Heather Weaver is a Senior National Diabetes Closed Loop System Educator with the National Centre for Sustainable Delivery, established at NHS Golden Jubilee. Here, Heather reflects on her approach to supporting people with type 1 diabetes, her experience with diabetes technology and her role in the National Diabetes Closed Loop System Onboarding Programme.
My approach to diabetes care
I started caring for people living with type 1 diabetes in 2000.
As a healthcare professional with a specialist interest in diabetes, my aim has always been to support people self-manage their diabetes with confidence. If someone’s woken up with a high glucose reading or a lower-than-expected blood glucose, I want them to not feel panic-stricken but to instead say to themselves, "Okay, I know what to do with that".
Similarly, if someone is using diabetes technology and their blood sugar level is outside their target range, I want them to stay calm and draw reassurance from thinking "I know how to use the technology and how to deal with that".
I also want people to understand that managing diabetes is a challenge, and that being out of range is not something someone should be blamed for or something someone should blame themselves for. It's just a challenge.
Diabetes technology training
Training for healthcare professionals on insulin pump therapy and technology has in my experience typically been given by industry suppliers. I have built up my understanding of diabetes technology myself, during a spell when I worked in the diabetes technology industry and during my time as a healthcare professional with the NHS.
I would personally like to see more on diabetes being embedded into undergraduate nursing programmes. In addition to what diabetes is and the complications associated with the condition, I’d like to see students having to learn about diabetes technology, what the various devices do, and the part technology plays in helping someone live well with type 1 diabetes.
I welcome Glasgow Caledonian University embedding Diabetes UK CPD modules into its adult nursing curriculum.
How diabetes tech has advanced
Back in 2000, diabetes technology was in its infancy. There were only nine people in Scotland using insulin pumps, and pumps were clunky.
Over the years, pumps have become more refined, technology has advanced tremendously and more people across Scotland are using insulin pumps, CGM and closed loop systems.
Technology takes a lot of the burden off the person with diabetes because the pumps and closed loop systems are automated. I liken the experience of moving onto diabetes technology to going from using a bicycle to experiencing cruise control in a car. It requires confidence and getting used to.
Widening access to diabetes technology
Personally speaking, access to technology is not where I’d like it to be. However, the onboarding programme that I’m part of is a huge step forward towards widening access.
The National Diabetes Closed Loop System Onboarding Programme has been set up to support NHS Scotland Health Boards to allow more timely access to this diabetes technology for eligible people living with type 1 diabetes who have been referred by their Board.
The National Onboarding team is made up of Senior Diabetes Educators, Assistant Practitioners and Peer Support Workers.
The team provides support and training on how to use these technologies to individuals. The support aims to build confidence in using the device and provide an opportunity to learn with other new users. The onboarding programme usually lasts between 4-6 weeks. The number and length of sessions varies depending on the devices making up your closed loop system.
Because the onboarding sessions are online, people don't have to take a day half a day off work or get somebody to pick up the children from nursery. They are in their own home, and we only need a few hours of their time.
As someone who has been around diabetes technology for almost 25 years, I'm so impressed with what the wider team - the National Centre for Sustainable Delivery, clinicians and many more - who have pioneered this approach has done to get the programme up and running. It's been a huge undertaking and I’m thoroughly enjoying supporting people who have been referred to the programme by their Board.
Final thoughts
When I’m transitioning someone onto a closed loop system, my aim is to make that as positive an experience for them as possible. I don't want it to be another trauma for them.
Every person with types 1 diabetes will remember when they were first diagnosed. They will remember having to do a blood test. They will remember taking the first injection. My watchwords are patience, perseverance and together, let’s look for solutions.
Read more about the National Diabetes Closed Loop System Onboarding Programme. Your local diabetes team will assess your suitability for closed loop systems and will be responsible for referring you to the Programme.
