Voices: The message to those of us with diabetes is: you’re on your own

·5-min read
Type 1 can muck you up every bit as effectively as, well, Covid (Getty Images)
Type 1 can muck you up every bit as effectively as, well, Covid (Getty Images)

The letter from Whipps Cross Hospital came as no surprise: my regular check-up for type 1 autoimmune diabetes had been cancelled. For the second time.

It was supposed to be a phone consultation and it goes without saying that these are vastly inferior to seeing the doctor in person. Another fresh call has been scheduled for March 2023, which will be nearly two years since my last contact. I’m putting the odds of it actually going ahead at, hmmm, shall we say 10/1? That’s an implied probability of 9.1 per cent. Sounds about right to me.

The fact that I managed a lone phone call over the course of the pandemic for what is a serious condition, albeit relatively well controlled in my case, actually counts me as one of the lucky ones.

When Diabetes UK ran an online survey among people living with either type 1 or type 2 diabetes at the beginning of the year, it found that one in six had had no contact whatsoever with their healthcare teams since before the pandemic.

Only a minority (36 per cent) had received all their recommended care checks in 2020-21 (the lucky ducks) compared to 57 per cent during the prior year.

Almost half (47 per cent) experienced difficulties with managing their condition in 2021. Almost two-thirds of those (63 per cent) attributed this, in part, to not having sufficient access to their healthcare teams. This rose to 71 per cent in the most deprived areas of the country. There’s a postcode lottery at work here and it won’t surprise you to learn that those in poorer areas fare worse. So much for “levelling up”, eh, Michael Gove? You really are the minister for meaningless slogans.

It seems clear that the message to those of us with diabetes, regardless of the type, is “you’re on your own, kiddo”.

I can live with that. I’ve found hospital appointments to be a somewhat unedifying experience at best and I’m fortunate enough to have a first-rate GP, who monitors my blood sugars and has been pleased with my results.

I do most of the stuff you’re supposed to do (no one does it all). I prick my finger several times a day like a good little human pin cushion. I keep an eye on my carbs. I take my medication. I’m confident with adjusting my insulin. I’ve adapted to a new variety with zero input from the hospital, which prescribed it and left me to it. Granted, this was somewhat nerve-racking, but the stuff works great, so no harm done. I’m lucky.

Some aren’t.

Some people with type 1 do all that stuff and still have to cope with sugar levels that ping around like the stock market after one of Boris Johnson’s more economically illiterate speeches.

Some people with type 2, which works very differently, might be able to control their condition simply through diet if they could just get the right support, as Labour’s former deputy leader Tom Watson did.

As I’ve pointed out, diabetes, regardless of cause (in my case, my immune system killing my insulin-producing cells), and type 1 is a serious condition. It has the capacity to muck you up every bit as effectively as, well, Covid. And I’m not kidding.

Complications can include blindness, amputation, heart problems, strokes, kidney failure, neuropathic pain. There’s more human misery in diabetes complications than you’d find in one of those EastEnders marathons that occasionally run on small cable TV channels, which somehow cling on in the age of Netflix and are a good excuse for turning off the goggle box and doing something less depressing instead.

A government made up of decent, fair-minded, compassionate people would recognise that there is a problem here in need of addressing but, of course…

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So shall we put it in terms that might register with the morally addled minds of ministers? Treating those complications, and the others I could have listed had my head not started to ache when I looked at the list, costs a bloody fortune.

Something like 10 per cent of the NHS budget goes on diabetes, but around 80 per cent of that is spent on complications which can be avoided.

If you can reduce the level of them – an eminently achievable goal – you can dramatically reduce the cost. Everyone wins.

Trouble is, you’re not going to do that if the rubbishy phone appointments people are offered get cancelled and then cancelled again, and if large numbers of people can’t access the medical help and advice they need.

“Devastating,” is how Diabetes UK described the situation, which I would describe as scandalous. And both might be an example of that British habit of understatement people like to talk about.

Here’s the really troubling thing about all this.

It isn’t just diabetes this is affecting. Humans suffer from any number of chronic conditions. They all have their own icky lists of complications, which are similarly difficult and expensive to treat if they’re not picked up on early enough.

Upon the release of its report, Diabetes UK called for a recovery plan to be put together. Perhaps someone might like to have a word in the health secretary’s shell-like? Their department’s going to pay an enormous price if they don’t wake up to the problem.

But patients will pay a still higher one.

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