Diabetes

Diagnosing and Classifying Diabetes for Primary Care

Overview: Diagnosis of type 1 diabetes is most often done when presenting with osmotic symptoms. A majority of type 2 diabetes are also recognised on routine testing. There may be some complex scenarios where the type of diabetes cannot be established on first visit. The diagnosis will impact on the choice of interventions made. The increased awareness of rare types like genetic diabetes, if diagnosed right, can make huge difference to patient outcomes.

Learning Outcomes: We discuss case-based scenarios with diagnostic criteria for diabetes and when to consider rare forms of diagnosis. 

Speaker: Dr Vinay Eligar, Consultant in Diabetes and Endocrinology and Deputy Clinical Lead for Diabetes, Cardiff & Vale UHB.  

Facilitated by: Dr Nimish Shah GP CPD Lead.

Transcript

Recorded: October 2021  Duration: 38 Minutes

Insulin Resistance and Prediabetes

Overview: Prevention is better than cure! 

Join this recorded webinar to uncover the metabolic changes that occur in the decades before the symptoms of Type 2 Diabetes occur. 

Insulin resistance underpins many chronic diseases; from hypertension to polycystic ovarian disease, from obesity to dementia and most notably Type 2 Diabetes. Yet it is largely unknown and unidentified amongst healthcare professionals. We aim to unpick the signs, understand the importance and identify the patients at risk. Within this session we will understand why looking for the root cause of disease is critical in its management.

Learning Outcomes: A session designed for busy GPs; we discuss how to implement important lifestyle measures to be delivered in minutes in an attempt to halt the development of Type 2 Diabetes

Speaker: Dr Nerys Frater, GP. Hywel Dda UHB.  

Facilitated by: Dr David Lupton CPD Lead.

Transcript   

Recorded: November 2021 Duration: 52 Minutes

Remission of Diabetes

Overview: Join us for a webinar to uncover the exciting world of Type 2 Diabetes remission! In a session designed for busy GP's we delve into the research driving change to uncover new ways of thinking and the possibility of aiming for cure for a previously uncurable disease! From bariatric surgery, to the ‘shake diet’ to therapeutic carbohydrate restriction we aim to gain a better understanding of each with the theory to underpin it. With 1 in 10 individuals set to develop type 2 diabetes by 2034 there has never been a more important time to tackle this debilitating illness. Having the understanding to know what’s achievable is a key part of this mission. 

Learning Outcomes: We discuss the work that’s already going on in Wales, what GP’s can do and what can really be expected.

Speaker: Dr Nerys Frater, GP. Hywel Dda UHB. 

Facilitated by: Dr Nicola Flower GP CPD Lead.

Transcript

Recorded: January 2022  Duration: 42 Minutes

Cardiovascular Risk in Diabetes

Overview: We are all aware that the management of type 2 diabetes goes well beyond glycaemic control.  People living with diabetes are twice as likely to have a CV event than people without, and these events are often premature.  Assessment and effective reduction of CV risk is an important part of managing diabetes in primary care. 

Learning Outcomes: In this recorded webinar, we cover CV assessment in diabetes, update on hypertension and lipid management in the setting of type 2 diabetes and discuss the role of some of the newer treatments here as well.

Speaker: Dr Sarah Davies GP, Cardiff & Vale UHB PCIC Clinical Director for Diabetes, All Wales lead for Diabetes in Primary Care and Diabetes UK Clinical Champion.

Transcript

Facilitated by: Dr Nimish Shah GP CPD Lead.

Recorded: February 2022  Duration: 51 Minutes

Type 2 Diabetes NICE Guidelines Update

Overview: The NICE Guidelines for the management of Type 2 diabetes in adults (NG28) had a significant update in February 2022.

Learning outcomes: In this recorded webinar, we look at the changes to the NICE guidelines, the rationale and how to implement these changes into our clinical practice.

Speaker: Dr Sarah Davies GP, Cardiff & Vale UHB PCIC Clinical Director for Diabetes, All Wales lead for Diabetes in Primary Care and Diabetes UK Clinical Champion.

Facilitated by: Dr Nimish Shah GP CPD Lead.

Transcript

Recorded: March 2022  Duration: 54 Minutes

Insulin management

Overview: The availability of insulin as a treatment for diabetes is now in its centenary year, which should confer a high degree health professional confidence to use safely and effectively. However, a perception of mystery and art to insulin management exists in clinical practice that can often create delays to initiating and adjusting this very effective treatment for diabetes.

We will explore indications and top tips for insulin initiation and insulin dose adjustment in the Primary Care setting.

Learning outcomes: In a session designed for busy primary care practitioners, we explore insulin therapy, including newer insulin products and where they sit within a wider choice of glucose lowering therapies to support effective diabetes management.

Speaker: Julie Lewis, Primary Care Nurse Consultant, BCUHB.

Facilitated by: Dr David Lupton GP CPD Lead.

Recorded: March 2022  Duration: 73 Minutes

Diabetes and Eye Disease

Overview: Diabetes can lead to microvascular complications such as diabetic retinopathy. Diabetic retinopathy is an avoidable cause of blindness. Loss of vision is one of the most feared complications for people with diabetes. However, with effective diabetes, blood pressure and cholesterol management, early detection through screening and improved treatments the onset of diabetic retinopathy can be prevented and delayed and sight loss reduced for most people.  

Learning Outcomes: In this recorded webinar, we cover:

• Screening for diabetic retinopathy
• Management of diabetes, blood pressure and cholesterol to reduce the risk of development of diabetic retinopathy
• Effects of newer diabetes medications on the development of diabetic retinopathy

Speaker: Dr Rebecca Thomas, Senior Research Officer (Retinopathy), Informatics Lead Diabetes Research Unit Cymru, Co-Programme Director MSc Diabetes Practice at Swansea University

Facilitated by: Dr Nimish Shah GP CPD Lead.

Recorded: March 2022  Duration: 44 Minutes

Prevention of Diabetic Foot Disease: A Primary and Community Care Approach

Overview: Diabetic foot disease is a massive problem.  We have the narrative being produced by Diabetes UK which says there are over 7,000 diabetes related amputations (leg, foot or toe) every year in the UK; more than 135 a week are carried out. We also know diabetic foot disease is the most common cause of diabetes-related hospital admission. And we know at any one stage, 18% of patients admitted to hospital have diabetes. Diabetic foot disease is normally the main cause of the complications. The cost to the NHS is vast. Foot ulcers and amputations impact hugely on morbidity, mortality and the quality of life for people with diabetes.

Learning Outcomes: In this recorded webinar we look at a partnership approach to the prevention of diabetic foot disease and answer these questions: Where are we? What are we looking at? What have we been measuring from a primary care point of view and what is the NDA data showing us? What should we do? How do we go about identifying those people who are at risk? What should we be looking out for? What are the red flags? Where are we going? What are we trying to achieve in Wales and how does it fit in with the national strategies?

Speakers: Scott Cawley MBE HCPC, RCOP National Diabetic Foot Co-Ordinator for Wales Cardiff and Vale UHB

Vanessa Goulding BSc (Hons), MSc, HCPC, RCOP Professional Lead Podiatrist, Honorary Tutor Cardiff and Vale UHB

Recorded: April 2022  Duration: 46 Minutes

Diabetes and Renal Disease

Overview: Diabetes can lead to microvascular complications such as diabetic nephropathy. Diabetic nephropathy is the leading cause of chronic kidney disease in the developed world. In the last 5 years, there have been major advances in the treatment of this condition with the introduction of multifunctional cardiometabolic agents such as SGLT2-inhibitors.

Learning outcomes: In this recorded webinar we cover:

• General investigation and management of diabetic kidney disease and when to refer to secondary care
• The interplay between cardiorenal metabolic medicine in diabetes
• Effects of newer diabetes medications on the modulation of diabetic kidney disease progression and cardiovascular risk, with focus on SGLT2i implementation

Speaker: Dr Alexa Wonnacott, Consultant in Renal Medicine and Honorary Senior Lecturer, CAV UHB.

Facilitated by: Dr Nimish Shah GP CPD Lead.

Recorded: May 2022  Duration: 53 Minutes

Diabetes and the Elderly

Overview: Diabetes can be challenging but particularly so in the elderly population who may have co morbidities; mental health issues such as dementia; frailty; diminished functional ability; social issues and then polypharmacy. This often causes a real dilemma in the management and care of these patients.

Learning outcomes:  In this recorded webinar we explore indications and top tips for supporting and managing the elderly population living with diabetes in the Primary Care setting.

This session is designed for busy primary care practitioners. We explore issues such as HbA1c targets; identifying those at risk of hypo and hyperglycaemia and frailty. We discuss practical tips around functional ability to promote self-management and independence whilst identifying those at risk who may require further support where we may be looking at symptom control and quality rather than quantity of life.

Speaker: Chris Cottrell, Diabetes Specialist Nurse and Lead for Diabetes Education & ThinkGlucose,SBUHB.

Facilitated by: Dr Chris Price, Head of Revalidation Support Unit, HEIW.

Recorded: April 2022  Duration: 54 Minutes