Monthly Archives: September 2013

Costings for PreDM stand at Newbury Show

These are the costings for the PreDM Stand at Newbury Show

Equipment

6*6m erected tent = 890
3*2m trestle table = 43
Car Passes = 15
Power Supplies * 2 = 228
Work tables * 3 = 51
Passes * 24 = 229
iPads * 4 = FOC (loan)
Public Liability Insurance = 71
Laptop for data entry = FOC
Banners for tent 6m * 2 = 175
Banners for tables 4*2m = 222
Table cloths = 58
Board covering = 10
Thermal Rolls = 11
Pins, tape etc = 6
Velcro for banners etc = 25
t-Shirts for E4H * 4 = 110
Mileage for E4H
Leaflets from Diabetes UK = 15
Chairs * 10 = 100
Projector and screen = FOC
Display boards/privacy screens * 5 = FOC
HbA1c test strips * 110 = 440
HbA1c machines * 2 = Loan
Gloves and lancets etc = from stock from Dept of PH
Sweatshirts * 5 =120

Misc catering etc circa 100

Staffing

E4H staff * 4 = 500
PH Nurses * 3 = (approx 500) funded by PH
PreDM staff * 3 for front of house daily = 1200 (paid at 15pph)

Total cost for the 2 days, (excluding planning and setting up the previous day), approximately 5000 (of which half was staffing, split between the PreDM staff doing the QDiabetes screening, the E4H staff promoting exercise, and the nursing staff running the HbA1c tests and counselling)

It is impossible to break down the individual value of each component but this “bought”

310 QDiabetes screening and lifestyle advice
111 HbA1c tests and lifestyle advice
80 Body compositions analyses and lifestyle advice
5 new diagnoses of Diabetes
Approximately 10 borderline results
At least 30 people signed up for weight loss program, Eat4Health
General raising of awareness of diabetes risk in the community (approximately 60,000 people at the show) and both the wider public and local clinicians

Newbury Show Pre-diabetes Project Results

A few days on and I have the final results from our Newbury Show stand.

We performed

310 QDiabetes assessments and risk counselling conversations.

111 HbA1c point of care tests on those with a QDiabetes Risk of 10% or more.

80 Body Composition Analyses as part of healthy lifestyle discussions.

We provisionally diagnosed 5 people as diabetic who were not previously diagnosed.

There were 8 people with HbA1c 42-47 (at risk of DM) who were advised to get further assessment.

We have subsequently booked 30 people into the Eat4Health Sessions as a result of the stand

 

Notes.  Many of the QDiabetes calculations were prompted by people requesting them (particularly at busy times) though we did invite passer-by people to be tested (and we recognise a slight bias to inviting those people who might have a higher BMI!)

The threshold for offering HbA1c was set at 20% QDiabetes risk on Saturday, (plus clinically driven exceptions) but having assessed the day one data we revised our threshold down to 10% risk on the second day.  This was based on the experience of identifying someone with DM with a risk of 16% on day one.  Overall there is a balance to be struck between cost, workload and pickup rate, but informally we would suggest a 15% QDiabetes risk would have caught all of the “hidden” diabetics in our small cohort.

There was a fairly “generous” approach to applying the rules, with clinicians asking for HbA1c according to their judgement at times.

Some people slipped through the net and only told us they were diabetic after QDiabetes assessment (!) but gratifyingly their risks were generally over 30%.  Similarly we tested a couple of people with very low apparent QDiabetes scores, due to symptoms, BMI or suspicions.

In our overall small sample there was a small bias of risk score to be higher in the male subjects.  There appears to be an overall trend of higher HbA1c results in those tested, correlating to the QDiabetes risk score.

Risk vs score graph

End of Newbury Show – immediate thoughts

We are exhausted after 2 full-on days of PreDM work at the Newbury Show.  We are still counting the numbers but know we did in excess of 300 QDiabetes assessments, about 120 targetted HbA1c tests and advice sessions (based on their QDiabetes score), and about 80 Body Composition Measurements (full body fat analyses).  We have provisionally diagnosed 5 people with Diabetes (based on combined readings of HbA1c up to 64, Raised random blood sugar and symptoms) and a similar number of borderline results (generally HbA1c 42-47).  The biggest impact, albeit un-measureable, is likely to be the general raising of awareness in those just passing, or visiting the stand.

We did have one lady with a Blood Sugar of 28, until we washed the doughnuts off her hands!

Further details and analysis to follow

Many thanks to the whole team for a fantastic weekend

The Pitch during a quiet time!

 

predmshowinaction

 

Some members of the team

 

 

predmshowteam

predmshowgirls

predmshowteam2

Long and exhausting 1st day at Newbury/Royal Berkshire Show

Up at 5am to get everything organised, though in reality public didn’t really start to arrive until 9am.  Got through 140 QDiabetes assessments, loads of advice and health promotion and three new diagnoses of Diabetes.

Some people really seemed to like and get the idea of future risk and interpreting into what actions might be possible to change things…  Others reported “oh I’ve had a recent blood test so I am OK” and therefore struggled with the idea of prevention…

Strange mixture of worried well, and unworried unwell!  Highest risk of the day about 50%

Roll on Sunday!

PreDM project stand at Newbury Show

newburyshow

We have had our final planning meeting and full steam ahead for the show, looking forward to a sunny weekend according to the forecast.  Come and see us on Stand 301 south of the main showground arena (towards the funfair corner).  We are looking to screen as many people as possible (age 25-84 who haven’t already got diabetes) using the QDiabetes tool and then offering enrollment and advice from the Eat4Health team and on the spot HbA1c screening for diabetes via a finger prick test.  The HbA1c test tells us what you blood sugar has been like over the last 3 months.

We will post our results here.

Newbury PreDM project comes to Royal Berkshire Show

newburyshow

As part of our project to promote early intervention for Diabetes to the Newbury and District CCG area, we have managed to get a trade stand at the Royal Berkshire Show 21-22nd September 2013 in Newbury.  This is a fantastic chance to spread the word to the anticipated 60,000 attendees many of whom may be from rural and isolated farming communities.

We are looking to offer QDiabetes Screening via iPads associated with Eat4Health advice and Point Of Care Diabetic Screening.  Come and see us there and check out your diabetic risks.

Interview transcript from Paul Coia Show on BBC Radio Berkshire 27th August 2013

 

5.16 pm—Paul Coia

Now doctors in West Berkshire say the chance of getting diabetes can be cut by as much as half if people take part in a ground-breaking new scheme. A pilot is taking place where they are scoring people’s chances of getting the condition by looking at their family history, their lifestyle and blood sugar levels. The risk of heart disease and stroke is also reduced by the scheme.

And one man from Newbury who has seen it working close up is Martyn Williamson

Paul Coia: Hi there Martin,

MW: Hi there, Paul.

PC: Not only have you seen it close up, you have seen it closer than anybody could. You were one of the victims in all this. You actually had problems with your medical conditions. Didn’t you?

MW: Number of difficulties, yes, that’s right.

PC: When did you realise that you might be at risk of diabetes.

MW: To be perfectly honest, Paul, I never considered diabetes ..I have got one or two other issues. I had a letter from Dr West, our GP. Basically, if I cut to the chase, he said, we have estimated that you have higher than average risk of developing diabetes and we estimate your personal risk to be 32.4 percent over the next 10 years. It was a wakeup call, if you know what I mean.

PC: Definitely, how did you feel seeing that then?

MW: Old.

PC: May I ask how old you are?

MW: I will be 68 on Thursday. I don’t feel 68 but there we are

PC: No, no, you should feel young and you are quite right especially when you have been given a second chance. You got this wake up call. Presumably your doctor then referred you to this pilot scheme.

MW: The letter then goes on to say We would like you to consider doing the following: One of them is attend a tailored 3-month lifestyle intervention course called Eat4Health. And that was indeed the course I went on.

PC: So what does that involve?

MW: Well, it’s over 10 weeks. We met on Friday evenings for couple of hours, and each week takes one particular topic. Would be interested in knowing the topics..? Behaviour change was one week, healthy eating was another session, goals and rewards, physical activity internal and external triggers –that’s for road eating, fats and sugars food labelling, dealing with evening outs and takeaways and of course, alcohol.

PC: Oh dear. See if I went along they would be ashamed of me, because I love all that, I love grazing, I love the curries, I love a pint of lager now and again.

MW: We get on really well then Paul.

Both giggle

PC: I probably will look at the list of dos and don’ts very good but probably, forget it. What made you follow the advice?

MW: That’s interesting because that would have been under normal circumstances the reaction you had just described would have been me. However, there are number of things that have triggered me to want to do something as a matter of some urgency about weight and lifestyle. One of them is..I have got two artificial hips. Whilst my mobility is much better than it was it still could improve I had noticed that my own attempts had a marked effect on my mobility. So I was really really anxious to give this my best shot. There was that and the fact that I didn’t particularly fancy having diabetes. I know I have a few heart problems. How could I not want to do it?

PC: Be honest and forgive the impertinence of the question, but would you describe yourself as a bit lardy.

MW: Errr…errmm….heading that way, yes. It hurts to say it you know, but yes.

PC: Do you have people around you who were saying you know Martyn you pulling the pants now; you are looking a bit chubbed up.

MW: It has been said, not actually in those words but the inference was there.

PC: You probably wouldn’t have listened to that but this medical advice made a difference to you. Tell me the difference it has made to your life.

MW: Well, I can give you one concrete example. One of my pleasures in life is to walk around the local Penn woods with my dog.  I hadn’t done that in five years. I now do it every morning.

PC: Brilliant. That’s fantastic. So would you recommend this scheme to other people?

MW: Yes, I would. The only proviso I would say is like anything that involves a small element of will power it’s only going to work if you really wanted to. I really wanted to and everyone else who was on the course did as well. It was a success.. As such it gets a 10 out 10 from me.

PC: Brilliant and this is the first in the country apparently.  Could be the first of many more. It’s great that it made a difference to you and presumably if anybody thinks they can benefit from this in the area, they can talk to their GP.

MW: So I understand, yes. I just wish I had heard of this, years ago. It’s life changing.

PC: What a great recommendation! Martyn Williamson, thank you very much indeed. Martyn Williamson, as he said, had his life turned around by the new initiative of Newbury and District Clinical Commissioning Group.