Diabetes Type 2

Diabetes was one of the key areas of concerns with service users when Healthwatch Blackburn with Darwen (BwD) consulted the public about their 2019/20 annual work plan.  They developed a survey to gauge whether the current level of type 2 diabetes education awareness is effectively being met. 62 people in total completed the questionnaire. Ten of these agreed to do in depth interviews.  

Survey

79% of respondents indicated that when initially diagnosed with type 2 diabetes, they were offered a place on a course to help them understand and manage their condition. Of these, 46% (26) said that they attended the course they were offered.

Only 27% said family or friends, who may be involved to support them to manage their condition, were also invited to attend the course with them. whilst 49% (27) said that they were not. Of the respondents who said that family or friends were invited to attend with them, less than half did attend.

82% attended within twelve months of being diagnosed. Of the people who attended a course, most people found the time, duration and day suitable.  A number of comments received indicated that the days on which the courses were offered did not always fit around people’s work or family responsibilities.

74% said that they had found the course fairly to very useful and had made some changes to their lifestyle as a result of attending the course.

People were asked what could be improved to support them to manage their diabetes and the most similar prevalent response was that they wanted more support and information at regular intervals rather than just an annual check by their GP or Practice Nurse.

Interviews

Six out of the ten respondents had more than one health problem. Some of these also took multiple medications. As such, these respondents were unconcerned about having to take medication to control their diabetes because they already took several tablets a day. Four out ten respondents were either not motivated or not concerned enough to make any significant changes to control their condition.

Where respondents reported that they did not ‘feel their diabetes affects them’ adversely, there appeared to be less compliance with advice or educational programme provided.

Eight out of the ten respondents found it difficult to make the lifestyle changes required to control type 2 diabetes, because: they didn’t cook or prepare family meals;  they could only attend the diabetes awareness courses if they took leave from work; they couldn’t connect with the education provided, or relate to it to follow in their day to day life, or they needed greater support with motivation due to underlying depression and anxiety.

Many of the respondents commented that they had other problems in their day to day life which were of higher importance to them than managing their diabetes and undertaking significant lifestyle changes.

Three out of ten were complying with dietary advice and trying to exercise more but found it difficult, especially as the majority of respondents were in their late fifties and early sixties.

They felt that national diabetes awareness could be improved by not focussing on fat-shaming; access to healthcare professionals at times suitable for working people; providing cooking sessions that show people how to cook the appropriate foods and portion sizes from both Western and South Asian recipes, providing mentoring and information in languages that they could understand.

Recommendations

 There needs to be clearer information about the diabetes programmes on offer, especially what they are, how the needs of the patient can be met and how to access them, with support if needed. Ideally this should be following or at the diagnosis stage and should be supported with literature that the patient can understand including easy read.

There needs to be a more personalised approach to diabetes awareness and education with some targeted diabetes education for the South Asian community delivered by people who can speak directly to participants and can relate to the culture. Although this is said to be available it is not clear if patients are made aware of this option.

 People need to be made more aware that if they cannot attend weekday sessions due to work and family commitments, alternative times and weekend dates are available.

Set up local drop in advice and support groups to help people ‘stay on track’, run by facilitators or peers who have experience of type 2 diabetes and managing it successfully.

There needs to be better mental health support to increase motivation and compliance especially for people struggling with anxiety and depression.

The same local groups could also help with the emotional health and wellbeing of people struggling to engage with their diagnosis and comply with the lifestyle changes required to effectively control their condition.

 People should not feel stigmatised for being overweight and having diabetes. A more positive approach, not only by health professionals but also the general public, would be more effective in supporting people to affect change in their lifestyle choices.

There needs to be a joined-up approach when supporting people with complex health needs so that a consistent message is given to reinforce how to make positive lifestyle changes that the individual can relate to.