Tunde Peto (Mentor)
I am looking forward to this course! I hope you are all well and safe and that we will have lots of good discussion, TUNDE PETO
Location United Kingdom
Activity
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Tunde Peto (Mentor) made a comment
These 7 questions concentrate the mind on what needs to be thought of when diabetic eye screening is about to be started. Working with patients and patient organisations help to understand how we might help our patients best.
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Absolutely true, high level support is necessary.
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Guidelines a lot of the times are seen as difficult to see how they might lead to the betterment of care. However, without them it is difficult to harmonise pathways and there is a chance that good quality care suffers. Guidelines offer chance of good quality care constantly and insure against haphazard actions.
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Tunde Peto (Mentor) made a comment
It is sometimes difficult to visualise the costs of the disease and how to incorporate the care for these patients into the health budget when there are other pressing needs. Do you have any thoughts as to how in your setting these costs can be appropriately analysed?
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thank you, it is great to know that it helps to understand such a complex disease.
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I am glad to hear
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I understand your worry, and I hope that this knowledge helps you to ask for the right information that will lead you to the right care.
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thank you
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you are right, some early signs are extremely subtle and so it is great to concentrate so nothing is overlooked.
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that is great to hear; and I am also glad to to hear that your family member has regular eye examinations.
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thank you!!!
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Tunde Peto (Mentor) made a comment
Knowing the signs of the disease enables appropriate risk stratification and making sure that we see people at the right time, and at the right clinic.
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prioritisation is often difficult and you and all ophthalmologists in your area have lot of other diseases to deal with. Diabetic eye disease is a difficult one as it causes no sightloss until very late and so people do not appreciate its impact until it is too late. Diabetes and diabetic eye care requires long-term planning just by having the information...
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you are absolutely right; hence we need to take once step at a time. that is how every programme started. the approach of knowing the number of people with diabetes, how they are treated, what is available and what might the next steps be are vital. Having a team of people looking after those with diabetes and knowing who to train and when is essential...
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understood, and lack of treatment for late disease makes it even more important to have early interventions to help every individual with the disease
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thank you for your contribution, it is very insightful and I am sure your patients benefit a lot from the expertise you ahve locally.
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Appropriate intervals help with seeing the right people at the right time. If we see people with low risk of vision loss less frequently (but still safely), then we will be able to see those requiring more frequent monitoring to be seen on time. It is great for the individuals with diabetes and also creates opportunities for risk based stratification of those...
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thank you for this comment; these cases indeed highlight the need for diabetes care in principle and diabetic eye care in these people. Without diabetes care and diabetic eye care, there would be many more people who lost their sight.
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Tunde Peto (Mentor) made a comment
This week has been an amazing opportunity to think through the organisation of services for DR and how such services will lead to less sight loss throughout the world and how people with diabetes in areas where such services exist are likely to do better for their sight.
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completely agree, it is extremely important that people are prepared to come for screening and that they understand why they should come.
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I also add my welcome!
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I hope you are enjoying the course and will be able to use the knowledge.
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we are privileged to hear from so many wonderful people from around the world; and that you chose this course to understand diabetic eye disease better. We are very much looking forward hearing from you all throughout the course.
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you are absolutely right, the more we know, the more we are able to help prevention and also those with the disease
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I hope you find this course useful and that you will be able to use the knowledge to save sights of people in Sudan!!
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research, audit and service improvement projects are essential so we can make life easier for out patients with diabetes and keep their sight
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you are very welcome and I hope you are finding this useful. I am sure that you see some differences between Japan and Canada, and that you can use this knowledge you are gaining here.
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RN-s and diabetes nurse specialists are absolutely essential for the good work on diabetes care and so it is great to have you here
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you are so welcome here, Mexico is really hard hit with this disease and I am sure your generation will be instrumental in beating this disease.
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I am sorry to hear that, and I hope that your second eye is seeing well. I am sure that the information you find here proves useful.
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knowledge and passion about the subject is what we will enable us to help patients with this disease. I hope you will find the information useful and we are looking forward hearing your experiences throughout the course
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wonderful goal, and after this course I would hope that you will be able to put together a "script" in your head as to what you need to say and at one point during patient education/experience. Not everyone can take everything in immediately and so timing will be the key!
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you are welcome on the course, and it is always great to hear the experience of those who have the disease, so we are looking forward to your insight
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you are very welcome; with your new knowledge you will be able to make such a difference in Ghana!
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this sounds like a fascinating background, and one that will really resonate with this topic. we are looking forward to your insights on the topics
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hope you will enjoy the course and we are looking forward to your contibution!
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it is great to have an endocrinologist here, diabetic eye disease cannot be sorted without your input!
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you are very welcome and we are looking forward to you sharing your experiences with the group throughout the course
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great to see you here Bessie, I am sure you will find that this course will refresh your knowledge
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This will help you to understand what your patients are going through
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Welcome Lajos and I hope you find the course insightful
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this is a great goal and we know that research active units do better on patient care as well, so good luck with the course.
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Mariam, good to have you here, and I am sure you will find some relevant information; also, some you might not know why it is relevant just as yet, but you can make it relevant to your patients by talking about the subject, making sure that they understand what is happening to them. I am sure you will not be able to help everyone, but slowly, more and more...
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this knowledge I am sure will provide you with some insight into your chosen profession and you will be able to contribute positively to patients' life where they are affected by the disease.
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excellent idea to do this course so you can provide better information and better care!
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thank you, and Pakistan also has a lot of people with diabetes and sight loss related to that and so your knowledge will be very beneficial to society
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great to have you; people with diabetes also have dental issues, and many times those go unnoticed until too late, just like eye disease, so you are very welcome
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thank you for joining, and I am sure you will be able to use some aspect of this knowledge in your professional life as well. It is great to have a well informed RN, and many of your patients might not ever say anything about their eyesight but suffer in silence, you will at least be able to ask the right questions!
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what a great thing you are doing for your friend, he must be very lucky to have such a good friend
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Thank you, and yes, diabetes is growing with an alarming rate in Africa and so it is great to have people in the course so you can all contribute to saving sight!
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thank you for joining the course, you are very welcome and your views and input will be very valuable to the whole group!!!
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you are welcome, we hope this will be useful for you and will help you to guide your son through this disease
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you are right, optometrists do play a part, in some areas more than in others, depending on how the health system is organised. We are looking forward to your input in the later parts of the course as well.
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great to have you and we are looking forward to your comments as we go along.
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diabetic eye disease is very common and affects all part of life; even basic functions such as being able to take your medications and so the more you know how to prevent it, the better it is for your patients. This will set you up well for your future work
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thank you Hamza and you are absolutely correct, the rise of diabetes in certain parts of Africa is truly astronomical and there are people going blind needlessly. I hope you learn new things in this course that will help your people.
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great to have you, there is so much diabetes in Nigeria and not a lot of people who can diagnose and treat it, so I am sure you will use your knowledge in your everyday work.
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as a nutritionist you would see a lot of people with diabetes, probably many with eye disease and sight loss; and of course once people lose their sight, their cooking and other every day activities might suffer as well. It is great to be able to prevent sight loss and give good advice so they can eat well and see what they eat
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this sounds like a great way of learning more about the eye and prepare for your chosen profession. it will also help you with your entrance interviews and be able to see some aspects of your chosen career early on. we do need optometrists with special interest in diabetes and so this will put you in a good place to get started! you are absolutely right, the...
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thank you for choosing us and it must be great to have a friend like you who is willing to go and learn about the disease! it will help you, and will also enable you to help your friends in coping with the disease!
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excellent, what a noble cause. Good luck with converting your degree, and I agree, this will give you some idea about the eye disease aspect of diabetes and how to minimise the impact it has on people.
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what a wonderful way of spending some time in the pandemic and learning something new! you are very welcome
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what a wonderful thing to do for the charity and for your patients/members! We run a lot of group-meetings and attend a lot of charity meetings, nowadays on different online media, and I find that support from those who work for the charity is essential so we can provide the right information. hopefully this course will also help you to ask the right questions...
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welcome Yasmin and I hope you are learning useful things; these should help you not only with screening, but also with general diabetes care!!!
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I am sorry to hear that; you are very welcome and hope you will find lots of useful things so your family members will not have to endure the same loss.
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a lot of the information in this course will be very helpful for that diploma; and also for your activities in clinic!
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Tunde Peto (Mentor) made a comment
Dear All, Dear Fellow Diabetic Eye Care Enthusiasts, you are all very welcome to this course.
We are looking forward working with you during the next few weeks, please post your comments and questions so we can all learn from each other. TUNDE -
Tunde Peto (Mentor) made a comment
I am glad you enjoyed the course so far, and am looking forward hearing from you in Week 2.
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The UK has been working on making screening accessible and equitable and this is why it offers such a service. It is important that other countries think about the necessary modifications so their patients have the benefits as well.
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Thank you for sharing this; the situation is not easy for anyone at the moment. Your insight into the situation is good to hear.
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Thank you for your insight, it is true that the eye is somewhat taken out of joined-up diabetes care; this is truly something we collectively need to work on.
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Agreed, awareness on every level is important, and spotting who might be the best healthcare professional to take care the patients with the diabetes.
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Great thinking process, and good that you have thought about your circumstances in Spain. Optometrists are, just like the mobile units, part of the puzzle, but they are not the solution in all places. Sometimes patients worry about the fact that if they are seen by an optometrist, they also need to buy glasses and so they do not attend? Does this happen in...
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Losing confidence and other psychological issues are vital to address in diabetes care, so well spotted that we need to take care of these issues.
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you are absolutely right, mobile unit might be part of the puzzle that eventually help solving the problem, but not the absolute solution in many places. Even if a mobile unit is commissioned, it needs to be maintained, staffed; most importantly, patients need to want to attend the service it offers. How effective public health campaigns are in your country?...
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it is always difficult to see what help might be substantial for people; you are right, taxi might be the best thing for one person, others might need other type of help. Knowing our patients' needs is important and it helps with planning and delivering the best programme.
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Thank you for letting us know what your situation is in Malawi. How do you find the patients who are most at risk for visual loss? Or do you carry out opportunistic screening? if you do, that is good for many patients and will save sights and it is a great start.
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Thank you Miriam, these are good points to consider.
We have a long way to go with patient education in every country; even in most developed countries only the minority of patients receive appropriate education.
Mobile units are excellent solutions, but logistics, patient and staff safety can be difficult to enable. -
These points are all so valid, and they show the different realities we all have for our circumstances in diabetes care and diabetic eyecare. One of the issues that we all face is that while general principles are true for everyone, we all need to think about implementing the programme appropriately.
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I hope you had a great time on weeks 2-3 and I wish you all a happy Easter!
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Tunde Peto (Mentor) replied to Lydia Kwao
The good aspect is that you can use several aspects of what you learn in different aspects of healthcare, and in your own plan for caring for patients.
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Tunde Peto (Mentor) replied to Abigail Ennin
Thank you for being here and dedicating your time to this course!
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Tunde Peto (Mentor) replied to Godwin Kunafa
Good to have you in the course. How did you find the second week?
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Tunde Peto (Mentor) replied to Lucianus Nuoseg
excellent, welcome back and I hope you enjoyed it!
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yes of course, the information is all coming! if you are still wanting more information after what is presented, let us know.
What is it that you are specifically interested in relation to DED? -
Tunde Peto (Mentor) replied to ROSEMARY ATAKORA
I hope you did! Did you find something that you can use in your everyday work.
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Tunde Peto (Mentor) replied to dinsukh ladwa
Absolutely, and many patients on dyalisis miss out on eye-care as many are unable to find the time and the energy to attend further appointments. Both complications are microvascular and so many times they go hand in hand.
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Tunde Peto (Mentor) replied to Sandra Insaidoo
I hope you are achieving your targets and also that you are still enjoying the course. What is it that you want to achieve with this knowledge?
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Tunde Peto (Mentor) replied to Narendra Kumar
Completely agree, and this is a good point to make. The diabetic eye screening programme depends on reliable knowledge of who has diabetes and if the diagbosis of diabetes is made too late, more people will present with sight threatening disease. Working together for good quality ascertainment of the underlying conditions of diabetes, blood pressure and lipid...
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Tunde Peto (Mentor) made a comment
Dear All, I am very happy to see you all on this course; I will be one of the Mentors. I hope you are all well and do stay safe in this difficult period for us all. TUNDE
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These are the areas that give us a lot of headaches, but then most joy when a healthy baby is born!
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Yes, that is devastating to watch; we have been through that stage and it is absolutely wonderful when you know what to do about it. You will probably always get a few end-stage patients, but when you start seeing some earlier patient, that is excellent.
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Tunde Peto (Mentor) made a comment
Welcome to week 2, and it is wonderful to have you all on the course!
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Tell us more pls, and let us know which part of the course were helpful! Also let us know what we can do to help!
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thank you for sharing.
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is there a way that you can be involved in developing those guidelines, even if locally?
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Completely agree, governmental buy-in is essential, and what you describe is extremely challenging. However, this course should help you to see what can be done locally, and if you might be able to get a team together.
All countries, where the screening works well or at all, worked on it for years to get some results; so pls do not be afraid of not seeing...
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Currently the UK standard is that those newly diagnosed with Type 2 diabetes must be screened within 89 days of diagnosis. This is to make sure that we catch people early if they might have had the disesae for a while, undetected. The downside of it is that there are so many appointments in those first few months that some people just cannot cope with one...
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Thank you for sharing your situation with us, and I am sure you will find some areas that you can improve on once you finished the course. It might be, that you give better information, or be able to relate to your patients differently given the amount of information you now have!
