Teenagers with diabetes ‘falling through system’

Scotland has the third highest incidence of Type 1 diabetes in the world
Scotland has the third highest incidence of Type 1 diabetes in the world
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HEALTH experts are calling for a major shift in care for teenage Scots with Type 1 diabetes amid concerns that they are falling through gaps in the system.

When they move to adult care – usually between the ages of 16 and 18 – some 30 per cent of them drop out of the NHS treatment system in Scotland. This in turn puts them at greater risk of complications such as kidney disease, stroke and amputation.

Sarah Strachan. Picture: Phil Wilkinson

Sarah Strachan. Picture: Phil Wilkinson

Type 1 diabetes occurs when the body cannot produce insulin and is not linked to lifestyle factors or weight.

Scots with Type 1 diabetes receive poorer care than those with Type 2, as 91.3 per cent received a crucial monitoring check in 2014 compared to 94.3 per cent of people with Type 2.

Diabetes professionals will call for the implementation of a pioneering Dutch model which runs up to the age of 25, at the Diabetes Scotland conference in Glasgow this week.

Pioneered by leading expert Dr Henk Veeze, the Diabeter clinic, in Rotterdam, is solely for under-25s with Type 1 diabetes who are in constant contact with doctors through electronic monitoring and tele-health services.

Dr Kenneth Robertson, a consultant paediatrician for NHS Greater Glasgow and Clyde, which looks after more than 700 diabetic patients, said: “We also really see young people disengaging from health services, which is
not unique to diabetes, but it has exceptionally bad consequences.

Dr Robertson called for Scotland to follow the Diabeter model by moving diabetes care out of hospitals.

Scotland has the third highest incidence of Type 1 diabetes in the world and NHS Scotland spends £1bn annually on treating complications, most of which are avoidable.

A presentation on “The Glasgow Experience” will look at how the city can combat its particularly high levels of diabetes, which directly or indirectly affects more than 200,000 Glaswegians.

Jane-Claire Judson, director of Diabetes Scotland, said: “Scotland is behind the rest of Europe in terms of the care delivered to young people.

“The Dutch have a holistic approach. We are looking at how we can deliver that here.

“Diabetes is a significant condition, particularly in Glasgow, and it is really tied to deprivation and health inequalities.”

‘At 16 you are expected to deal with it all on your own’

SARAH Strachan from Dundee was diagnosed with Type 1 diabetes aged ten. Now 20, she admits the first few years were challenging.

Strachan, who is starting a psychology degree at Dundee University this year, said: “My family had no knowledge of it and I didn’t know anyone with diabetes at that time.

“I found the doctors were good in terms of getting medical advice but what could have been really helpful would be advice on social matters to do with Type 1.

“There’s so much you have to consider about going out for a meal or what to do when you are ill and you have diabetes.”

Strachan visited the Diabeter clinic in Rotterdam earlier this year as part of a team from Scotland. She was impressed by its flexible and innovative approach.

She said: “It’s about more than just getting insulin and checking your blood sugar levels. Diabetes can be quite stressful.

“When you are receiving diabetes care in children’s services, often you are with your parents who are absorbing lots of information. Suddenly when you are 16 you are expected to deal with it all on your own.”

Scotland is lagging behind on the emotional and psychological support offered after diagnosis, she said.

She said: “In the early stages after diagnosis I found it quite difficult. Access to support groups or even social groups involved with Type 1 would have helped.”

More training for staff in dealing with teenagers could help as young people can feel judged if their blood sugar readings are not what they should be, Strachan added.