BLOG: Frustrating times for diabetes care

BLOG: Frustrating times for diabetes care

I have been reflecting on the varied experiences of individuals with diabetes that I have the good fortune to work with at the surgery. Ranging from women who are trying hard to achieve good glycaemic control to enable them to access fertility treatment, to those receiving chemotherapy for cancer which has caused hyperglycaemia alongside those who are battling with addictions alongside their long-term condition every day.

Each and everyone have a story to tell and challenges to face. Moreover, as a practitioner I need to remember that although diabetes is my priority as the diabetes nurse, it is not always top priority for my patients. This is why I have such an interest in diabetes because every case is different, and it has an impact on so many aspects of a person’s health.

With the global shortage of GLP1 injections (glucagon-like peptide receptors), it has been a frustrating time for my patients with diabetes. These injections have been historically used for the management of glucose levels in people with type 2 diabetes.

The problem now with the lack of availability is partly due to the surge in semaglutide becoming available on the open market for weight loss. As you can imagine now the companies cannot meet the public demand and the supply has dried up. This has been distressing for some of my patients who have been able to achieve impressive results and get their diabetes under control with the aid of this medication.

Thankfully, we do have had clear pathways and regular updates by the primary care network pharmacists on how to proceed and prescribe for those affected with alternative options. Hopefully, it will resolve soon.

I do fear that some people may see their control deteriorate because of them not being able to use the GLP1 and become less engaged. If you put in the challenging work to make progress only to be knocked back again due to a problem that is no fault of your own, I can understand it must be hard to stay motivated. Diabetes is tough enough without added challenges.

This leads me onto diabetes distress which is something I have been educating myself on this week. Diabetes distress is when a person feels frustrated, defeated, or overwhelmed by their diabetes. I feel most people must have this at varying degrees and for me to care for individuals holistically I would like to cover this topic with my patients.

It has been proven that the more severe the diabetes distress, the worse the glycaemic control and engagement, so it needs to be recognised as part of the review. There are screening tools available to measure people’s levels of distress and I am going to trial one of those with a small number of patients initially. I will ask them to complete these questionaries pre review while waiting in reception or via text.

To screen and identify is useful but only if there are the appropriate provisions in place to then signpost the individuals to the support they need. I do not want it to be merely a tick box exercise but to service a purpose. I will give this some thought and investigate but these patients would need quite a specific input from a trained professional in this area.

Author: Philip Lopez