Diabetes

About diabetes

Many people have diabetes but don’t know it. In 2021, 34,150 people in Cornwall and the Isles of Scilly were known to be living with diabetes.

Type 1 and type 2 are the most common forms. The causes of both types are different, but both result in too much glucose (sugar) in the blood.

Type 1

Caused by the failure of the cells that produce insulin. Insulin is a hormone released by the pancreas to help control levels of sugar in the blood. It can occur at any age but usually appears before the age of 40. Type 1 is always treated with insulin.

Type 2

Caused by the body not producing enough insulin or not using what it produces effectively. It is the most common form and accounts for around 90% of all diabetes. It is treated with dietary changes, medication and sometimes insulin.

Diabetes can increase the risk of developing other conditions, such as heart disease. It can be managed effectively, and many people lead a healthy, active life.

Diabetes education programmes

We support a range of education programmes for people who are at risk, those who are newly diagnosed and those people who are living with diabetes to help manage their condition. If you are looking for more information on how you can look after your diabetes, visit the Diabetes UK website.

Type 2 diabetes education

Diabetes and You

Diabetes and You is a free course for people newly diagnosed with type 2 diabetes or those living with type 2 diabetes who would benefit from healthy lifestyle support to better manage their diabetes.

The course is delivered by trained diabetes educators who will make you feel very welcome. 

These sessions can help you to:
• understand more about type 2 diabetes
• learn about things you can do to look after yourself and stay healthy
• meet other people like you, recently diagnosed with diabetes
• sessions are informal, friendly, and non-judgemental. You can share your experiences and ask questions if you would like to.

You will meet other people with diabetes, and you are welcome to bring your partner, friend, or family member with you for support.

Sessions are for those 18 years and over and run over 3 x 90 minute sessions.

Kernow Health run local face-to-face Diabetes and You courses with GP practices around Cornwall as well as offering  remote Diabetes and You sessions to offer an alternative for those who cannot attend in person. The remote sessions cover the same information and are also delivered by one of Kernow Healths experienced Diabetes Educators, but the course will be delivered virtually via Microsoft Teams.

Booking:

If you are interested in joining a Diabetes and You course please use the following link to book directly

For more information please contact Hayley Burgoyne at Kernow Health:

Telephone: 07881 257452

Email: hayley.burgoyne@nhs.net

Diabetes UK Learning Zone

Learning Zone will give you videos, quizzes, interactive tools which are tailored just for you. From tasty food swaps to tips about managing day-to-day, the courses are all completely free.

Healthy Living

Healthy Living is a free online NHS service for people living with type 2 diabetes, which supplies knowledge and information that will support you to manage your condition. It includes:

  • information and treatment advice
  • advice on emotional and mental wellbeing
  • advice with adopting and maintaining healthy behaviours with food and exercise

The Healthy Living programme is currently being developed but you can still sign up, start the course, and find answers to your questions. Over time you will notice changes to the way pages look and get access to more information and features, as updates to the website are based on the feedback received.

Type 1 diabetes education

Carbohydrate awareness course (Introduction to Carbohydrate Counting)

The Carbohydrate Awareness Course is a 3 ½ hour group session for people with type 1 diabetes who have been recently diagnosed or have been living with the condition for longer but would like a refresher / taster session on carbohydrate counting.

The session is delivered by a Registered Diabetes Specialist Dietitian and is designed to make learning easy and interactive. The aim of the course is to introduce the concept of carbohydrate counting and to allow you to develop the knowledge and skills relating to diabetes self-management.

The course also covers a range of other topics including management of hypos as well as how exercise and alcohol affects your diabetes. 

Referral to the course is via the secondary care diabetes team (Diabetes Consultants, Diabetes Specialist Nurses, Diabetes Specialist Dietitians)

Carbohydrate Counting Course

The Carbohydrate Counting Course is for people with type 1 diabetes who would like more in-depth education about carbohydrate counting. The course consists of 2 group education sessions, which each last 3 hours and take place 2 weeks apart.

The course is delivered jointly by a Registered Diabetes Specialist Dietitian and Diabetes Specialist Nurse and is designed to make learning easy and interactive.

The aims of the course are for you to be able to:

  • Identify the foods and drinks that contain carbohydrate and therefore impact on blood glucose levels
  • Calculate the amount of carbohydrates in a range of food and drinks using a variety of methods
  • Understand how much insulin you will need to take for the amount of carbohydrate you have eaten
  • Understand how to recognise and treat hypoglycaemia
  • Understand the other factors that impact on your blood glucose levels, including alcohol, illness and exercise
  • Gain the knowledge and skills to learn how to best manage the condition

Referral onto the course is via the secondary care diabetes team (Diabetes Consultant, Diabetes Specialist Nurse, Diabetes Specialist Dietitian)

NHS diabetes prevention programme

The Healthier You prevention programme is available to anyone who has been told by their GP or another healthcare professional that they are at risk of developing diabetes. The aim is to support people to make good lifestyle choices by giving them knowledge, ability, and confidence. The programme provides people with support meetings and information for a year. People may also benefit if they are living with another long-term condition. It is free to attend.

The programme includes information on:

  • diet
  • managing stress and your emotional wellbeing
  • physical activity
  • weight monitoring and why it is necessary

A healthcare professional from your GP practice will refer you to the national prevention programme.

Continuous Glucose Monitors (CGM)

Continuous glucose monitors or CGM, are devices that allow people with diabetes to see their (or their children’s) glucose values continuously, rather than finger pricking to test.  

The device has a sensor which is fitted under the skin. The sensors are time limited (usually 5 to 7 days) and need to be replaced regularly. The real-time monitor shows trends in glucose levels on the persons smart phone or other device.  This shows the rate of glucose change.

These devices may have alarms for high or low glucose level and depending on the model may warn of impending hypoglycaemia or hyperglycaemia by sounding alarm. Sometimes these devices are known by their manufacturers name and those commonly used are the Freestyle Libre I and II.

In Cornwall and the Isles of Scilly adults and children with type 1 diabetes should be seen by the specialist diabetes teams who can prescribe these CGM devices.  This team will assess the person, against agreed clinical criteria. Initially the device is prescribed for 6 months on a trial basis, and can be extended if the user shows benefit of this device.

CGM are not currently commissioned for people with type 2 diabetes, unless the person uses insulin and is living with a learning disability, as recorded on their GP learning disability register. 

Some CGM are more technically advanced than others and can link with insulin pumps for the purposes of managing blood glucose.  The prescribing of CGM in order for it to combine with an insulin pump is not available within the NHS in Cornwall and the Isles of Scilly. For more information see below. 

Hybrid Closed Loops

Sometimes known as an ‘artificial pancreas’, hybrid closed-loop systems work by linking insulin pumps and continuous glucose monitors (CGM) with a computer algorithm that can calculate the amount of insulin someone needs based on blood sugar readings.   This allows the system to do some of the work to help manage blood sugar levels. Manual input is still needed to alert the system when eating or doing exercise.

The NHS in Cornwall and the Isles of Scilly are expecting guidance from NICE in December 2023 that will require us to provide access to hybrid closed loop to adults and children with type 1 diabetes, who meet clinical criteria. 

The NHS will have 5 years to make this available to all people who are eligible.   This means that not everyone who is eligible will be able to get it straightaway.  We intend to carefully plan how to approach the roll out and will aim to do so in the way that offers the greatest benefit to the people with the greatest unmet need.

For further information on hybrid closed loops please see the Diabetes UK website

Insulin pumps

NHS Cornwall and Isles of Scilly pay for the cost of insulin pumps (sensor augmented pump therapy) for adults and children with type 1 diabetes, that fit the National Institute of Clinical Excellence (NICE) criteria.

Diabetes in remission

NHS Type 2 Diabetes Path to Remission Programme, provided by Counterweight

Would you like to put your type 2 diabetes into remission? If you have been diagnosed within the last 6 years you could be eligible for the free 12-month programme.

Benefits of joining the programme

  • Weight loss – 10kg average weight lost by patients on the Counterweight Plus programme.
  • Potential type 2 diabetes remission – 86% of people who achieved target weight loss achieved remission from type 2 diabetes.
  • Reduction in medication – 1 in 2 people completely stopped their diabetes medication.
  • Improved blood glucose levels.

The programme consists of 3 steps

  1. Total diet replacement (soups, shakes and porridge) – 12 weeks. Replace all food with nutritionally complete meals.
  2. Food reintroduction – 6 weeks. Stepped reintroduction to food.
  3. Weight loss maintenance – up to 1 year. Support in maintaining weight self-monitoring and reaching goals.

You will have a coach to support you throughout the programme who will guide you with making healthy food choices, as well as tailored, sustainable behaviour change techniques to ensure you feel confident maintaining your new habits.

The service is tailored to you and can be delivered either face-to-face or remotely (video call/phone call) alongside the Counterweight app or hardcopy workbook.

To check eligibility or to find out more information see the Counterweight website or speak directly to your GP practice for a referral.

Page last reviewed: 1 March 2024

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