1. Grampian guidelines 2009 Grampian MCN meeting 27 th May 2009 Donald Pearson Consultant Diabetologist NHS Grampian Lead Clinician for Diabetes in Scotland

2. Improving the lives of people with diabetes in Grampian Research Research Evidence Evidence Guidelines Guidelines Implementation Implementation Evidence Evidence Guidelines Guidelines Implementation Implementation Better Outcomes Better Outcomes

3. Improving the lives of people with Diabetes in Grampian ResearchEvidence

4. Improving the lives of people with Diabetes in Grampian Research Research Evidence Evidence SIGN SIGN Evidence Evidence SIGN SIGN Local Guidelines Local Guidelines

5. Electronic Guideline Four main sections

6. A: CLASSIFICATION, DIAGNOSIS, INITIAL MANAGEMENT, PREVENTION AND SCREENING A: CLASSIFICATION, DIAGNOSIS, INITIAL MANAGEMENT, PREVENTION AND SCREENING B: SUPPORTING SELF-MANAGEMENT B: SUPPORTING SELF-MANAGEMENT C: GLYCAEMIC CONTROL C: GLYCAEMIC CONTROL D: COMPLICATIONS D: COMPLICATIONS

7. Scottish Diabetes Survey 2007 Prevalence of Diabetes in Scotland NHS Boards 2006

8. Prevention of Type 2 Diabetes Mellitus In Adults Set realistic goals – don’t worry if the odd day is missed but try to make sure physical activity is part of everyday life Encourage the person to select activities that they enjoy – such as walking, cycling, swimming, aerobics and gardening Minimise sedentary activities, such as sitting for long periods watching television, at a computer or playing video games. Build activity into the day – for example, get off the bus a stop earlier and walk, take the stairs instead of the lift, take a walk at lunchtime.

9. Electronic Guideline Four main sections A: CLASSIFICATION, DIAGNOSIS, INITIAL MANAGEMENT, PREVENTION AND SCREENING A: CLASSIFICATION, DIAGNOSIS, INITIAL MANAGEMENT, PREVENTION AND SCREENING B: SUPPORTING SELF-MANAGEMENT B: SUPPORTING SELF-MANAGEMENT C: GLYCAEMIC CONTROL C: GLYCAEMIC CONTROL D: COMPLICATIONS D: COMPLICATIONS

10. “ The average person with diabetes will spend 3 hours with a Healthcare Professional and will take care of themselves for the remaining 8757 hours in a year” 0.034%

11. Electronic Guideline Four main sections A: CLASSIFICATION, DIAGNOSIS, INITIAL MANAGEMENT, PREVENTION AND SCREENING A: CLASSIFICATION, DIAGNOSIS, INITIAL MANAGEMENT, PREVENTION AND SCREENING B: SUPPORTING SELF-MANAGEMENT B: SUPPORTING SELF-MANAGEMENT C: GLYCAEMIC CONTROL C: GLYCAEMIC CONTROL D: COMPLICATIONS D: COMPLICATIONS

12. ≤ 7.5 % ≤ 140 mmHG ≤ 5 mmol/l HbA1c Systolic BPCholesterol Patients reaching targets for HbA1c, Blood Pressure and Cholesterol in 2004-2007

13. Electronic Guideline Four main sections A: CLASSIFICATION, DIAGNOSIS, INITIAL MANAGEMENT, PREVENTION AND SCREENING A: CLASSIFICATION, DIAGNOSIS, INITIAL MANAGEMENT, PREVENTION AND SCREENING B: SUPPORTING SELF-MANAGEMENT B: SUPPORTING SELF-MANAGEMENT C: GLYCAEMIC CONTROL C: GLYCAEMIC CONTROL D: COMPLICATIONS D: COMPLICATIONS

14. Scottish Diabetes Survey 2007 Diabetic retinopathy screening

15. Improving the lives of people with Diabetes in Grampian Implementation Implementation Diabetes Action Plan 2006 Better Diabetes Care : Consultation Document 2009 Outcomes Outcomes Quality Improvement Scotland 2004, 2007 Scottish Diabetes Survey 2001-9

16. Working in partnership with patients to deliver patient centred care Listen to patients and respond to their concerns and preferences Listen to patients and respond to their concerns and preferences Give patients the information they want or need in a way they can understand Give patients the information they want or need in a way they can understand Respect patients’ right to reach decisions with you about their treatment and care Respect patients’ right to reach decisions with you about their treatment and care Support patients in caring for themselves to improve and maintain their health Support patients in caring for themselves to improve and maintain their health GMC Good Medical Practice 2006