Kettering Park Spa Hotel
Saturday 28 September 2024
IDDT 2024
Get Together Report
On 28th September 2024, IDDT was delighted to welcome 70 delegates to this year’s Get Together. Lots of people said how good it was to meet others living with diabetes, how much they valued being able to ask personal questions of “experts” and of course, lunch was highly praised!
This brief write-up is for members who were unable to attend in person – we hope we can encourage you to do so next year.
We have already booked the same venue for 4th October 2025.
Continuous Glucose Monitoring – is it important?
This was addressed by Professor Alan Sinclair with input from Dr Guiseppe Maltese and Sarah Page from Abbott Laboratories, suppliers of the Freestyle Libre.
The advantages were presented:
- less finger pricks
- alarms when going low or high (though a delegate remarked carer observations can pick up hypo signs before the machine – or the person using it)
- can be used with some pumps in a hybrid closed loop system (automatically increasing background insulin if going high, or decreasing it if going low)
- and the ability to monitor time in range (TIR), now known to be very important as swings in blood glucose can increase vascular problems and therefore health/survival, especially in older adults
The disadvantages were also discussed:
- the expense (unless getting on prescription)
- difficulties with insertion of sensors if mobility issues
- alarms being so frequent they get turned off
- people with cognitive impairment might struggle to use them, as might those with visual impairment or those with poor digital literacy. Some healthcare providers might unfairly think there are too many barriers to prescribe to older people. It was commented that hospitals are reluctant to let you keep using your CGM on admission – this maybe because the hospital staff are inexperienced in their use
Sarah from Abbott explained that the Libre 2 sensor is being upgraded to Libre 2-plus, a 15-day sensor and users should ask for their prescription to be updated in line with this. You won’t need to update your app or reader. Children from the age of 2 can now have a Libre 2-plus sensor and as this can be linked to an Omnipod closed loop pump so that optimal blood glucose levels can be obtained. The Libre 3 sensor is not an upgrade but a different sensor for use with a different pump. Sarah asked us to let you know that anyone, even those self-funding, can sign up for the free Abbott training on the Libre and how to get the most out of it.
Contact the Customer Careline on 0800 170 1177 to find out more.
Small Discussion Groups
Diabetes Everyday Eating
Dr Mabel Blades led one of her popular Diabetes Everyday Eating sessions which was very participant focused and had tips on changing to higher fibre, complex carbohydrates and lower glycaemic index foods to optimize blood glucose. Informally participants commented on having learned more from Mabel over the years than from any professional they have been lucky enough to see in clinic or general practice!
Type 2 & You
Ken Heard led a session on Type 2 and You. The points raised were: delegates stressed that upon diagnosis they did not receive helpful information nor were they signposted to where they might get information and support. Vague comments from GPs such as “cut out sugars and carbohydrates” and “eat well” were unhelpful, hence finding IDDT information so useful. Some had not been allocated a diabetes specialist, such as a diabetic nurse, and were not aware of the key checks. Some were not receiving results of their diabetic eye screening tests.
Diet & Fitness
On a positive note, one delegate was successfully managing his diabetes by switching to a Mediterranean diet – a struggle at first but he has now adapted to it. Another delegate has started an online petition on change.org, Living with diabetes, campaigning for all those with diabetes to receive free CGM’s as this will save the NHS money in the long run by enabling people to better manage their condition. Over 46,000 signatures so far and needs 100,000.
Professor Alan Sinclair led a discussion on the importance of maintaining muscle bulk and balance to avoid falls and complications in older age.
There Are No Silly Questions
Dr Charles Fox led a session entitled “There are no silly questions”. He was thrilled to meet a nursing student of his from 30 years ago and a patient he had treated whose baby, now 40, he had held many moons ago! Participants could receive highly personalised advice. He discovered:
- people not knowing if they had Type 1 or Type 2 diabetes
- he explained that people with Type 2 usually need insulin 7-8 years after diagnosis because the pancreatic beta cells have failed
- he gave some helpful advice on useful medications, and he confirmed that injecting insulin leads to weight gain
- he also uncovered a worrying lack of education around the basics such as carbohydrates, dose adjustment for meal size, minimising complications’ risk and was concerned one participant was not getting help with neuropathy
Diabetes & Primary Care
Abban Qayyum led his session on Diabetes and Primary Care. Again, the main concerns raised were that GP’s were not providing enough timely information. Abban gave an explanation on a GP role and how they can improve the consultations by potentially sign posting more and covering the fundamentals. It’s near impossible for a GP to diagnose, discuss diabetes at length and signpost given the pressure, clinical demands and time constraints.
After a delicious lunch – we returned to the main hall for our afternoon speakers.
Afternoon Speakers
Supplies for Ukraine
Oliver Jelley gave a more detailed update, with a video, on just how many supplies have been donated and delivered to the Ukraine. He also told us more about the membership drive campaign (VERA) which has been highly successful.
It has also been good value for money as over 3000 people have signed up to become IDDT new members which means that at least 3000 more people living with diabetes are receiving the information and support they need.
The Impact of Physical Activity on the Management of Diabetes
Abban Qayyum, Clinical Specialist Physiotherapist
Abban has a specialist role in Primary Care where he often sees older patients with multiple problems in addition to their diabetes, some may be on 6 or more medications. His team tries to look at the psychological and social impact of ill health, not just the physical impact. He helps patients become more involved in shared decision making and he takes a pragmatic approach when advising on symptoms’ management. He trains primary care workers in how to optimise the care they give in the limited time available.
Moving onto physical activity – he confirmed that an exercise programme and other lifestyle changes can prevent or delay the development of Type 2 diabetes when someone presents with moderately elevated blood glucose levels (sometimes called pre-diabetes). He described the different kinds of exercise:
- aerobic, which works the large muscles and is good for cardiovascular health. It includes high intensity interval training – short bursts of intensive exercise within a longer session
- Hypos may be avoided in Type 1 by doing resistance exercises first, by carb loading and by reducing insulin before, during and after the exercise
- Flexibility training helps the joints, resistance training with weights and elastic bands and balance exercises help gait and prevent falls. Tai Chi and Yoga combine these in a gentle way
For people newly diagnosed with Type 2, sensible advice is to cut down on carbs and start an activity routine, perhaps with others. Some useful videos for home exercise can be accessed from the links below, but it is also worth finding out if gym, swimming sessions or walking groups can be accessed in your area on a social prescription.
Physical activity videos – Make Your Move | Age UK
Chair-based pilates video workout – NHS (www.nhs.uk)
https://torbayandsouthdevon.nhs.uk/uploads/chair-based-home-exercise-programme.pdf
Strength exercises – NHS (www.nhs.uk)
Lose weight – Better Health – NHS (www.nhs.uk)
Person Centred Care
Dr Charles Fox
Charles gave a presentation on work he does with professionals to help them support people with diabetes and enable them to achieve their health goals. He pointed out that 98% of diabetes care is self-care – we in the audience knew that, but apparently most professionals don’t!
Thanks were given to the staff for providing so much information, support, direction and assistance during the day.
