IDDT Get-Together: Report
Kettering Park Hotel, Saturday 23 October 2021
The staff and Trustees were delighted to welcome so many attendees to our meeting in October. It felt great to be back! We understand that many of our members still felt wary of travelling and being in a group, so here is a summary of what we covered.
After a brief Annual General Meeting, Jenny Hirst welcomed everyone and announced changes to the day’s programme caused by illness.
The first keynote address was given by Dr Mabel Blades, Dietician, and was entitled:
Healthy Eating and You
Dr Blades sympathised with many of us who have found dietary advice confusing, or who have been put on diets without discussion which have made us feel unwell. She simplified dietary guidance by pointing us towards the Eatwell Guide for the general population and recommended:
- 2 litres of fluid per day
- 5 x 80g portions of fruit or vegetables per day (for gut health and a better immune system)
- A moderate amount of carbohydrates containing fibre
- Adequate protein: we need more as we age. This can include pulses
- Have minimal confectionary and sugar, but don’t cut this out completely
- Choose monounsaturated fats like rapeseed oil (‘vegetable oil’ is usually this) or olive oil.
There were some interesting points from the floor, including side effects from very low-calorie diets (850 kcal per day). These push the body into starvation mode which increases hunger hormones and the metabolic rate which can mean being programmed to overeat for a considerable period after the diet has finished. The point was also raised that the advice given on a well-known insulin:food course to “Eat what you like and just take enough insulin to cover the carb” was unhelpful for most insulin users as it just leads to weight gain and swinging blood sugars. If a predictable and minimal amount of carbohydrate is eaten at every meal it can be simpler to get insulin doses right and there is not such a risk of weight gain.
(a) Getting the most from the NHS (Gill Coleman)
The main points covered in the morning and afternoon groups were about poor communication (between healthcare professionals, and between the professionals and patient); not being able to access checks and information during Covid restrictions; and frustrations with being told to use technology – if you don’t! Tips were to get involved with the local PPG; find out about private services (e.g. chiropody) which are often cheaper than you think; and always prepare for appointments, whether telephone or face-to-face, by communicating clearly what you need to get from the appointment; repeating back any advice or plan to check understanding; and by agreeing what to do if the plan doesn’t work.
(b) Diabetes Management and Medication (facilitated by Jenny and Martin Hirst)
The group was made up of people with Type 1 and Type 2 diabetes but there were many points that were common to all the people in the group irrespective of their type of diabetes. While understanding that the pandemic has put the NHS under pressure, there was concern that people have not been receiving their annual routine checks and how this would affect their future risks of complications. Concern was also expressed that the increasing use of technology for consultations adversely affected people without internet access, such as the elderly and those with limited income.
It was clear from points raised from the floor that the care and education of people with diabetes varied considerably according to where people live, so the postcode lottery still exists. It was proposed that IDDT leads lobbying the Government to improve the services for people with diabetes. Jenny explained that it was no longer possible to lobby nationally for better care, treatment and education because the decisions are made at local level, eg CCGs so it was suggested that IDDT helps members to lobby at local level.
(c) Diabetes-related stress, anxiety and depression (facilitated by Anne Aubin)
Having diabetes can feel like having a frustrating full-time job. It can be easy to lose motivation to self-care if the costs seem to outweigh benefits. There is triple the rate of depression in people with diabetes in comparison to the general population. Bearing this in mind, we looked at how much we felt in charge of our lives, rather than diabetes, or its treatment, being in charge. This led to us looking at setting specific realistic targets to motivate us, with a clear action plan, that we felt we could achieve 4 out of 5 times. Tips were also shared on fitting into our daily lives the things that do make us feel good.
(d) Carers – we live with diabetes too (facilitated by John Birbeck)
Group members found it helpful to have a space to discuss their issues and to find support from one another.
(e) Associated auto-immune conditions (led by Jenny Hirst)
We defined auto-immune as “when the body’s immune system attacks its own healthy cells”. Type 1 diabetes is an auto-immune condition but Type 2 is not. The Trust gets more enquiries about Coeliac disease than any other associated condition, but discussion group members also spoke about thyroid problems, frozen shoulder, rheumatoid arthritis, and vitiligo. Dr Blades joined the group and did not advise the “anti-inflammatory” diets which are being touted at the moment, but suggested trying to lose weight, particularly if you have joint problems, drinking plenty of fluids, take Vit D supplements and have a diet rich in fruit and vegetables.
Keynote address: Health Sustainability in People with Diabetes by Abban Qayyum, Senior Specialist Physiotherapist
Abban kept us wide awake after a splendid lunch with a fun quiz about the body, before focussing on how we store and use glucose as fuel. He reminded us of the huge benefits of exercise to those with Type 2 diabetes. Any activity increases blood glucose control and decreases the requirement for medication. After only two weeks on an intensive exercise regime there are clear benefits. Dedication to a long-term endurance activity improves insulin sensitivity. He recommended strengthening exercises, aerobic exercise to work the heart and lungs, and stretching to maintain or increase flexibility at the joints and to improve balance. Some examples of exercise were Tai Chi, yoga, massage and gardening: it’s not all about buying an exercise bike! Abban also reminded us of the improvements in mental well-being that come from regular exercise.
Questions from the floor led to advice about non-jarring exercise if you have retinopathy; overcoming the first hurdle by just getting started; carefully monitoring blood glucose as hypos can be a problem during exercise (but missed if your hypo signs are feeling hot and sweaty with an increased heart rate) and up to 24 hours afterwards (as exercise has used up your stored glycogen). It was also recommended to wear good socks and shoes and monitor feet regularly; and that you do not start vigorous exercise if you have ketones. A point was raised that there are published guidelines on reducing insulin and increasing carbs depending on the intensity and duration of planned exercise. Some insulin pumps have an exercise function that reduces insulin. Finally, Abban recommended the We are Undefeatable Campaign which has lots of advice on exercise for people with long-term health conditions.
Closing address by Jenny Hirst
Jenny reminded us that it is 100 years since the discovery of insulin as a treatment, and that IDDT was formed to fight for ongoing access to different kinds of insulin: especially animal insulin.
Finally, Jenny thanked all those involved in making the day a success and the staff for their work for both the organisation of the Event and their work during the year.
Feedback on the Get-Together has been very positive with comments such as “very informative and reassuring”, “excellent day and super venue” and “looking forward to 2022”.
And on that note, the staff and Trustees are also looking forward to another meeting next Autumn: keep an eye out for news.