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Patient living with cancer and diabetes praises staff for support

A man who is living with cancer and type 3c diabetes has praised specialist staff for helping him gain control of his diabetes.

Five months ago, paramedics had to be called out to help Doug Harryman several times after his blood sugar levels became too low. One episode left him unconscious.

Doug, from Loughton, had been managing his diabetes mostly on his own. The 75-year-old had type 2 diabetes for about eight years, which was controlled by diet and then with medication.

Then in September 2020, he had an operation for cancer and his pancreas, spleen, gall bladder and part of his duodenum (the first part of the small intestine) were removed.

As the pancreas makes insulin, a hormone that helps your body use sugar for energy, he became a type 3c diabetic and needed insulin injections to control his blood sugar levels.

He was referred to the West Essex Community Specialist Diabetes Service five months ago after a series of hypoglycaemic episodes, when his blood sugar levels dropped too low.

He has been supported by Joanne Gallagher, diabetes structured education co-ordinator, and Rose Kyere-Diabour, a specialist diabetes nurse.

 

Doug, who is receiving chemotherapy treatment for cancer, said:

“Before I got involved with Jo and Rose’s team, my diabetic control was very haphazard.

“I had several bad ‘hypos’ four or five months ago, requiring paramedics to be called out. “I was unconscious for one of them.

“My GP was told about these episodes and he urgently referred me to the team at St Margaret’s Hospital.

“I then had a phone call from Rose and she thought I might benefit from trying out a glucose monitoring device and app and invited me into St Margaret’s for a chat.

“There she told me about an online course for managing my diabetes and recommended getting enrolled on one. It sounded an excellent thing to do.”

 

 

The course, called Dose Adjustment For Normal Eating - or DAFNE for short - gives people with diabetes the skills to count the carbohydrates they eat and take the right amount of insulin to manage their blood sugar levels.

It also covers topics such as exercise, keeping safe while driving, and how to manage their diabetes when eating out.

Doug said: “Rose is an excellent teacher and was brilliant at helping us work through the DAFNE course workbook.

“She was clearly totally familiar with its contents and was able to teach it to us very well over the five online sessions. She was very good at making us feel at ease and not to be worried or concerned.”

With the team’s support, Doug is now able to better manage his diabetes and planning, assessing and monitoring is an essential part of his life.

He said: “I can still do lots of things that I did before having type 3c diabetes but now I also need to constantly monitor my sugar levels and think about what I’m about to eat and assess its carbohydrate value as it will affect how much insulin I will need to inject.

“The sugar level reading also affects how much insulin I will need. I then have to think about what I’m going to be doing over the next few hours such as exercise, what I’m going to eat if I’m going to eat out, consumption of alcohol, snacks between meals, and driving.

“I can still drive but I need to carefully check everything beforehand and make sure I can monitor for a hypo and have what’s needed to deal with it.”

Joanne said: “Without Doug’s determination and perseverance, Rose and myself would have found it a lot more difficult in helping him achieve what he has over the past few months. 

“We both appreciate that he has been a very difficult journey and we’re both very proud of him.”

The West Essex Community Specialist Diabetes Service is run by Essex Partnership University NHS Foundation Trust.

The team of nurses and dietitians who specialise in diabetes currently support 84 patients and serve Harlow, the Epping Forest district and Uttlesford.

They support adults with type 1 diabetes to make any lifestyle adjustments to help keep themselves well, and also provide care to patients who are housebound or living in nursing and residential care homes who have type 1 or complex type 2 diabetes.

Patients can be referred to the service by their GP, practice nurse, district nurse, care home, or secondary care.

For adults with type 2 diabetes, there are set criteria for referrals to the service.

In addition, they also deliver a number of courses for adults with type 1 and type 2 diabetes.

DAFNE course

The DAFNE course is a structured education programme for anyone aged 17 and over who has type 1 diabetes. It teaches patients how to self-manage their diabetes by working out how much insulin they need to take for what they want to eat. 

Patients can choose to do the online course, which runs for three hours week over six weeks, or face-to-face classes, which run for one day a week over five weeks, or can be completed during one week.

More information can be found at dafne.nhs.uk

 

Courses for people with type 2 diabetes

The West Essex Community Dietetic Team delivers education programmes for adults with type 2 diabetes.

The X-PERT online course runs for two hours a week over six weeks, or face-to-face classes that run for two-and-a-half hours a week over six weeks.

More information can be found at xperthealth.org.uk.

The team also deliver a Carbohydrate and Insulin Management Programme, which is designed specifically for people with type 2 diabetes who are taking insulin. It provides more detailed information on insulin treatment so that patients can increase their understanding of their condition and make lifestyle choices to manage their blood glucose levels more effectively.

 

Referrals

If you feel you would benefit from any of these courses, you can ask for a referral from your GP, Podiatry Service, Healthy Living Team, or Secondary Care provider.

You can also self-refer by calling 01279 973705 or 01279 827621 or emailing joanne.gallagher@nhs.net

Patients who attend the DAFNE course and fit certain criteria will be considered to apply for initial funding for a glucose monitoring device.  

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