Dearest darling GP

Dearest darling GP,

I moved my healthcare to your business a couple of years ago because my previous GP was failing to deliver. He was medically mediocre and administratively hopeless. I like your surgery because you take in a lot of trainee GPs. Terrifying as this may first sound, they’re actually rather good – they’re young and enthusiastic, they haven’t heard it all before so they actually listen to what I say and when they don’t know something they run off and check with a grown up, rather than just making stuff up. I find all that quite endearing in a doctor.

Overall, you’ve been doing very well. Medically you’re performing. You developed a worrying interest in delivering my diabetes care but I managed to steer you away from that and we’ve agreed that you won’t meddle in things that you don’t really understand. We’re getting along just fine.

Administratively you’re above average in my experience, although my benchmark for good GP admin is pretty low. If I ask for a repeat prescription you normally manage to issue one within 48 hours. And most of the time it’s more or less correct. You also get extra brownie points for not accidentally giving my medical records to a little old lady to read whilst she was in the waiting room as one of your predecessors did.

It’s not all good though. We’ve been having a little issue for a while now. You understand that I need blood testing strips and you’re happy for me to have as many as I need. You’re not misinterpreting any silly PCT guidelines about rationing strips like some of your less bright colleagues. More brownie points there. Sadly, while your intentions are good, your delivery is a little random in this area. If I request blood test strips sometimes I get them, sometimes I don’t.

We’ve talked about this and you explain that the nasty PCT won’t let you put blood test strips on my repeat list in case I order too many, start selling them on the black market and the NHS isn’t left with enough money to buy biscuits with. I explain I’m happy for people to put sensible measures in place to manage budgets, but we still need a process that works. At the moment if I order blood test strips I sometimes get them and I sometimes don’t.

You say that I should ask my pharmacist to check my prescription when he collects it for me. I say it isn’t his job to double check your work. You say I should highlight when I’ve requested blood test strips. I say the list I sent in only had 5 things on it and blood test strips were in bold size 14 font and you still managed to miss it. Short of sending a singing telegram I don’t see what else I can do.

For the love of god this shouldn’t so difficult. Please put a process in place that means I get blood test strips when I ask for them. I’ve spent a couple of years training you to deliver my healthcare and you’ve been doing it well, I don’t want to have to start all over again with someone new.

Lots of love

Alison

Have you been to a diabetes event?

Great people of the diabetes online community, I’m pleading with you to share your wisdom with me (if you don’t think you can manage wisdom, don’t panic, general thoughts would be much appreciated). I’m preparing a presentation on the wonders of events for people with diabetes. Why they’re so important and why they make such a difference to people.Please help! The aim is to secure extra funding for them.

As a child I went on several holidays for children with diabetes organised by Diabetes UK. They were brilliant, I loved them. Lots of sports and adventures along with some diabetes education. And that amazing feeling when you realise that you’re not the only person in the world who does injections. And that slightly strange feeling when you first see someone else have a hypo – do I really look like that?!

As an adult I’ve spoken at several events for parents of newly diagnosed children about what it’s like to grow up with diabetes. They seem reassured to see a normal person enjoying life to the full with all limbs still attached and major organs still functioning perfectly.

And then there are the events for people who are diagnosed as adults where the education is important but the really valuable advice seems to be traded in the bar in the evening. For me the most powerful moment at any of these events is when I listen to people with diabetes discovering that they’re not alone, that someone else is going through the exact same thing as them.

Personally I think these events make a difference but that’s just me. I’d love to know about your experiences.

Have you been to events like this as an adult or as a child? What did you get out of them? Would you recommend them? What difference did they make to you?

Thank you!

If Disney did diabetes…

Finding a copyright-free Disney-related image proved impossible. So here' s a picture of a kettle instead.
Finding a copyright-free Disney-related image proved impossible. So here’ s a picture of a kettle instead.

We’re off to Disneyworld in a couple of weeks for a bit of much needed Disney magic. Amidst the excitement it did set me thinking. What would diabetes be like if it was managed by Disney, that all encompassing factory of magical happiness?

If Disney did diabetes…

  • My pump would wake me up in the morning with a cheery blast of Zip-a-de-doo-dah
  • I wouldn’t be high, I’d be magically elevated
  • I wouldn’t be hypo, I’d be having a magical moment
  • You’d no longer experience that horrid time in limbo when you’re sitting on the floor waiting for the sweat to subside and the sugar to kick in after a hypo. Oh no, that time would be filled with amazing fireworks displays, beautifully choreographed to classic Disney tunes.
  • Insulin would be measured in fairy drops, not units
  • I’d have to fight with a certain mouse named Mickey to get to a nice low carb cheese snack
  • As a motivator to maintain glucose levels within target range, any results out of range will trigger my meter to play “It’s a small world” on a loop until it gets a result within range. (This way lies madness me thinks!)
  • HbA1c results would be delivered via the medium of dance – a good result gets you Mickey and Minnie surrounded by hundreds of dancing showgirls. A less than favourable result is delivered by a screeching Cruella de Ville.
  • Snow White would lend me one of her dwarves to carry my diabetes junk round for me (I’m not fussy which dwarf, although I’m pretty good at being Grumpy and Dopey myself so it’s probably best she lends me one of the other 5)
  • When I’m having a bad diabetes day and the world is getting me down, a meerkat/warthog dancing combo would appear and serenade me with an uplifting rendition of Hakuna Matata
  • The whole thing would be even more expensive than it already is, but somehow you’d feel it was worth the money

Any more suggestions? Have a nice day!

Statistics, statistics, statistics

Diabetes UK have just published their Key Statistics on Diabetes report, 2009. It makes for interesting reading and certainly puts the diabetes problem into perspective. Here’s a look at some of the numbers.

Diabetes affects 246 million people worldwide and is expected to affect 380 million by 2025 – so we’re definitely not alone! There are 2.5 million people in the UK who have been diagnosed with diabetes.

Of that 2.5 million, around 15% or 370,000 have type one diabetes – we’re a significant minority in the big world of diabetes, and there’s a constant battle to differentiate between T1 and T2. But at the moment, as a T1 in the UK I can see real opportunity for healthcare improvements as a result of the huge growth of people with T2 – it means that diabetes is firmly on the government agenda. It’s seen as a significant issue that needs addressing, which opens the doors for improvements in care for T1′s and T2′s.

And why are the government interested in fixing the diabetes problem? Because we’re very expensive.

Current estimates show that around 10% per cent of the NHS budget is spent on diabetes. This works out at around £9 billion a year. Or:

- £173 million a week
- £25 million a day
- £1 million an hour
- £17,000 a minute
- £286 a second.

Whichever way you look at it, we’re not cheap to keep.

As I pointed out to my PCT when I was applying for funding for my insulin pump and CGMS, the presence of diabetic complications increases NHS costs more than five-fold, and increases by five the chance of a person needing hospital admission. In other words, it’s far cheaper to help me stay healthy than to pick up the pieces later when it all goes wrong. That’s the argument I use all the time, it works on every level – financially, morally, ethically – it’s always better to prevent the problem rather than treat it later. Unless perhaps you’re an NHS finance director with an annual budget to balance who doesn’t intend to be in the job when the cost of my complications arrives 20 years from now!

All figures in this article are sourced from the Diabetes UK Key Statistics on Diabetes report, 2009

Comatose and rotting toes – the lighter side of insulin dependency