The Diabetes Specialist Nurse and Health Promotion events… not just a day out of the office!

Bethany KellyApril saw the first ever national NHS Diabetes Prevention Week; to raise awareness of Type 2 diabetes and how to prevent it. We all know that nursing teams across all of the NHS revel in a day out of the everyday working environment to promote ourselves and the work we do, and our team is no exception to this!

Anytime a specific health promotional day or week comes around with our name on it, our team can’t wait to hang out the bunting, iron our branded t-shirts, dust off the ‘not-so-mobile’ display boards, adorn the stickers and tweet the associated hash tags. Jokes aside, taking our work to the general public, that we may not always come across in our ‘normal day to day’ role, is such a fulfilling part of our job.  Our team actively try to attend or at least do something for the various diabetes promotional days throughout the year – whether they are worldwide, national or local initiatives. Some other examples of this include World Diabetes Day held in November, JDRF’s Diabetes Wellness Days, Diabetes UK’s Diabetes Week in June, and attending local temples during Ramadan and other Sikh and Hindu religious festivals.

As a team of diabetes specialists working within this area, we can never ignore the astounding figures that are highlighted day in and day out in the media; I am sure most would agree that this only propels our enthusiasm for health education and promotion. We all know that Type 2 diabetes is a big issue for the NHS; it is a leading cause of preventable sight loss in people of working age and a major contributor to kidney failure, heart attack, and stroke.

There are currently 3.5 million people with the condition in England, with around 200,000 new diagnoses every year.  Our inpatient colleagues know all too well that one in six of all people in hospital have diabetes – while diabetes is often not the reason for admission, they often need a longer stay in hospital (Diabetes UK). As well as the cost to individuals, Type 2 Diabetes treatment accounts for £8.8 billion a year. The number of people in Southampton with Type 2 diabetes has reached 12,954 (Diabetes UK). Which is why, as a team we were so keen to promote Diabetes Prevention Week.

In the run up to April, we emailed all the GP surgeries that we cover in our area, with a snapshot of the statistics and what they could do in-house to promote the week. We included details of the Diabetes UK “Know your risk” website and the link on how they could order a toolkit for use within their waiting rooms. We also included some ideas on how they could promote awareness, such as running “at risk clinics” and promoting the ‘40yrs+ NHS Health Check’. We also reminded them of the ability to refer to the NHS Diabetes Prevention Program (NHS DPP) which is a centrally funded lifestyle advice and modification programme specifically for people at high-risk of Type 2 diabetes.  Furthermore, we provided details of the local facilitator for the surgeries to contact.

With social media being one of the most accommodating platforms to promote our profession and work, we took to Twitter and sent multiple tweets on behalf of our team account (@SolentDSNs) regarding our plans for the week; our aim was to share our purpose and help provide advice and up-to-date information. Our communications team, and managers, reinforced our mission by sharing information on the trust’s webpage, tagging in the local CCGs and GPs that we work closely with. Hard work and dedication meant that we were able to reach out to a much larger audience.

Lots of planning goes into these days: we need to plan the staffing and clinics around it, making sure clinical work is covered first and foremost. The team approach days like this as a multidisciplinary team; giving a well-balanced holistic approach to the people we meet on the day. This means involving our managers, our fabulous team of three admin ladies, the DSN team, the amazingly knowledgeable dietitians from our team, and of course the local peer support groups and Diabetes UK local reps that we work so closely with (and appreciate so much). Behind the scenes, what also ensues, is many more emails to supermarkets, coordinating of diaries, tweets and tags. We get together to discuss the aims of the day, what each of our professions can bring to the table. Staff members begin emptying their cars of child seats, spare insulin pens and blood glucose meters in order to make space for branded balloons, piles of leaflets, demo kits, and anything else we may need.

With prevention of Type 2 diabetes being the key here, we felt, there was little else we could do but go out and perform actual risk assessments amongst the general public. Our local Diabetes UK representative ordered the risk assessment questionnaires, and accompanying traffic light system leaflets for us to give out. Coupled with the Diabetes Prevention Week toolkit we collected from the Diabetes UK Professional Conference back in March, we were well armed.

At the beginning of the week we tweeted information about Type 2 diabetes and how to be aware of the risk factors. With the help of retweets from various big players in the diabetes world, this reached over 8,000 people! On the Thursday; we turned up to a local supermarket making our presence known as we carried in hordes of things, including portable scales and height measuring devices. Our display boards held information about at risk groups, how individuals could assess their risk, and importantly; information about what to do next.

As part of these risk assessments we discussed the person’s overall lifestyle, thinking about family history, their gender and age, we also measured their waists, and their BMI, looked at their blood pressure and then gave them an “at risk score”. Based on this score, the person was given some leaflets and pointed in the right direction for further advice and help. Those assessed as low and increased risk were given some personalised health information. Those assessed at moderate and high risk were given access to health intervention changes they can make to their lifestyle factors that had an effect on their risk scoring; we also made them aware of the NHS DPP and advised them how they can access this. We also discussed local access to health intervention teams they can see. Coupled with all of this, they were given a letter to take to their GP saying that they had been assessed as high risk and so therefore might benefit from some blood tests or being on the GP’s radar for potential risk of developing Type 2 Diabetes. We also bought the symptoms of diabetes to their attention to try to prompt them to seek early detection should they notice them.

We carried out 48 risk assessments, on people from all ethnic minority groups, aged between 18 and 93, including staff members from the Sainsbury’s café and our very own Operations Director, Solent NHS Trust, who came to support us. 77% of the people assessed were either moderate or high risk, which I think shocked us all; however we came away knowing that we had potentially changed the journey of some of those people.

We had an eye opening day, as we always do at these events! It is not only our job, but an absolute pleasure and we love promoting our work, the cause and overall circulating health promotional advice to the public. Some stand out points from the week included when a lady spent a good 20 minutes talking to our dietetic team and then went off to do her shopping. After about an hour, she returned with a trolley full of chickpeas and salad items, and she gladly came for approval from the team. We appreciated knowing that we made a difference to her weekly shop that day and potentially supported her in some lifestyle changes. The second moment, happened when my four-year-old daughter went to school with her sticker and some little tit bits of info I had tried my best to instil in her memory over breakfast. When I picked her up, I had half the male teaching staff approach me to say that because they “were boys and old” they’d get diabetes. I can’t help but smile that my little one did her bit too, for I am sure, that a conversation about their risk is better than no conversation at all, despite her being slightly confused with the information.

It is so important that people who are at high risk of Type 2 Diabetes are identified so that they can get the education, care and support they need to reduce their risk. I know that our team see it is an essential part of our job, and luckily we are the ones who have time to dedicate to this and should at every opportunity get out there to do so. We can’t wait until the next campaign, follow us on @SolentDSNs to see what we get up to next…