NHS England London is having a monthly focus on diabetes through July, with the aim of raising the profile of the work going on inside the NHS to treat the condition.

We spoke to one of NELFT’s specialist diabetes dietitians Julie Taplin, who works in a team of 12 clinical staff in Basildon that provides support for approximately 24,000 people with diabetes and receives around 500 referrals a month. We took the opportunity to find out what a typical week is like for Julie:

Monday – Newly diagnosed

I saw a 75-year old gentleman who was diagnosed a month ago. He arrived with his wife, as she does the meal planning and cooking. Like most newly diagnosed he wanted to know what he could and could not eat. We discussed his typical diet and addressed some concerns and portions sizes. When it came to fruit I gritted my teeth as he said ‘I was told I can’t eat bananas’. I wish I had £1 for every time someone had been told that. After assuring him he could eat bananas as long as it was only a small snack-size one I offered him the opportunity to attend our type 2 structured education group.

Tuesday - MDT working

A long-standing patient came for a review today. She has type 2 diabetes - which is controlled by insulin only. This is because she also has Crohn’s and found that many of the diabetes medications upset her digestive system. She is aiming to lose some weight, so we looked at the range of foods that we know she can tolerate and how we could reduce calorie intake without compromising nutritional value. We then called in the diabetes specialist nurse to discuss changes she may need to make to her insulin regimen to avoid having blood glucose lows (hypos).

Wednesday – Home visit

I had a call from a lady worried about her mother who was recently out of hospital, wasn’t eating well and had lost a significant amount of weight. They wanted advice on ways to increase her weight and appetite, but not increase her blood glucose levels. Luckily, the lady drank milk and liked cheese and butter. This meant that I could encourage her to swap to whole fat milk for cereals and in drinks and also add extra cheese, butter, oil and cream to her meals. We call this food fortification and it is used as a first line treatment to help with weight gain before using supplements. I have arranged to see or speak to her again in two weeks.

Thursday – Group education

I taught our new Type 2 Advanced Medication Programme. We developed this group for our patients with type 2 who have attended our newly diagnosed programme and would now like a refresher on diabetes-related topics and are also on a lot more medication. The aim of the session is to look at the different medications, how they work and when to take them. From a dietary perspective, we look a lot more at the types and amounts of carbohydrates they are eating and if they are able to see a relationship between high intakes of carbs and high blood glucose levels. The session was held from 5pm to 8pm to try and increase access for working people.

Friday – Motivational interviewing

A gentleman had requested to see me as he had been warned he may need to go on to insulin. He was aware that if he lost weight he may be able to delay this process. He was very honest in describing his poor habits. One of which was snacking while watching TV at night. Using some motivational interviewing techniques he was able to identify the pros and cons of cutting out or changing these snacks to lower calorie options we then looked at how to overcome any barriers and finally he set himself a weight loss goal which he agreed he would monitor but also email me weekly to advise me of his progress. Sadly, I can’t see people weekly for this support due to a lack of time but I am happy to review people by phone or email if asked.

For further information about diabetes services available in the localities, visit: www.nelft.nhs.uk/our-services

For information about diabetes, you can access the website of the charity Diabetes UK here

Pictured are Julie Taplin (on the left) and the team at Craylands Clinic.