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Working in partnership with diabetologists

Dr Helen Partridge, a UK based consultant diabetologist, describes her role in supporting people living with both type 1 and type 2 diabetes.
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Helen: So I’m a Consultant Diabetologist. I’ve spent many years specialising in diabetes and its management and risk factors. And my role very much is to support people living with both type 1 and type 2 diabetes, and some of the other slightly more esoteric versions of diabetes, but …so that they can manage on a day-to-day basis and live their lives as full as they possibly can. They’re very complex diseases that are often maligned in the public eye. They’re actually very, very complicated. So my role very much is to support people and to offer them education and information so that they can live on a day-to-day basis.
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People often see us in clinic once, maybe twice, a year but then have to live the rest of their lives with their diabetes at home. So our role is very much in guiding them in how to manage things on a day-to-day basis. I work with a huge group of people, multi-specialist teams, because of course, unfortunately, diabetes can be associated with quite complicated problems in the long run. People do run into problems with eye disease, with heart attacks and strokes, with kidney problems, with nerve problems. So we’re very much there, first of all, to try and minimise those risk factors.
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So when someone comes to see us, we typically look at things like their diabetes control, their blood pressure, their cholesterol, whether they smoke, what their weight’s doing. So lots of risk factors that add together that can contribute to problems in the long run. And we’ll try and minimise all those. And some of them are relatively easy to minimise, and some of them are much more tricky. And that’s where our role really comes into its own. I do work with a big team. So I have specialist nurses. I have psychologists. I have dietitians. And I work with allied health professionals, such as the retinal screeners, such as pharmacists, such as podiatrists.
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Other specialist teams, the cardiologists, the nephrologist to manage the kidney disease, vascular surgeon. So there’s a huge group of us work together. And it’s really important that as a team we all communicate closely and accurately. And our first role, really, is to minimise risk factors. So what we hope is that if we treat diabetes and its associated parameters well at the beginning, people don’t run into problems with complications in the long run. Obviously, if they do, then we are there to try and help them as much as possible to live with those complications, and to minimise them, and to stop them progressing any further. And that’s one of the big roles of screening.
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And that’s one of our big jobs that we do is to look at the processes of screening, so picking up any complications that could be arising really, really early so that actually we can do something about it before it’s become a significant problem then there’s very little we can do. So they’re are our main roles.

Each person with diabetes is constantly managing their condition. However, they also need access to a comprehensive service that delivers across the whole care pathway, from diagnosis to management of complications. All parts of the health system have to work together to achieve this.

The traditional diabetes service delivery model has often been too rigid in distinguishing between the primary care provided in the community and the secondary care provided at a specialist facility after referral from primary care. Instead we should aim to integrate diabetes care where possible and refocus services around the person with diabetes. This means removing as many barriers as possible between different specialties and organisations and introducing an approach focussed on achieving good outcomes for individuals and value for the system.

The diabetologist plays a central role in the management of diabetes and influences the outcomes of specialist interventions in the eye clinic. In this video Dr Helen Partridge, a UK based consultant diabetologist, describes her role in supporting people living with both type 1 and type 2 diabetes to manage the disease.

As you watch the video, navigate the health management path someone with diabetes has to follow in your setting. Are there practical or innovative options, perhaps using new technology, that can be used to strengthen the connection between people with diabetes and eye clinics?

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This content is taken from London School of Hygiene & Tropical Medicine online course
Diabetic Eye Disease: Building Capacity To Prevent Blindness
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Diabetic Eye Disease: Building Capacity To Prevent Blindness

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