The Tayside Diabetes Handbook serves as the on-line reference manual for all healthcare professionals involved in the care and management of patients with diabetes in Tayside. It contains locally developed guidelines, protocols, information and clinical advice based on the SIGN 116 Guideline and other relevant clinical and research evidence.
The Handbook is intimately linked to the patient specific clinical information in the SCI-DC record in such a way that clinical staff in Tayside can instantly access relevant protocols and guidelines during the consultation
The handbook is maintained and updated according to the Tayside Diabetes Handbook Update Procedure (see below)
The guidelines in this document are advisory and are not intended as rules and regulations for diabetes care. The management of a particular patient should be decided upon by the practitioner responsible and should reflect the circumstances and needs of the individual.
Following the St Vincent declaration (1989) and the SIGN Guidelines for the care of diabetic patients in Scotland, the members of the Tayside Diabetes Managed Clinical Network believe that the healthcare of people with diabetes in Tayside should include:
- yearly checks of eyes and vision, kidney function, feet and general well-being
- assessment of risk factors for heart disease such as blood pressure, cholesterol and smoking habits
- assistance with self monitoring and injection techniques
- eating and lifestyle advice
- regular review of progress and treatment
- continuing education
EPIDEMIOLOGY
The prevalence of diabetes in Tayside at March 2010 was 4.6% (n=18355) with 1626 new cases diagnosed during 2009, an incidence of 0.43%. 90% of these are Type 2 Diabetes.
The prevalence of diabetes in Tayside is currently rising by ~7% per annum.
Diabetic patients display:
- a 2-4 fold risk of developing heart disease
- a 17 fold increase in risk of renal failure
- a 25 fold increase in the risk of blindness
- a 14 fold increase in risk of amputation
- a reduced life expectancy of between 8 and 10 years in those who develop type 2 diabetes between the ages of 40-50
TAYSIDE DIABETES HANDBOOK - UPDATE PROCEDURE
The Managed Clinical Network has an obligation to ensure the quality and relevance of the information contained in this document if it is to remain a reliable source of reference for all health professionals caring for patients with diabetes in Tayside.
We therefore outline our procedure for updating the handbook and identify the individuals with key responsibility for meeting this requirement. Where the handbook is used outwith Tayside, responsibility for maintenance lies with the local clinical Team.
A specific advantage of using website technology to share information is the potential to respond to change in a dynamic way.
Update Mechanism
Responsibility for reviewing the Handbook lies with the Network Information Sub-Group. This Group is chaired by a Consultant Diabetologist, currently Dr Geraldine Brennan, E-mail Geraldine Brennan at geraldine.brennan@nhs.net
A formal process of revision/updating of the entire Handbook will be undertaken on a two yearly basis as a rolling programme. In addition, in the light of new evidence or developments, the following procedure will be followed whenever a possible change is identified.
- Submissions will be considered from anyone involved with the care of patients with diabetes in Tayside.
- All proposed updates or additions will be submitted to the Information Sub-Group Chair, for consideration.
- The Information Sub-Group will formally review any suggested major revisions. Minor revisions will be dealt with directly by the Information Sub-Group Chair.
- An appropriate member of the Network will be nominated to prepare a draft of any proposed major revision.
- Drafts will be circulated by e-mail to all members of the Information Sub-Group for formal approval.
- Upon agreement of any changes the Chair will provide electronic documentation to the Tayside Diabetes MCN Administrator, who will then update the electronic version of the Handbook.
- The MCN Administrator will maintain a log of all updates.