#WorldDiabetesDay: Diabetes care and management

16 Nov 2020

In our final guest blog to mark #WorldDiabetesDay 2020, Deborah Wilson from our Faculty of Podiatric Medicine Executive Board writes about the work of podiatrists and nurses in diabetes care and management.

I qualified as a podiatrist in 1997 and graduated with an MSc in Podiatry in 2014 from Glasgow Caledonian University (GCU). I am currently a lecturer in Podiatry (Clinical Academic) at GCU. I consider myself a lifelong learner and joined teaching in 2015 from an NHS background whereupon I developed my clinical expertise in diabetes, wound care and vascular conditions of the lower limb and foot. My current role is split between undergraduate and postgraduate teaching, and as a podiatric clinical specialist in diabetes. The consolidation of these two roles to one post is has fuelled my passion for podiatric education which has been enabled through a collaborative and strategic partnership between GCU and NHS Lanarkshire.

Annually, 14 November provides an opportunity to raise the profile of diabetes globally through the international campaign ‘World Diabetes Day’, and this year is no different, where the theme is to raise awareness of the amazing role that Nurses have in diabetes care and management, and how much they ‘make the difference in diabetes’.

However, 2020 has been a year like no other where global attention has been dominated by the devastating world pandemic of COVID-19, which to date, over 46 million people around the world have been known to be infected and over 1.2 million deaths (1). But let’s not forget, diabetes is also a condition with global pandemic status (2) and in 2019, was responsible for 4.2 million deaths. The majority of which having type 2 diabetes, living in low- and middle-income countries (3). According to the International Diabetes Federation (IDF), in 2019, the global estimates of diabetes prevalence was 9.3%, that’s just under half a billion adults (approximately 463 million adults between the age of 20-79 years) and projected to increase to 10.9%, or 700 million adults with diabetes by the year 2045. Currently, if diabetes was a country, it would be the third largest country in the world (4)!

Having diabetes however, does not mean you are more likely to catch coronavirus, but statistics have shown that those with diabetes who do catch coronaviruses can have more severe symptoms and complications. Therefore, the world pandemics of diabetes and COVID-19 form a ghostly double for an already vulnerable population. For this reason, the focus on effective diabetes care and management becomes even more paramount.

Diabetes is a complex multi-system condition which necessitates inter-professional involvement where skilled nursing lies at the core. Commonly nurses have multiple roles to provide effective management of the disease in both community and hospital-based settings such as; advanced caregivers, motivators and educators. COVID-19 has drastically challenged how all healthcare professionals deliver care to patients, but a reduction in face-to-face contact has been particularly impactful for nurses, especially when trying to support patients through unprecedented stressful and fearful times.

As a diabetes specialist podiatrist working within a multi-disciplinary diabetes care and management environment, I recognise first-hand, the amazing and highly skilled work that the nursing profession provides with expertise in; diabetes control and medications management, structured lifestyle and education, pump management and new tech monitoring systems, as well as supporting and recognising patients with diabetes associated anxiety and depression.

But despite diabetes being a global issue, there still remains no universal approach to the nursing structure to facilitate effective opportunity for the specialised nurse. My experiences of the nursing team with a vast range of skills are unfortunately not common, particularly in countries where there is an absolute lack of resource to train and provide posts. This is wrong, particularly when we reflect on the staggering statistics. But alas, this is not only applying to the profession of nursing, but also podiatry where there are countries that don’t even recognise our profession.

World Diabetes Day raises awareness of the devastating impact that diabetes has globally. That there remains huge pockets of care poverty and provision, and that nurses are at the core of expert care provision for this population and ‘make the difference in diabetes’.

References

(1) https://www.ecdc.europa.eu/en/geographical-distribution-2019-ncov-cases

(2) Editorial. The Diabetes Pandemic. Vol 378, Issue 9786, P99, July 09, 2011. DOI:https://doi.org/10.1016/S0140-6736(11)61068-4       

(3) IDF Diabetes Atlas. 9^th edition 2019

(4) www.census.gov