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NavyDiver
14th January 2025, 04:04 PM
I thought some of you might be interested in my usual RANT/feedback I sent this to a few people/organizations today. Feel free to use to any of your health types if you have any interest in the topic

Link to Professor Alan Sinclair, of the Foundation for Diabetes Research Older people with diabetes vulnerable due to disjointed care - Diabetes Research & Wellness Foundation (https://www.drwf.org.uk/news-and-events/news/older-people-with-diabetes-vulnerable-to-poor-health-due-to-disjointed-care-services/)


He says it better than I can of course. I am not Diabetic very thankfully. I know people who are!.


Subject: Feedback and Suggestions for Improving Diabetes Care Management
Summary:Effective diabetes management is essential to prevent complications such as frailty, dependency, disability, and reduced life expectancy, as well as to avoid significant costs related to ambulance services and emergency care. Disjointed care across various settings—home care, general practice, hospitals, and community healthcare—can lead to poor outcomes for individuals with diabetes. Therefore, a standardized, clear, and concise Diabetes Action and Management Plan is necessary to ensure comprehensive care and consistent management.
This plan should be accessible to all individuals involved in diabetes care, including home care providers, general practitioners, community healthcare professionals, and hospital staff. It should be incorporated into the Medicare Diabetes Annual Cycle of Care and be funded under the M.B.S.
Proposed Diabetes Action and Management Plan:This plan should be led by the patient’s General Practitioner (GP) or an endocrinologist and should include the following key components:


[B]Blood Glucose Level (BGL) Target Range
Medication Instructions:

Long-Acting Insulin: Set dose
Short-Acting Insulin: Adjusted according to BGL
Additional Short-Acting Insulin for carbohydrate intake
A carbohydrate counting guide or resources


Actions for Hypoglycemia (BGL < 4.0 mmol/L)
Actions for Hyperglycemia (BGL ≥ 15.0 mmol/L)

Immediate corrective actions to be taken.


Background:I recently observed my family member in a hospital setting, where they were administered the same fixed dose of short-acting insulin at regular intervals, regardless of fluctuations in blood glucose levels. In one instance, nursing staff were unsure how much additional insulin should be administered for meals, and the patient, often confused by their fluctuating blood sugar levels, struggled to communicate effectively with staff. I noticed that no instructions were in place to guide adjustments for varying blood glucose levels.
Despite raising these concerns with diabetic education staff, it became clear that essential knowledge and instructions were not readily available for all hospital personnel. On the third day, diabetic education staff created a reference guide for insulin doses based on blood glucose levels, which was useful for both hospital staff and the patient at home. However, a more structured and universally accessible Diabetes Action and Management Plan could significantly improve care.
Key Insights:Recent research highlights the fragmented nature of diabetes care, especially for older individuals. Professor Alan Sinclair, a recognized expert in diabetes care for the elderly, warns that such fragmentation leaves people more vulnerable to poor health outcomes. Over a quarter of care home residents have type 2 diabetes, underscoring the need for consistent and well-coordinated care. Poor diabetes management leads to complications, frailty, and even premature death.
In addition, Diabetes Vic advocates for a Diabetes Action and Management Plan for all children and students with type 1 diabetes in schools, emphasizing the importance of structured care. However, the absence of specific insulin dosage information in some existing plans is concerning.
Conclusion:This suggestion is intended to improve the care for people living with diabetes and should not be viewed as a criticism of the individual healthcare providers or organizations mentioned. I appreciate the efforts of general practice doctors, district nurses, community care teams, and hospital staff. I hope that the feedback provided here will help in the ongoing development of effective, coordinated, and patient-centered diabetes care.
Thank you for considering this feedback and suggestion. Please feel free to use any part of this submission to further enhance diabetes care.
Sincerely,[Your Name]
References:


Diabetes Vic: School Diabetes Management Plan [Link]
RACGP Summary of Recommendations [Link]
Integrating Care for People with Diabetes: Statewide Initiative [Link]

DoubleChevron
15th January 2025, 11:42 AM
If your talking type 1 diabetics, the hospital staff should be deferring to the patient. No-one will understand diabetes care better than the patient themselves. Pretty much every type 1 diabetes person with any sort of mental faculties would be an expert on diabetes ... they have to be in order to survive. Some are deliberately terrible and stupid (I'm thinking of my mother inlaw when I say this). If they can't be bothered looking after themselves though, it shouldn't be the medical fields problem.

I would be very hesitant to criticise anyone in the healthcare industry. My son is a type 1 diabetic, and I've had a few run-ins with people in the care system. I would never for one second mention a name or location. I think those people are doing there absolute best given the sheer volume of workload and limited staffing levels. Most would bend over backwards to try and help you.

Where I had "issues" was trying to get my son on a pump. I ended up getting quite fed up with them, and contacted the pump manufacturers directly and going around all of the locals. They were NOT happy with me for doing this. You see they all get kickbacks from the insurance companies to get people onto pumps. I couldn't get anywhere as I kept saying "I want to buy a pump up front". So this means they wont get there kickbacks. I contacted medtronics, and not only will they get you on a pump within a couple of weeks, they will give you a 10% discount for upfront payment.

Nothing is perfect, but if you can get people onto a modern pump that talks to a glucose monitor, it is life changing.

seeya
Shane L.

NavyDiver
16th January 2025, 08:02 AM
If your talking type 1 diabetics, the hospital staff should be deferring to the patient. No-one will understand diabetes care better than the patient themselves. Pretty much every type 1 diabetes person with any sort of mental faculties would be an expert on diabetes ... they have to be in order to survive. Some are deliberately terrible and stupid (I'm thinking of my mother inlaw when I say this). If they can't be bothered looking after themselves though, it shouldn't be the medical fields problem.

I would be very hesitant to criticise anyone in the healthcare industry. My son is a type 1 diabetic, and I've had a few run-ins with people in the care system. I would never for one second mention a name or location. I think those people are doing there absolute best given the sheer volume of workload and limited staffing levels. Most would bend over backwards to try and help you.

Where I had "issues" was trying to get my son on a pump. I ended up getting quite fed up with them, and contacted the pump manufacturers directly and going around all of the locals. They were NOT happy with me for doing this. You see they all get kickbacks from the insurance companies to get people onto pumps. I couldn't get anywhere as I kept saying "I want to buy a pump up front". So this means they wont get there kickbacks. I contacted medtronics, and not only will they get you on a pump within a couple of weeks, they will give you a 10% discount for upfront payment.

Nothing is perfect, but if you can get people onto a modern pump that talks to a glucose monitor, it is life changing.

seeya
Shane L.

It is type 1, The issue was magnified by confusion and exhaustion post significant highs treated in intensive care. The Pumps are fantastic for many people. Sadly this is not one of them. I am getting great feed back from some a bit higher up the food chain about the Care Plan Template which may be helpful for people who get a little confused at times or people helping them like dopey me perhaps

Roverlord off road spares
16th January 2025, 04:07 PM
Hi James I had a bit of scare end of May 2024, my Dr asked if I had ever had a blood test for diabetes, which I have never any way the test came back and I was 1/2 a point away from getting diabetes. Which put the be scare in me. So from June last year I stopped eat rubbish and processed food I do still have 2 slices of 7 grain bread toast in the morning changed to eating more fruit veggies nuts and small amount of meat. I now walk 3 and 1/2 klm in the morning and afternoon. Which started me on the right track of losing weight. I dropped 7kg in 3 months and had another test and I had dropped so far away from getting diabetes. I wasn't looking after my self when Mario passed away. Well to date I have lost 19kg which is 3 stone, I see the dr again at the end of the month as I have blood tests done every 3 month because of a tablet I have once a week for rheumatoid arthritis. I saw the Dr at the end of Oct 2024 and he was please with the weight I had lost which was 14kg then. It will be interesting to what he say at the end on the month. I can remember Mario saying to me a couple of times that was was getting a bit large on the back side. But when every thing happen over the last few years I knew I had to pull my self up for my boys. They didn't need to have another sick parent. I love my walks and even walk in the rain if not to heavy. The Dr I go to is the same Dr, Mario had, at one appointment we had with him Mario asked him to look after me after he was no long here, that is the type of person he was. Sorry for the long rant, Heather

RANDLOVER
17th January 2025, 11:06 AM
As a precaution I have a full blood and urine test every year, the non fasting one as that is easy to do. Some things can have no symptoms until dangerously late, like high cholesterol which can lead to heart trouble.

NavyDiver
4th February 2025, 09:57 AM
NOT INVESTMENT ADVICE!!!!!

A company in the US with some very smart doctors and scientists and a load of AI got my attention due to a non-opioid pain medication. My huge doses of Fentanyl were required in hospital are not an event I ever what again [biggrin][biggrin]


Once there The technology they have for curing type one insulin dependent was a lot of wow! How to use it is the next question for this of course and its not yet here like my EV 4wd ute [bawl][bawl][bawl].



The AI involved MAY make what would have been a 10-20 story a bit to a lot faster I hope as that will be a game changer for millions of people.




https://youtu.be/mgY2MtDyPDM