DIABETES NEWS
SPRING 2016
Local News from the Children’s and
Young People’s Diabetes Clinic
at the Oxford Children’s & Horton
Hospitals
CLINIC NEWS Dr Julie Edge Retires As you all know, Dr Edge will be retiring from her post as Lead Consultant in Paediatric Diabetes with the Oxfordshire Children’s Diabetes Service after more than 20 years. We hope you all received her letter sent out with the clinic newsletter in December. We are all going to miss her very much. She has been an inspirational leader of our service for a long time and has made an enormous contribution to improving the care of children with Type 1 diabetes, both locally and nationally. Her leadership has seen the number of staff employed to care for children with diabetes in Oxfordshire increase from 1 doctor, 2 diabetes nurses and half a dietitian to a team of 15 of us! She has overseen the continuous improvement in measures of diabetes control (HbA1c) which averaged 80 mmol/mol (9.5%) in 1995, when we had about 100 children in the service, to an average of 59.9 mmol/mol (7.7%) with 350 + children in the service; an achievement not replicated across the whole country and one which the whole team is proud. As good management of diabetes required more frequent injections, it meant children needed help at school. She worked for many years with the local Education Authority to develop the training of school staff to care for children with diabetes, which allowed them to fully participate in school life and manage their diabetes. This was pioneering at the time but, fortunately, is now replicated across most of the country. She has worked with the Department of Health and NICE (National Institute for Clinical Excellence), she has promoted improvements in diabetes care at international meetings and she has fought tirelessly for our local service, all alongside her day‐to‐day clinical work at the Children’s Hospital. At the heart of everything she has done has been her determination to see children with diabetes achieve their potential, be happy and live a long and healthy life. We wish her a very happy and healthy retirement. Introducing Dr Rachel Besser ‐ New Lead Consultant for the Oxfordshire Diabetes Service I am excited to be joining the excellent diabetes team in Oxford from May 2016. I will be moving from London, and I have worked in several large diabetes units over the years (University College, Southampton General, Evelina Children’s and Great Ormond Street Hospitals). I feel strongly that every child and young person with Type 1 diabetes should be allowed the opportunity to live a healthy life, with the same opportunities as someone without diabetes. Life with diabetes is never normal, but it can be just as exciting and fulfilling as one without diabetes. In addition to delivering top clinical care, I am also passionate about research. I completed my PhD in 2012 at the University of Exeter, in which I developed a home urine test, which can detect whether an individual with diabetes is still making their own insulin. I have continued working in diabetes research and I will bring you updates from what’s going on from around the world. In fact, I’ve just come back from the ATTD (Advanced Technologies & Treatments for Diabetes) conference in Milan, where I was giving a paper. There was a real buzz in the air with information about all the latest diabetes technologies ‐ from closed loop systems to an implantable 90 day glucose sensor. I know that Julie Edge will be greatly missed and she has left big shoes to fill. However, I am very much looking forward to meeting you all over the coming months and years and I hope, if you see me around Oxford, you will come and say hello. Introducing Dr Kate Green, Paediatric Clinical Psychologist Kate has recently joined the Children’s Diabetes Team and will be working with Dr Anna Disney to provide psychological support to children and families. She will be working with the team at the Horton Hospital, available at clinic and to provide individual appointments, which means we are able to offer more support to families who attend the Banbury clinic than has been previously available. She is looking forward to meeting you all there. OTHER NEWS JDRF Type 1 Discovery Day Magdalen College School, Oxford ‐ Saturday, 19th March, 1‐4pm The Juvenile Diabetes Research Foundation (JDRF) is holding a discovery day at Magdalen College School in Oxford on 19th March 2016 from 1pm‐4pm. This free event is open to anyone affected by Type 1 diabetes. There will be talks on the latest research, living with Type 1 and on the work of the JDRF. Entertainment for children will be provided. To register email: erowley@jdrf.org.uk at JDRF or telephone them on 0207 713 2030. SCHOOL HOLIDAYS Many of you are now using either an Expert meter, to assist with your insulin dose calculations for your injections, or an insulin pump. The insulin doses calculated are based on how your meter or pump is set up. There are usually a number of different time blocks during the day which may have different insulin to carbohydrate ratios and different insulin sensitivity factors (correction factors) programmed into them. When the daily routine of life changes, for example when it is a school holiday and breakfast is later in the morning than a school day, or when you are away on holiday and the time on your meter or pump may not be the same as the country you are in, incorrect doses of insulin may be calculated for some meals or snacks. For example, if your breakfast time block starts at 6am and finishes at 10am and is set at 1 unit per 10g carbohydrate and the lunchtime block starts at 10am and finishes at 2pm and is set at 0.7 units per 10g carbohydrate, when you get up and have breakfast at 11am in the school holidays, you will be getting your lunchtime dose for breakfast! In this example this would be a lot less insulin for your breakfast than you usually have, resulting in your blood glucose level being much higher later in the day. To ensure you always have the correct dose during school time and in school holidays, it is important to make sure your time blocks are set correctly for your daily routine at the time. This may mean having to change the time blocks for holiday periods and then change them back again once back at school. Something worth considering. This may also apply when you travel abroad and are in a different time zone ‐ if you don’t change the time on the meter, it may think you are having dinner when you are actually having breakfast!!! Calling Children/Young People to OUH Young People’s Executive (YiPpEe) ‐ Oxford University Hospital Foundation Trust needs your help The hospital’s Young People’s Executive has been in touch with us to ask if children who attend our diabetes clinic would be interested in helping them with the YiPpEe project. Here are the details for you: Would your children or young people like to improve the experience of children and young people
in hospital? Could they design a logo, plan a menu or set up a Facebook page? It can be hard for
older people to really know what young people want and need when they’re in hospital.
We need young people to share their ideas and knowledge, to help us improve the hospital
experience for the young people we care for. They can help us by joining YiPpEe - our Young
People’s Executive at Oxford University Hospitals.
YiPpEe members have had their say on everything from what’s for lunch or on the website, to
privacy on the wards and children’s rights. They could make friends, learn new skills and make a
real difference to young people in hospital. (It looks pretty good on a college application or CV
too!) Email us and find out more at: yippee@ouh.nhs.uk or visit the website: www.ouh.nhs.uk/getinvolved/yippee.aspx.
Diabetes news
Parent’s Evening ‐ Wednesday, 16th March 2016 Have you noticed that:  Diabetes is getting in the way of your relationship with your child/teenager?  You are often having arguments about diabetes?  Sometimes you find it hard to communicate within the family about diabetes?  You would like to know more about how to emotionally support your child/teenager now and in the future? Kate Green and Anna Disney, Clinical Psychologists working in the Children’s Diabetes Team, are running a pilot session for parents only to provide more families with practical help. It is on Wednesday, 16th March 2016 at 7.30pm in Seminar Room 1 of the Teaching Suite on Level 2 of the Children’s Hospital in Oxford. This session will:  Focus on practical skills for parenting children and teenagers who have Diabetes. National Paediatric Diabetes Audit ‐ Available until 19th April 2016 The National Paediatric Diabetes Audit (NPDA) parent/carer survey ('How are we doing? Your diabetes clinic wants your views') will be available to complete online until 19th April 2016 at https://www.ewp.rcpch.ac.uk/npdaprem/home/en, and can be completed for each time an appointment is attended. The NPDA measures standards and reports on outcomes on diabetes clinics in England and Wales. 
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Show how recent relevant research into children, families and diabetes can help. Give a chance to ask questions of Anna & Kate. Trouble shoot common difficulties reported by families and children. Give guidance around helpful reading and resources, including examples provided on the night to browse through. We are offering this session to all parents/guardians (regardless of the age of the child), however, we anticipate that the majority of the session will be focused on ages 7‐15, although the information will hopefully be relevant to you all. Please email Mary Cheeseman by 7th March to book a place (Mary.cheeseman@ouh.nhs.uk). Places will be allocated on a first come first served basis and your place will be confirmed by email. The session is filling up fast, but don’t worry if you don’t get a place this time as we will be running another session in the near future and will add your name to the waiting list. The survey enables patients, parents and carers of children and young people with diabetes to tell the NPDA about their experience and express their views on the healthcare received from their diabetes clinic. There are two surveys, which involve answering a short set of questions, that take approximately 5 minutes to complete; one survey is targeted at parents and carers and the other is targeted at children and young people with diabetes. The results will be analysed, producing a final report which will effectively communicate your views to your local units based on the findings from the survey. The reports will include a comparison between your local clinic and other diabetes clinics within your region. Local results of the survey will be available in 2016. Diabetes news
Email Addresses If you would like to receive information from the Children’s Diabetes Team via email, please do let us have your current email address. Some emails have been bouncing back, so don’t forget to let us know if your email address has changed recently or if you have not been receiving emails from us ‐ it could be that your email address has not been updated. Please email Mary (mary.cheeseman@ouh.nhs.uk) so that she can update her records and ensure that you don’t miss out on important information. FUNDRAISING Virgin London Marathon We have two participants in the Virgin London Marathon on 24th April 2016 to tell you about. Firstly, your very own paediatric diabetes specialist nurse, Mrs Diana Yardley, is participating and now following a rigorous training programme. Diana obtained a place in the marathon via the public ballot and so did not have to fundraise to take part, but this was too good an opportunity to miss! So, Diana has set up 2 just giving pages to raise money for: 1) The Children’s Diabetes Education Fund here at the hospital, which supports our education programme for children with diabetes in Oxfordshire, and 2) The Life for a Child Programme, run by the International Diabetes Federation, which supports children with Type 1 diabetes across the world. There are an estimated 1 million young people under the age of 25 with diabetes in the world. In high income countries children with diabetes have full access to the care required to lead healthy and productive lives. By contrast, in low resource countries, insulin and other essential aspects of care may be unaffordable or even unavailable. Since 2000, the IDF Life for a Child Programme (LFAC) has been supporting the provision of the best possible healthcare, given local circumstances, to all young people with diabetes in developing countries, through the strengthening of paediatric services in these countries [idf 2015]. If you would like more information about the charities Diana is supporting and/or would like to make a contribution to her fundraising efforts, please look at her donation website: http://www.justgiving.com/teams/Dianamarathon ALSO: Orlando Ross, now aged 18, having had diabetes from a very young age, is also running the London Marathon in April for JDRF. If you would like to support his efforts to raise money for the valuable research JDRF support, please visit his donation website: http://uk.virginmoneygiving.com/OrlandoRoss. We wish him lots of luck with this challenge and look forward to hearing about how he gets on.