Patient-centred care at the heart of new diabetes guidelines
Care & Medication In January 2016, Diabetes UK reported a 65% increase in the disease over the last decade and estimate that it swallows up a colossal £10 billion each year from the NHS budget. Whilst it’s draining resources, it’s also devastating lives.
What defines diabetes is hyperglycaemia (literally ‘high blood sugar’), which occurs when blood glucose levels are too high because the sugar cannot get into cells to fuel the body. What many people don’t realise is hyperglycemia also increases your chances of experiencing problems with your eyes, kidneys, nervous system and even feet, as raised blood sugar levels can damage tissue, reduce circulation and dull nerves. Ulcers and infections are not uncommon and amputations of toes, feet and legs have been known in the very worst cases.
Type 2 diabetes is further complicated by the fact that so much of the treatment relies on self-management. Which is why the NICE guidelines, updated in 2015, offer the most comprehensive outline of tools and therapies to help patients navigate their options and manage their condition.
Dr Amanda Adler is a consultant physician at Addenbrooke’s Hospital, Cambridge and helped develop the guidelines. She is quick to point out that NICE guidelines are not protocol. The focus is very much on patient-centred care, helping healthcare professionals and patients to assess their choices and tailor therapy around their unique circumstances.
“There are many things you need to take into consideration including possible long-term complications, other medical conditions, someone’s age and even their job,” explains Adler. “The guidelines help to make the best personal assessment for what will work for each individual.”
The government has an obligation to offer therapies that work well, but that also reflect good value for money. As a completely independent report, the guidelines also offer clear comparisons of drugs available on the market as well as advice on how to evaluate their effectiveness.
“It is well known, if not well acknowledged, that not all drugs work in all people,” explains Adler. “You don’t have to be a doctor or health economist to appreciate that it doesn’t make sense to continue drugs that don’t work. So, NICE defines how well some drugs should work to decide if they’re worth continuing.”
Aside from drugs and medical interventions, a considerable proportion of the guidelines are devoted to dietary advice and life style. Adler is keen to point out that drugs are not always the answer when simple lifestyle changes could be equally as effective.
It goes without saying that such a highly individualised level of care requires healthcare professionals and patients alike to familiarise themselves with the guidelines. “This is the most comprehensive set of guidelines in the world,” says Adler. But for the guidelines to have effect, more people need to be aware of them, access them and put them into practice.