Date of prep: December 2020
Prescribing information and
adverse events reporting
For healthcare professionals only
How long have you had diabetes?
Does diabetes rule your life or do you control it?
My diabetes used to run around my life, but at this stage of my life I like to say it co-exists with my me. Not happily all the time but it most certainly does not rule my life. I have never liked the word “control” and do not use the same terminology. Though it still used a lot by medical practitioners and others when talking about diabetes.
Are you happy to share what medication you have been prescribed to control your diabetes?
Yes. Long-acting and short-acting insulins. Novorapid and Tresiba; Metforim 2500mgs daily.
What is a typical day for you living with diabetes?
|6.45||Test blood glucose (BG), depending on reading drive daughter to training/have something small to eat (three days per week).|
|6:45 – 7.30||Test BG, carb count what I am having for breakfast, take insulin according to carbs to be eaten and decide if insulin adjustment required according to BG.|
|7:40||Breakfast and take Metformin and other medication not diabetes related.|
|8:40||Get organised for work.|
|8.15||BG test, school run.|
|10/11||Attempt to get a 30-minute walk in if possible, test BG before and after walk.|
|12:30-1:30||Half hour lunch break BG test, carb count for lunch, take insulin according to carbs for lunch and decide if insulin adjustment needed lunch and then take Metformin.|
|13:00/13:30||Back to work.|
|16:00-18:00||After school activities run with a test of BG at all times before driving and work.|
|BG test, carb count for dinner, take insulin according to carbs for dinner and decide if insulin adjustment needed, dinner and then take Metformin.|
|21:00||BG test, work.|
|BG test, bed.|
|Twice weekly 2:00/3:00 am
Has your diabetes affected your mental health and is this ever considered the by the professionals who look after you?
Yes, mental/emotional/psychological health has been adversely and badly affected. I had to request help as I was never asked about my mental health. After four years on a waiting list just I have had the first appointment with a psychologist.
Are you happy to tell us about your worst diabetes experience? What happened and how did it feel?
The worst was when after successfully obtaining my first job, I had to go for a medical and of course sod’s law, there was sugar in my urine. Yes, it was that long ago. A big hullabaloo ensued about not having disclosed diabetes on my application form, and so I was not eligible for the position. However, due to a brilliant letter from my endocrinologist where he declared that diabetes was a condition and not an illness/disease as the question was phrased on the application form and therefore “vital and significant” information had not been omitted I was re-instated back to the position. This had a tremendously positive impact on me as it left me feeling empowered that diabetes cannot stop you doing anything you want in life.
Have you suffered any long-term effects of having diabetes and how have you managed these?
Slight retinopathy. I attend an ophthalmologist every 6/12 months. I had one session of the laser over 16 years ago and no repeat was needed. I suffer macular degeneration. No treatment has so far been needed for that. I suffer neuropathy and I attend physiotherapist twice a month and take pain relief occasionally.
Do you have a good injection technique?
Would think I have but please define “good” injection technique.
Do you use any innovative technological solutions to manage your diabetes?
No but just received approval for constant glucose monitoring so looking forward to this.
Do you attend your annual diabetic review?
Yes. I have one every 4/6 months.
Do you feel these reviews improve your diabetes control?
No. The “dealing with” diabetes is up to me, but the reviews can be a good place to pick up small nuggets of information or ask questions.
Have community pharmacists been helpful to you on your diabetic journey?
Not so much in my specific diabetes journey but have got good recommendations for over the counter pain relief for the neuropathy from my community pharmacist.
If you visited a specialist diabetic clinic what one tip would you give me as a pharmacist prescriber?
Talk to the person with diabetes, but more importantly, listen to them.
Do you feel insulin usage is a good indicator of diabetic control?
No not a definitive one but can be a good indication. For example, I had a good HbA1c but was taking massive amounts of insulin and was told to stay on it because of my HbA1c readings however subsequently it was discovered I had insulin resistance and after taking prescribed medication for a time, my insulin reduced by nearly 60%. And my HbA1c got even better though there is room for big improvement here still.
In your view why are people still dying from diabetes?
This is a very broad question, i.e. does it relate to T1 diabetes, T2 diabetes, or just generally?
In my opinion, there is no definitive answer for the same. However, a few things that stick out in my personal view and they are as follows;
In certain countries insulin prices are extortionate, and people cannot afford it and hence are rationing/doing without – as a T1D this is lethal. I am so grateful that I live in Ireland as all my diabetes supplies are covered by our national health service, the HSE.
Education for all people with diabetes is severely deficient – there is a lack of education/ insufficiently trained diabetes educators, so people, when newly diagnosed, are not getting the proper education to take on board their diagnosis and generally there is little if any ongoing/continuous education for diabetes which is a necessity.
The psychological effects of T1D can be devasting where people just give up and stop taking care of themselves and their T1D, and ultimately this can cause death.
There are probably loads more, but these are the ones that spring to mind instantly.
Pharmacy in Practice is a UK pharmacy publication with its roots in Scotland.