Outcomes in diabetes

It’s funny when you start a discussion on outcomes in a condition such as diabetes. The usual tripe comes out – HbA1c and then some idiot talks about cost-effectiveness and then those silly QIPP indicators and QoF points. I can even get angry when someone adds medicines safety and adherence. My heart sinks and I really know that the NHS has problems.

So – let’s start from a different place. The person with diabetes wants to feel confident that they can manage their condition over a long period of time. They want to feel that they are in control and they are on top of things. They want to feel well. I even highlighted the key words to make it simple.

Hmmm – the room has now gone totally silent.

I now have to stop the ones that are trying to tell me that they do this, by reading a couple of comments from patients:

‘The diagnosis of diabetes feels like an albatross around my neck’. ‘I seldom feel in control and often feel unwell with my diabetes’. ‘My diabetes makes me feel isolated and alone’. ‘My diabetes makes me feel unwell and unhappy’.

There were also many comments about dependency on the healthcare system and nobody talked about independence – sometimes almost an abdication – my doctor/nurse tells me what to do. And so many that felt that diabetes got in the way of them living their life. A couple were afraid of the complications etc

The comment that really made me stop in my tracks – ‘I sometimes use my wife’s blood for the glucose test because I don’t want to disappoint my doctor’.

Do you want me to go on…..

Well the rest of the day went much better. There might be a plan coming together. One that is patient focussed, that empowers, that connects, that gives hope and delivers confidence and control. Might even help people to feel well.

We agree that when this happens other outcomes will improve and dependency on the healthcare system will reduce. There might even be a VAS for confidence, control and wellness – now that would be innovative.


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