Diabetes information for patients

What is Diabetes?

Diabetes occurs when the pancreas fails to make insulin, unable to make enough, or the insulin produced does not work properly. It is a condition that causes blood glucose (sugar) levels to be too high. Glucose enters our blood stream as a result of us eating carbohydrate foods and carbohydrate containing drinks. Insulin is a hormone made in the pancreas that allows the glucose in our blood to enter our body cells to be used as a source of energy/fuel.

Watch this short video from Diabetes UK: 'What is Diabetes?' (opens in a new tab)

Diabetes types

The three main types of diabetes are type 1, type 2 and gestational diabetes.

Other types of diabetes

There are also more rare forms of diabetes beyond type 1, type 2 and gestational diabetes. The rare forms of diabetes make up around 2% of all people with diabetes.

This includes cystic fibrosis related diabetes, monogenic diabetes, type 3c diabetes and diabetes caused by rare syndromes.

Further information can be found on the Diabetes UK website (opens in a new tab).

Patient education programs

Type 1 Diabetes Structured Education: DAFNE

Diabetes courses are encouraged for all with type 1 diabetes no matter how long you have had it. People who have completed structured education have more stable blood glucose levels and fewer diabetes related complications as well as seeing improvements in their mental wellbeing and overall quality of life.

Addenbrooke’s diabetes clinic offers the Dose Adjustment For Normal Eating (DAFNE) group structured education for type 1 diabetes (T1DM). DAFNE has been running at Addenbrooke's since 2002.

About the course

The course based around group work, sharing and comparing experiences with the group members. However, there are opportunities for each person to speak to DAFNE educators individually.

DAFNE allows people to fit diabetes into their lifestyle, rather than changing their lifestyle to fit in with their diabetes.

DAFNE has been proven to:

Improve general wellbeing
Improve treatment satisfaction
Improve dietary freedom
Reduce the frequency of hypoglycaemia
Improve overall glucose control (HbA1c)

Course format

The course is delivered in different formats:

Over 5 days (Monday to Friday within the same week)
Over 5 days (One day a week for 5 consecutive weeks)
Over 5 days specifically for insulin pump users

To a group of up to 8 people with T1DM, with a follow up 6-8 weeks after the course finishes. The course is delivered by a diabetes specialist nurse and diabetes specialist dietitian as well as input from a diabetes consultant.

Click here to read about how DAFNE can help you. (opens in a new tab)

See this video on the DAFNE course (opens in a new tab).

Course Location

Courses are held within the Diabetes Clinic at CUH. We may also hold courses in the community setting, such as in Ely.

Contact us:

Telephone: 01223 348781
Email the DAFNE administrator

Key personnel

Lead DAFNE Dietitian: Sarah Donald
Lead DAFNE Nurse: Caroline Byrne
DAFNE administrator: Allison Housden

Resources

DAFNE Online (opens in a new tab)

Online community of DAFNE graduates, health care professionals, management and friends and family of those with type 1 diabetes. Here you’ll find online blood glucose diaries, app information, DAFNE online forums, carb portion list information and even access the latest version if the DAFNE course handbook.

Type 2 structured information: DESMOND

In Cambridgeshire, DESMOND (opens in a new tab) is offered for people newly diagnosed with type 2 diabetes, or those with type 2 diabetes who wish to have further information on how to manage their diabetes.

DESMOND is also offered in: Bedfordshire, Great Yarmouth and Waveney, Hertfordshire, Luton, East Suffolk and North Essex.

If you live outside of the above areas, please enquire with your local GP surgery what type 2 diabetes structured education is available for you locally.

An overview of what is covered in DESMOND:

Thoughts and feelings of the participants around diabetes
Understanding diabetes and glucose: what happens in the body
Understanding the risk factors and complications associated with diabetes
Understanding more about monitoring and medication
How to take control – food choices – physical activity
Planning for the future

DESMOND group courses are run countywide and you can either be referred via your GP surgery or if you are able to then you can self refer on the DESMOND website (opens in a new tab).

If you are admitted

Handy tips for patients

If on insulin:

Mealtime insulin should be given before meals and the meal should contain carbohydrate (e.g. bread, cereals, rice, pasta, potatoes)
If the meal has arrived and insulin has not been given, please inform the nurse.
Never miss the basal/background/long acting insulin unless specifically advised by the doctors.
If the blood glucose level before bed is less than 8 mmol/L, consider having a small bedtime snack containing carbohydrate such as two digestive biscuits or one slice of toast.
A carbohydrate counting guide for hospital meals is available upon request.

If on tablets:

Metformin should be taken with/after meals
All other diabetes tablets should be taken before food

If not eating, discuss with the nursing staff before taking any medication.

How to contact us during admission

If you have any concerns about your diabetes management in relation to your hospital admission, you can request a DOT review during the admission by asking the nurses or the medical team to contact us.

On discharge

It is advisable to make contact with your usual diabetes healthcare professional, such as the GP or community diabetes specialist nurse, soon after discharge especially if any changes have been made to the diabetes management in hospital.

The blood glucose control may be more variable
On-going adjustments may be needed to further optimise control in the home setting
Adjustments may be needed in response to on-going changes in the doses of other medications
Changes made in hospital to cope with illness will need review/modification as you return to health

Your usual diabetes healthcare provider can support you with all these. More specific advice, if needed, will be given by a DOT member before discharge.

If we feel that you will benefit from further support following discharge we will offer you telephone follow up (up to 2 calls) and ensure your community diabetes specialist nurse/GP is aware of changes made during admission or to alert to any on-going review needs.