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Long and exhausting 1st day at Newbury/Royal Berkshire Show

Up at 5am to get everything organised, though in reality public didn’t really start to arrive until 9am.  Got through 140 QDiabetes assessments, loads of advice and health promotion and three new diagnoses of Diabetes.

Some people really seemed to like and get the idea of future risk and interpreting into what actions might be possible to change things…  Others reported “oh I’ve had a recent blood test so I am OK” and therefore struggled with the idea of prevention…

Strange mixture of worried well, and unworried unwell!  Highest risk of the day about 50%

Roll on Sunday!

PreDM project stand at Newbury Show

newburyshow

We have had our final planning meeting and full steam ahead for the show, looking forward to a sunny weekend according to the forecast.  Come and see us on Stand 301 south of the main showground arena (towards the funfair corner).  We are looking to screen as many people as possible (age 25-84 who haven’t already got diabetes) using the QDiabetes tool and then offering enrollment and advice from the Eat4Health team and on the spot HbA1c screening for diabetes via a finger prick test.  The HbA1c test tells us what you blood sugar has been like over the last 3 months.

We will post our results here.

Newbury PreDM project comes to Royal Berkshire Show

newburyshow

As part of our project to promote early intervention for Diabetes to the Newbury and District CCG area, we have managed to get a trade stand at the Royal Berkshire Show 21-22nd September 2013 in Newbury.  This is a fantastic chance to spread the word to the anticipated 60,000 attendees many of whom may be from rural and isolated farming communities.

We are looking to offer QDiabetes Screening via iPads associated with Eat4Health advice and Point Of Care Diabetic Screening.  Come and see us there and check out your diabetic risks.

Interview transcript from Paul Coia Show on BBC Radio Berkshire 27th August 2013

 

5.16 pm—Paul Coia

Now doctors in West Berkshire say the chance of getting diabetes can be cut by as much as half if people take part in a ground-breaking new scheme. A pilot is taking place where they are scoring people’s chances of getting the condition by looking at their family history, their lifestyle and blood sugar levels. The risk of heart disease and stroke is also reduced by the scheme.

And one man from Newbury who has seen it working close up is Martyn Williamson

Paul Coia: Hi there Martin,

MW: Hi there, Paul.

PC: Not only have you seen it close up, you have seen it closer than anybody could. You were one of the victims in all this. You actually had problems with your medical conditions. Didn’t you?

MW: Number of difficulties, yes, that’s right.

PC: When did you realise that you might be at risk of diabetes.

MW: To be perfectly honest, Paul, I never considered diabetes ..I have got one or two other issues. I had a letter from Dr West, our GP. Basically, if I cut to the chase, he said, we have estimated that you have higher than average risk of developing diabetes and we estimate your personal risk to be 32.4 percent over the next 10 years. It was a wakeup call, if you know what I mean.

PC: Definitely, how did you feel seeing that then?

MW: Old.

PC: May I ask how old you are?

MW: I will be 68 on Thursday. I don’t feel 68 but there we are

PC: No, no, you should feel young and you are quite right especially when you have been given a second chance. You got this wake up call. Presumably your doctor then referred you to this pilot scheme.

MW: The letter then goes on to say We would like you to consider doing the following: One of them is attend a tailored 3-month lifestyle intervention course called Eat4Health. And that was indeed the course I went on.

PC: So what does that involve?

MW: Well, it’s over 10 weeks. We met on Friday evenings for couple of hours, and each week takes one particular topic. Would be interested in knowing the topics..? Behaviour change was one week, healthy eating was another session, goals and rewards, physical activity internal and external triggers –that’s for road eating, fats and sugars food labelling, dealing with evening outs and takeaways and of course, alcohol.

PC: Oh dear. See if I went along they would be ashamed of me, because I love all that, I love grazing, I love the curries, I love a pint of lager now and again.

MW: We get on really well then Paul.

Both giggle

PC: I probably will look at the list of dos and don’ts very good but probably, forget it. What made you follow the advice?

MW: That’s interesting because that would have been under normal circumstances the reaction you had just described would have been me. However, there are number of things that have triggered me to want to do something as a matter of some urgency about weight and lifestyle. One of them is..I have got two artificial hips. Whilst my mobility is much better than it was it still could improve I had noticed that my own attempts had a marked effect on my mobility. So I was really really anxious to give this my best shot. There was that and the fact that I didn’t particularly fancy having diabetes. I know I have a few heart problems. How could I not want to do it?

PC: Be honest and forgive the impertinence of the question, but would you describe yourself as a bit lardy.

MW: Errr…errmm….heading that way, yes. It hurts to say it you know, but yes.

PC: Do you have people around you who were saying you know Martyn you pulling the pants now; you are looking a bit chubbed up.

MW: It has been said, not actually in those words but the inference was there.

PC: You probably wouldn’t have listened to that but this medical advice made a difference to you. Tell me the difference it has made to your life.

MW: Well, I can give you one concrete example. One of my pleasures in life is to walk around the local Penn woods with my dog.  I hadn’t done that in five years. I now do it every morning.

PC: Brilliant. That’s fantastic. So would you recommend this scheme to other people?

MW: Yes, I would. The only proviso I would say is like anything that involves a small element of will power it’s only going to work if you really wanted to. I really wanted to and everyone else who was on the course did as well. It was a success.. As such it gets a 10 out 10 from me.

PC: Brilliant and this is the first in the country apparently.  Could be the first of many more. It’s great that it made a difference to you and presumably if anybody thinks they can benefit from this in the area, they can talk to their GP.

MW: So I understand, yes. I just wish I had heard of this, years ago. It’s life changing.

PC: What a great recommendation! Martyn Williamson, thank you very much indeed. Martyn Williamson, as he said, had his life turned around by the new initiative of Newbury and District Clinical Commissioning Group.

 

PreDM project : first results in

We have now completed the first cohort of patients through the PreDM intervention. Altogether 250 patients were invited to participate.  Although the classes were well subscribed there was a fairly high initial drop out rate at/before commencement.  However we are delighted that 37 people completed the 10 week course.

However what is astounding are the achievements of the group.  Together they lost a total of 110Kg, or 17 and a half stone.  This equates to about the average starting weight per person for the group.  We have also noticed a drop in resting heart rate of around 5 bpm.  We are now looking to analyse the blood results.

We are aware of 5 new diagnoses of Diabetes Mellitus found in the initial blood tests and are awaiting further results to confirm the numbers of IGT etc.

PreDM: Working with QDiabetes and non EmisWEB practices.

QDiabetes has already been integrated into EmisWEB.  In order to roll out the PreDM programme across the CCG we have been working with practices using LV and INPS to create extractions of data from their clinical systems.  These can be run through an Excel spreadsheet and formatted into a file that is compatible with the QDiabetes Batch Processor available from Clinrisk

We have been able to create a list of patients in a similar way as we have done within EmisWEB, and selected a similar list of 50 patients suitable for recruiting into the project from INPS and EmisLV practices.

We hope to develop a similar extraction shortly from SystmOne practices.

First tranche of PreDM sessions completed

The first group of sessions of Eat4Health has now concluded.  Initial invites went out to 250 selected patients at 5 (EmisWEB) surgeries, and we had approximately a 20% response to the sessions.

We know we have already picked up 4 previously undetected Diabetics (mainly based on HbA1c > 48) and suspect at least double that number will turn out to have IGT/IFG.  Although this is a worthwhile outcome in itself it is not the point of the project, which is to try and intervene before the point of diagnosis.

Once the post intervention bloods and measurements have been collated we can then identify the actual numbers of IGT/IFG.