Sweet music

The Diabetes and Endocrine Centre has developed a treatment programme which allows patients to eat and drink whatever and whenever they like.

Diabetes is a disorder in which levels of blood sugar become abnormally high. Over a long period of time, this can damage blood vessels and nerves, leading to serious complications.

In most people, eating or drinking stimulates the production of insulin, a hormone released by the pancreas to regulate blood sugar levels.

People with type one diabetes produce little or no insulin of their own, so they have to inject it daily. Traditionally, they are also told to restrict their diets, particularly avoiding sweet foods.

But in 1999, the Bournemouth centre developed a short course to train patients how to count carbohydrates in their food, and to inject the right amount of insulin to cover each individual meal.

The results have just been published in a medical journal. They show that "graduates" gain much greater control and confidence in managing their condition, reducing their risk of developing complications.

"In the past, people would take just one injection of insulin a day and make sure they had the right amount of carbohydrate through that day to stop their blood sugar going too low or too high," explained consultant Dr David Cavan.

"As time's gone by, treatments have become much more sophisticated, so most patients are on several injections a day, typically four. The advantages haven't been exploited properly.

"The old messages of restricting diet haven't really changed," he said.

"People tend to eat what they want anyway, but they get a sense of guilt about it."

Diabetes nurse specialist Joan Everett travelled to Germany in 1999 to learn about the new approach.

In Bournemouth, patients attend four once-weekly outpatient group sessions. After each one, they put into practice what they have learned, collecting data on their food intake, insulin doses and blood sugar levels. A unique computer programme, Diasnet, is used to illustrate to individuals how their insulin doses affect blood sugar levels.

So far, about 70 people have been through the programme, which has proved popular with all ages. "We had one chap on the last course who'd had diabetes from when he was a child and been brought up on a very restricted diet," said Joan.

"At the end, he said: 'I now know what my aim is going to be - I'm going to take my wife out for a meal.' He'd never been able to do that before."

One long-term diabetic in his sixties sent Joan a card after attending the course saying: "You have given me hope."

Since the service was set up, Bournemouth has had visits from doctors and nurses from other parts of the country interested in setting up a similar programme.

One satisfied customer is company director Shelley Holloway, 27, from Bournemouth, who was diagnosed with type one diabetes 10 years ago.

"For the first year, I was really good, then I decided it was all a mistake. I very quickly became ill and was admitted to hospital," she said.

When she started the programme, her blood sugar level was still poorly controlled.

"My favourite thing going out for dinner has always been the dessert. I have a sweet tooth," she said.

Her average blood sugar fell quickly under the new regime.

"To start with, it took a bit of getting used to, but I can eat as much or as little as I want. I can have as many as five or six injections a day."

Margareta Flicos, 37, also of Bournemouth, has been diabetic for 29 years and went through the programme in January last year. "I would say there was a big improvement in my quality of life," she said.

"There's a lot more flexibility, particularly with regard to diet, and I have more confidence to be able to do what I want and still keep my diabetes under control.

"Something like chocolate, which has always been regarded as a sin, can now be incorporated because I understand how to adjust my insulin to cope with it."