1. Staff competencies

2. Current medical (Spin) competencies
Understand the concept of insulin resistance, obesity and type 2 diabetes

3. Staff groups Clinicians Dieticians Nurses Psychology
Nurse and psychology volunteers needed

4. At Diagnosis
Understand the pathophysiology of type 2 diabetes mellitus
Be able to counsel children and their parents at diagnosis in an appropriate setting and deal with important issues including guilt
Be able to initiate treatment, choosing an appropriate regime
Be aware of the need to screen for comorbidities (hypertension, dyslipidaemia, metabolic syndrome, psychosocial issues) at diagnosis

5. Ongoing management of type 2 diabetes including education and psychosocial aspects
Gain experience in monitoring of comorbidities related to T2DM, and be aware of the aggressive nature of Type 2 diabetes in adolescence
Be familiar with the principles of dietetic management of type 2 diabetes and be able to advise on reduced calorie intake and portion sizes
Be able to use 2nd line and 3rd drugs if required
Aware of indications, side effects and be able to show a staged approach
Clearly understand the management of type 2 diabetes at the time of surgery
Be able to advise surgeons and anaesthetists on both pre and post-operative care
Be aware of the possibility of both DKA and HONK and how this may differ and why

6. Educational and Psychosocial aspects of type 2 diabetes
Understand the nature and effect of type 2 diabetes on children and families
Understand the element of partnership with families in the management process and to recognize when this is faltering
Understand cultural and lifestyle issues affecting diabetes care esp pertinent for T2DM
Be aware of how transition arrangements may vary for type 2 diabetes across trusts.
Be aware of the unique issues with disengagement at this time

7. 8.1 Specialty specific numbers and types of clinics expected to attend
(including outreach clinics):
See and review at least 5 type 2 Diabetic patients in Multi-Disciplinary Clinics
8.2 Specialty specific combined clinics expected to attend:
8.3 Specialty specific ward rounds consultant led and independent per week:
8.4 Specialty specific involvement in transitional care:
Attachment to Young Adult or Transition Diabetes clinic for at least 5 sessions over
the programme where type 2 diabetes patients are seen

8. Competencies: - Dietitians
Diagnostic criteria: (risk factors, co-motilities of obesity)
Disease progression:
Weight management:
Exercise:
Non-insulin medication:
Lipid lowering medication:
Psychology
Glycaemic index/nutritional management