GEP Medicine in Society Guide 2023/24

6. Themed Days - Primary Care

6.9. Diabetes

Preparatory work

In preparation students should have:

researched the causes and treatments of Type 1 and Type 2 diabetes. The Diabetes UK website is a good starting point for information about diabetes; there are resources for patients and healthcare professionals so whatever your level of prior knowledge you should be able to find some useful information;
reviewed some of the resources on healthtalk.org about type 2 diabetes, especially to get an understanding of a patient’s perspective on living with diabetes, such as symptoms, diagnosis, controlling diabetes and impact on lifestyle.

Aims

To introduce students to the pathophysiology of diabetes; and to the impact diabetes has on the individual and society.

Learning Outcomes

By the end of the day students should be able to:

describe the incidence and prevalence of Type 1 and Type 2 diabetes and the impact of diabetes on the general practice workload;
discuss some factors that may be contributing to the rise in prevalence of Type 2 diabetes;
describe the impact of diabetes on an individual;
describe some health promotion interventions to reduce the prevalence of Type 2 diabetes;
practise blood pressure monitoring, blood glucose testing, height and weight measurement.

Example timetable

9.30 – 10.30	Tutorial on diabetes
10.30 – 10.45	Tea break
10.45 – 11.45	Prepare for patient encounters Plan questions and observations Patient encounters Some students can sit in on a clinic with GP/practice nurse Other students to interview patient/s with diabetes
11.45 – 12.45	Students feedback to group on their patient encounters and group discussion. Set up afternoon activity; Debate - Is Type 2 diabetes a reversible disease of lifestyle?
12.45 –13.45	Lunch break
13.45 – 14.30	Students research and prepare for debate in 2 groups
14.30 – 15.00	Debate
15.00 – 15.15	Tea break
15.15 – 16.00	Debrief from day Set homework for next session

Suggested Activities

Tutorial on diabetes – could include discussion around types of diabetes, incidence & prevalence statistics (national/local) and factors causing increased prevalence Type 2 diabetes, a quiz (either set by tutor or each student to contribute 1 or 2 questions), student presenting on students presenting pre-agreed topics based around preparatory work, ‘hot topics’ e.g. lifestyle medicine.
Session with practice nurse/healthcare assistant to introduce students to the monitoring of patients with diabetes at the practice.
Observe a consultation with a patient with diabetes; this could be a diabetic review.
Interview a patient with diabetes, with the possibility of a home visit.
Interview a healthcare professional involved with the care of the patients with diabetes.
Group discussion after meeting patient/s and healthcare professionals to compare the patient’s and professional’s views on the management of diabetes and its impact on the patient’s life.
Group debate e.g. Is Type 2 diabetes a reversible disease of lifestyle?
Clinical skills teaching and practice e.g. blood pressure measurement, blood glucose testing, height and weight measurements and BMI calculations and interpretation. Discuss/observe how some diabetes monitoring is being carried out virtually.
Students join practice/MDT meeting.
Student-led research into local services and facilities for people with diabetes. This could include some students visiting local sites or conducting research on foot e.g. to local library/community centre if they are on site.

Questions for students to consider

If you met a patient with diabetes – what did you learn about the impact the condition has on their day to day life? Did anything they told you surprise you? Did you think they could do anything to improve their own situation? How can health care professionals help patients to help themselves?
If type 2 diabetes is increasing because of our sedentary lifestyle and increasing weight (as a population) what is the role of the doctor in diabetes? Should efforts be concentrated on prevention? How far should we go to ‘encourage’ people to make healthy choices? Or should doctors concentrate on treating the patients that present?