Clinical

update

Diabetes
Essential facts

Find out more

Three million people in the UK have been

diagnosed with diabetes, and a further
850,000 are estimated to have undiagnosed
type 2 diabetes. There are two main types of
diabetes: type 1 and type 2.
About 10 per cent of people with diabetes
have type 1 when the body produces no
insulin. People with type 2 diabetes do not
produce enough insulin, or the insulin they
produce does not work properly.

NICE public health

guidance on preventing
type 2 diabetes (July 2012)
tinyurl.com/qg9vaf9

Signs/symptoms
The signs for both types of diabetes include
passing urine more often than usual, especially
at night, increased thirst, extreme tiredness,
unexplained weight loss, genital itching or
regular episodes of thrush, slow healing of cuts
and wounds and blurred vision.
Symptoms tend to present more quickly and
be more obvious in people with type 1 diabetes.

Expert
comment
Siobhan Pender is a
diabetes specialist nurse
at Guys and St Thomas
NHS Foundation Trust
in London

NURSING STANDARD

ISTOCKPHOTO

Whats new?
Failures in care of people with diabetes have
been uncovered in two recent reports. The
extra bed days needed by diabetes patients
admitted to hospital are costing the NHS an
estimated 573 million a year, according to a
Joint British Diabetes Societies for Inpatient
Care report (tinyurl.com/qf4g9nn). It also
says that readmission rates within 28 days for
people with diabetes are 59 per cent higher
than for patients without the condition.
The National Diabetes Audit (www.hscic.
gov.uk/catalogue/PUB12421) found that
many people in England are not receiving the
nine annual checks to monitor their health
recommended by the National Institute for
Health and Care Excellence (NICE).

Causes/risk factors
The cause of type 1 diabetes is unknown, but it
is not related to weight. It is usually diagnosed
in childhood or young adulthood.
Type 2 diabetes is linked to obesity, family
history, age and ethnic background. Type 2
starts gradually, usually later in life, and it can
be years before someone realises they have it.

How you can help your patient

Diabetes UK urges healthcare professionals to
ensure that people with diabetes receive what
it calls the 15 Healthcare Essentials. These
include annual checks of eye and blood glucose
levels, access to education courses to help
them manage their diabetes, and a thorough
foot check at least once a year.
NICE says that practice, community and
occupational health nurses should be carrying
out risk assessments for type 2 diabetes using
an online tool such as the one provided by
Diabetes UK (tinyurl.com/qxj7p25) as early
diagnosis is important to avoid complications.

Educating healthcare professionals and

people with diabetes is vital to improve
care. As diabetes is so common, up to
date knowledge on how to prevent,
diagnose, and treat type 1 and type 2
diabetes is an essential competency for
all nurses. A nursing workforce with
skills in diabetes will ensure patients at

NICE clinical guideline on

managing type 2 diabetes
(May 2009)
publications.nice.org.uk/
type-2-diabetes-cg87
NICE clinical guideline on
type 1 diabetes (July 2004)
publications.nice.org.uk/
type-1-diabetes-cg15
Diabetes UK 15 Healthcare
Essentials
www.diabetes.org.uk/
15-essentials
Articles from Nursing
Standard:
Type 2 diabetes in south
Asian people (May 2012)
rcnpublishing.com/
doi/abs/10.7748/
ns2012.05.26.35.42.c9083
Self-management skills
for people with type 2
diabetes (October 2010)
rcnpublishing.com/
doi/abs/10.7748/
ns2010.10.25.6.48.c8039

risk of diabetes, or newly diagnosed, will

have access to quality care to prevent
devastating complications.
There needs to be investment in
specialist nurses to assess high risk
patients. Nurses should also be aware
that people with diabetes have an
increased risk of mental health problems.
january 29 :: vol 28 no 22 :: 2014 19

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