
The big news story this month is the latest position statement from the iDEAL Group, in collaboration with Professor Mike Edmonds and The Grumpy Pumper, amongst others.

The paper is undoubtedly persuasive in its recommendations to increase awareness of the need for better outcomes of foot healthcare, and to improve education for all people living with diabetes and those who care for them. It proposes a new mnemonic – ACT NOW! – to ensure that people with diabetes who develop a foot ulcer attend a multidisciplinary footcare team as quickly as possible for treatment.

Tweetchat hosts
We hosted the @GBdocTChost chat at the end of January, and it was amazing. The interactions, the comments and the connections made were incredible, with folk tweeting well into the night. People with diabetes, diabetes nurses and diabetes pharmacists shared the chat. Best of all, people were able to share thoughts and concerns, and the support was so lovely. It was a real giggle too. The consensus was that DSNs are wanted and needed, and there were some very generous compliments about the service we provide.

Libre and data sharing
The recent concerns about data sharing and its increasing complexities have been addressed jointly by NHS England, the NHS Diabetes Programme, NHSX and the NHS Chief Clinical Information Officer, with official letters sent to the device manufacturers. They also have the support of Diabetes UK, who wrote this blog.

More positive news is that the Libre availability issues appear to be slowly resolving, and Nick Cahm, the nation’s go-to on Twitter and presenter of data, has been a huge help to us all.

A selection of this month’s blogs
There was a well-received blog from Amy Stevens on exercising after an eating disorder, the relationship she had with exercise during periods of her life with an eating disorder, burning calories and time spent exercising, as well as practical advice on how to approach exercise if you have had an eating disorder. Izzy Marriet also wrote an insightful blog post about her complex relationship with type 1 diabetes and her negative relationship with food.

A hotly debated issue amongst healthcare professionals and people with diabetes revolves around conference attendance, and this post from Mike, aka @everydayupsdwns, summed it up perfectly. My best read of the month.

Finally, a lovely Valentine’s Day blog from Jen Grieves!

Pathway to Choice – let’s talk about tech
A big report from JDRF was presented in Parliament at the beginning of February, outlining the barriers for people with type 1 diabetes to accessing diabetes technology. The Pathway to Choice campaign aims to bring more equitable access to, and education about, the technology that is available for people with diabetes, and it cites the reasons why conversations around tech availability are not happening. It is a worrying reflection of health inequalities in 2020. I loved the carb-counted lunch menu at the launch! An A-list of folk with diabetes were amongst the presenters, including our own Maureen McGinn, and Theresa May posed for pics too!

News from ATTD
There was big news that Abbott is linking up with Insulet to move the progress of the commercial artificial pancreas system forward. Lots of posts and comments on that!

There was lots of feedback from people with diabetes attending the conference, which was great to see. However, there were not many nurses in attendance: the overall number of dietitians and nurses was less than 500! Very disappointing given that it is those very professionals who need to understand the tech, interpret data and advocate for people with diabetes.

Guidance update
The BSPED guidance on diabetic ketoacidosis in children and young people has been updated. If you work with our youngsters, here it is.

Deep water
Social media forums have been fairly unpleasant environments of late, where once they were supportive and kind. Twitter in particular and the Diabetes Online Community has become unhappy. Those who cannot articulate an opinion within the 280 characters are likely to be misinterpreted, ridiculed and bullied, and even those who can are still at risk! Tweet with respect, kindness and emotional intelligence.

A week after I had written this part of the newsletter, the suicide of Caroline Flack fronted every form of news media, with the “Be Kind” sentiment trending. What a world we have created! And still it continues. Then there was this from @RenzaS.

Twitter hasn’t all been bad, however! A healthcare colleague reached out to the DSN Forum for some feedback and support because they had received a query about the level of care people with diabetes who use an insulin pump were receiving, with a suggestion that they could be discharged from secondary care until pump renewal was due. The response was passionate, with the DTN-UK team taking control and offering an official response. Can’t ask for better than that.

Actrapid p.r.n. caused a good debate too, with a staff nurse refusing to give it hourly and needing some support before she tackled the issue head on.

Finally, we did a little poll about the meaning of the abbreviation BM. Blood measurement, bowel movement and blood mmol all came up. Please remember that BM stands for Boehringer Mannheim, which has absolutely nothing to do with capillary blood glucose in 2020!

Girl gossip
In personal news from the Forum, Beth drove to Swansea through Storm Ciara on Sunday 9 Feb for her Masters residential. She is also now the type 1 diabetes lead for her Trust – congratulations!

Amanda’s beloved Beetle broke down and went over the rainbow bridge to VW heaven. Although devastated, she is eyeing up Mini… It is just over a year since the little Bug did a tour of England for the first DSN Forum UK tour. I’ve included the tour pictures – a great reminder of what was achieved.

Amanda also had her PGDip graduation. Well done – Masters next! We have an anniversary looming soon, too. Watch this space…

Zoe and Susan have generally been drama-free; however, we are encouraging Zoe to become the next Adam Kay – better actually – with her anecdotes of life as a Mental Health DSN.

Awards
Theresa May’s diabetologist, Ian Gallen, received a CBE in her resignation honours – lovely news!

Dates for your diary
Diabetes Prevention Week is coming  on 20–26 April; be sure to access the campaign material and do your bit! The Diabetes Technology Network UK Annual Conference is also scheduled for 24 April in Liverpool.

Sadly, however, Diabetes UK has announced the bold decision to cancel its Professional Conference, due this month, owing to the coronavirus outbreak.

A list of planned events later in the year is shown in Table 1. Lots to get involved in, seek sponsorship and request leave for, register, raise awareness and enjoy!
 

Table 1. Event dates later this year.
Event Date
Insulin Safety Week  18–24 May
Diabetes Awareness Week 8–14 June
Hypo Awareness Week 5–11 October
Diabetes Professional Care Conference 11–12 November
World Diabetes Day 14 November

Real-life issues
I’d like to close with a reminder to always check your needles: always do an airshot. Here is why!


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