Better support could help patients like Steve, Sheffield research finds

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Ever since Steve Randall was diagnosed with type 1 diabetes, his condition has proved ‘very erratic’, he admits.

But, says the 61-year-old from Totley, being shown how to manage his condition at home by doctors and nurses has proved vital in helping him to control his symptoms.

Sheffield researcher Prof Simon Heller is now calling for type 1 diabetes patients to receive even more support, using targeted methods and special technology to reduce the complexity of calculating insulin doses and counting carbohydrates in meals.

A study has identified these as stubborn barriers which still put people at risk of complications from the disease.

Steve, a former civil servant, was diagnosed 20 years ago and took a course in 2009 called Dose Adjustment for Normal Eating, which teaches patients to match insulin doses to their food intake on a meal-by-meal basis.

The programme has been rolled out to over a third of diabetes centres across the country.

“Learning about how to control my blood sugar levels has done an awful lot to stabilise the disease and I feel much fitter and abler now,” he said.

“I used to get high levels of exhaustion and I couldn’t see properly. Basically the diabetes wasn’t doing my long-term prospects any good.”

Steve added: “I’ve always been pretty mathematical so sums and counting carbs are second nature to me.

“I even mentally gauge how many meals I could eat when I pass the bakery.”

The programme also taught him how to deal with hypoglycaemia - when blood sugar levels drop frighteningly low.

“I used to just accept that hypos were part of my life, and I sometimes lose consciousness for a couple of hours, but now I know I can take measures to at least reduce them or remove them from my life altogether,” said Steve.

However the five-year study, led by Sheffield Teaching Hospitals diabetes expert Prof Heller and Edinburgh University academic Julia Lawton, found that week-long, structured programmes such as DAFNE were not always guaranteed to prevent such life-threatening complications occurring.

The research, published in the National Institute for Health Research’s Journals Library, found ‘more integrated skills training’ should be offered, while a six-week pilot, using motivational techniques stressing the risks of low blood sugars, largely prevented dangerous episodes in high-risk patients.