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18 February 2019

Update from the Community Diabetes Dietitians Teams

Who we are

The Community Diabetes Dietitians Team works across Cambridgeshire and Peterborough and are based in the following locations:

  • East Cambs and Fenland – Jane Green (Jane.Green@cpft.nhs.uk), please be aware Jane is in addition to the Integrated Diabetes Team based in Doddington.                       

 

Clinics

The Diabetes Dietitians have been setting up new clinics within GP Practices across Cambridge, Huntingdon and Peterborough and a list of current clinic locations is attached.

If there is not currently a clinic at your surgery and you are keen to get one set up please let your local Diabetes Dietitian know on the contact details above and we will try to accommodate this if possible.

Please be aware that, within East Cambs and Fenland, our team are not currently setting up clinics as the service in that area is run by the Integrated Diabetes Team.

A reminder to those practices that we provide a clinic in, please say to patients that they MAY be seen in the surgery. However this is not guaranteed as this will depend on our triaging criteria and which dietitian is most appropriate to see them.

Examples of Patients Who May Benefit from Referral to a Diabetes Dietitian

All patients referred to a Dietitian will receive personalised advice and support, which is evidenced-based and tailored to their individual needs.  The following are some examples of who you might refer:

  • Patients who have attended DESMOND but require further support with their diet with regards to their diabetes management

  • Patients who need carbohydrate awareness advice (such as those on fixed insulin doses)

  • Patients who require carbohydrate counting advice (please consider whether referral to a carbohydrate counting group i.e. DAFNE / PDAC would be more appropriate first

  • Patients who have previously attended a carbohydrate counting group that need further support

  • Patients in which you are considering starting GLP-1 therapy

  • Patients who are on triple therapy that may benefit from making lifestyle changes

  • Patients in which you are considering intensifying diabetes medication that may benefit from making lifestyle changes

  • Patients who want more information on, for example, low carbohydrate / very low calorie diets.

The dietetics referral form is here.

Referral Criteria

The team have also been streamlining their inclusion criteria and are now only accepting referrals for patients who meet the following requirements:

  • Patients with an HbA1c below 53mmol/mol (that are treated with diabetes medications other than Metformin alone)

  • Patients with an HbA1c above 53mmol/mol

Patients with an HbA1c below 53mmol/mol

Patients with Type 2 Diabetes who have an HbA1c below 53mmol/mol, and who are not prescribed any diabetes medications or are treated with Metformin only, will be returned to the referrer.

It is recommended that these patients attend DESMOND if they require dietary advice for diabetes or their local weight management service if they require weight reducing advice.

Patients who require dietary advice for their diabetes, but are unable to attend the DESMOND (Diabetes Education and Self-Management for Ongoing and Newly Diagnosed) programme, due to, for example, a language barrier or anxiety in group settings, will still be accepted if this is clearly document on the referral.

Patients with an HbA1c above 53mmol/mol

If a patient has an HbA1c above 53mmol/mol but they have not previously attended DESMOND, please consider whether it would be more appropriate to refer them to this in the first instance, before referring to Dietetics.

If a patient requires dietary advice for their weight but is unable to attend their local weight management service, please consider whether referral to specialist weight management services would be appropriate.

Referrals for Pre-Diabetes will also be returned to the referrer, as they should be directed to the National Diabetes Prevention Programme, ‘Healthier You’.               

Promotion

The team are also keen to promote dietetic services for patients with diabetes and have created a poster (attached) which can be displayed in surgeries to spread the word.

Furthermore, the team are more than happy to attend VCRs, practice visits and lunch time meetings.  Please contact your local Diabetes Dietitian with any requests and we will try to accommodate them if possible.

DESMOND

The ‘Taking Control’ campaign by Diabetes UK, recognises that patients are more likely to attend an education course if their healthcare professional is positive and enthusiastic about the benefits of education.  It is important to make it clear that you believe attending a course is an essential part of their diabetes management.

One way to make the most of how this message is put across is to shadow a session yourself, to get a better idea of the format and information that is provided.

Part of the role of the Diabetes Dietitians is to co-deliver DESMOND and the team have had a variety of staff, including GPs and practice nurses, shadowing the course and have had lots of positive feedback.

The team would therefore like to strongly encourage more practice staff, in particular those who regularly refer patients into the programme, to shadow a session if they have not done so already.

Contact the DESMOND coordinator in your area on 0330 726 0077 if you would like to observe a session.

The following link also takes you to the DESMOND YouTube channel, which has a promotional video about DESMOND, available in 5 languages.  If you have a video screen in your surgery’s waiting room this may be useful to display to encourage patients to attend.

https://www.youtube.com/channel/UCk3CUZJkpXFbEGZwAs3UI7Q

In Summary

The Community Diabetes Dietitians Team have been getting some great feedback from patients, saying that they have benefitted from the information which has helped to guide and support them, in making changes to look after their diabetes.

As a team, we look forward to continuing to work closely with you, to support better care and to drive improved outcomes for all of our patients with diabetes.  

Diabetes bulletin 18 February 2019