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THE BIG INTERVIEW: Educating diabetics to help themselves
Stephen MacMahon, 64, was given the Supporting Others Award at Diabetes UK’s regional Inspire Awards ceremony. He is retired, following a career with the Post Office and later in finance, and served as a magistrate for 28 years before retiring from the bench in November. He is married to Helen and the couple live in Eldene...
“EVERY time you go for an appointment with a practitioner to discuss your diabetes,” said Stephen MacMahon, “you are the only person who is always at every meeting you go to.
“Obviously doctors, nurses, consultants can be different every single time. You must educate yourself so that you can take charge of your appointments, and make sure all the points you’ve got in mind are discussed.
“Nobody is going to care for you as much as you care for yourself.”
The no-nonsense approach is characteristic of this former Wiltshire secretary of the Magistrates’ Association, who also served as a deputy chair in the adult and youth courts.
He and his wife, Helen, are both involved with Diabetes UK, having become acquainted with the condition completely by surprise in about 2002.
“My wife was in hospital for another condition and they said, ‘How long have you been diabetic? You didn’t tell us.’ She said, ‘Well, I’m not.’ “They gave her an insulin injection because her blood sugar reading was very high. She’s never had one since.”
“They said she was diabetic, but we managed it for about seven years with diet and exercise. Then she moved on to oral medication, which she’s still on.
“Obviously she started to research diabetes for her own benefit and then she got to the local voluntary group.
“In the meantime we were making inquiries about how it might develop and what potential treatments there would be out there. Helen went along to an open evening at Purton GP surgery when they had a diabetes event and found Diabetes UK’s stand there.
“Then we found out they had a meeting in town, so we went to that meeting and we’ve been quite heavily involved with them ever since.”
That involvement includes roadshows, talks and a monthly public meeting at the Broadgreen Centre in Salisbury Street, with speakers including consultants, dieticians and specialist nurses. Stephen also served on a primary care trust steering group.
Thanks to the local Diabetes UK group, patients are issued with prompt sheets of questions to ask their doctors, and practitioners are receiving extra diabetes- focused training.
There are 10,700 diabetics over the age of 17 in Swindon. The condition, in which the pancreas fails to produce the insulin the body needs to process sugars, has a number of potential side effects.
One of the worst is neuropathy, a numbing of the lower extremities which makes them vulnerable to damage and infection. Nationally there are 10 lower limb amputations per 100,000 people per year, but in Swindon the figure is 19.
Stephen blames a lack of patient education and, until recently, a lack of personnel to provide that education.
“With the foot care and potential lower limb amputations, there were very few podiatrists in the community a year ago . There was the equivalent of 1.6 podiatrists in the whole of the Swindon area.
“Up to that point doctors weren’t referring people who came to them with foot problems because there were no podiatrists to send them to.
“So a doctor would quite often give you antibiotics if you had an infected foot, and if you went back with the same thing they’d give you more or change the antibiotics.
“If you got really bad, they’d make you an emergency appointment at the hospital.
“But now we’ve got 10 people, the equivalent of 7.4 posts in Swindon, and we’ve got a new consultant podiatrist at the hospital, and a new head podiatrist in the area as well.
“They’re going around training all doctors and practice nurses in how to identify foot problems and the essential need to refer.
“Nearly all amputations are avoidable if you have the proper care, and the cost of an amputation for social services and the person and the family is massive. It could be half a million per person.”
Stephen also promotes retinal examinations for patients, as retinal problems are another issue associated with the condition. Retinal care for diabetics in the area was recently switched from one contractor to another, and Diabetes UK is monitoring the situation.
He has never been intimidated by officialdom: “Being fairly firm has helped. At group meetings there might be 25 people, all medical practitioners apart from me.
“I have had to stand my own ground, and eventually I think became respected.”
Stephen and his colleagues at Diabetes UK are determined to help patients help themselves. His advice for the newly diagnosed?
“The situation is complex. You need to take care of yourself. Do as much research as you can through whatever means – by reading, going online, talking to the experts.
“Go on all the patient courses you’re offered. If they’re not offered, demand to go on them. Our take-up rate in Swindon, typically, has been about eight per cent and in other areas it’s 82 per cent.
“That’s because people aren’t being referred or they’re being told, ‘You’re diabetic, I’ll put you down for a course,’ but they’re not told they must go on the course because they can learn how to deal with their condition.”
The meetings at the Broadgreen Centre are held on the first Tuesday of the month at 7.30pm; the next is on April 1.
The 15-point checklist for patients can be downloaded at diabetes.org.uk/15-essentials
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