Treatment
We do not have ‘Patient Choice’ in NHS Scotland, we therefore normally have to stick with the clinic we have been referred to, there may however be several different doctors and nurses at the clinic and you can certainly request one in particular.
Most newly diagnosed will be prescribed MDI, (Multiple Daily Injections) this is a regime of one or two daily injections of a long acting background insulin and fast acting insulin injection before each meal.
Under 5’s are often started on an insulin pump. Pumps are available now in all areas but it is easier to get a pump in some health board areas than others. In Scotland around 25% of under 18’s use insulin pump therapy to manage their diabetes. For more information on pumps available in the UK visit iPAG.co.uk
Few children are on a regime of mixed insulin, this treatment normally consists of 2 injections of a pre-mixed insulin daily. This is a outdated treatment option and can make targets very challenging to achieve and can be very restrictive for the child.
Blood Glucose meters
Many areas have preferred meters, if you are unable to get the strips you want prescribed you will need to make a case to your diabetes clinic or GP. Strips should never be restricted, if you encounter problems contact your team asap.
CGM (Continuous Glucose Monitors)
CGM are rarely funded by the NHS in Scotland, as of 2019 there are a limited number of patients per board with full time funding. Chat about CGM on Facebook.
The Libre is now available all over Scotland subject to local criteria.
See iPAG for more information on all CGM in the UK
School
It is important to start as you mean to go on. A member of your diabetes team should visit your school to train any staff involved in your child’s care and educate them about diabetes. you may be able to play a role in the training. Diabetes is relatively uncommon and there may not be other children with diabetes at school so don’t assume the school will know anything about the condition.
Some things to consider:
A care plan ( IHP – Individual Healthcare Plan)
Awareness amongst staff
Spares stored in school, Glucagon
Allowing your child to test and treat anywhere at anytime. They should not have to go to the ‘sick room’ or office to test their blood glucose.
A lunch queue jump card
Exam/test arrangements – this should be an application by your school to the SQA as far in advance as possible requesting Exams Access Arrangements
consider:
Stop the clock – any time required to test or correct blood glucose levels to be added on at the end
Rest breaks – toilet breaks
Extra time – cognative function can be affected by high and low blood glucose levels
A separate room with other children with special arrangements
University
Register with the Disability Service and apply for DSA (Disabled Student Allowance)
DSA is paid through SASS. You will be assessed and may be awarded certain items to support you to do your course without a disadvantage with your health condition. Universities tend to follow on with any arrangements you had at school.
consider:
Dictaphone
Printer and ink
Equipment to work at home on diabetes sick days
Responsibility for the National Health Services in Scotland is a devolved matter and therefore rests with the Scottish Government. Any lobbying or campaigning must be done with a Scottish Address through your MSP or one of your elected members of parliament.