News archive 2009

King's Health Partners pioneer for diabetes care

09 Apr 2009, PR 71/09

A report published by Diabetes UK in collaboration with King’s College London and King’s College Hospital, which are part of King’s Health Partners, has highlighted the need for people with diabetes to receive psychological care in helping them to live and cope with their long term condition.

In the UK, there are currently 2.5 million people diagnosed with diabetes and it is estimated that up to half a million people have the condition but do not know it.  Around 85 per cent of adults with diabetes in the UK lack access to specialist psychological support and care, according to a new report¹ by leading health charity Diabetes UK.

‘Minding the Gap – The provision of psychological support and care for people with diabetes in the UK’ found that only 25 per cent of diabetes services can actually name and supply contact details for people who provide specialist psychological care, and in almost half of those services there is only local generic mental health provision which is provided by professionals with no specific knowledge or experience in the area of diabetes.

One of the few areas in the UK that have however developed a specialist Diabetes service is South London where King’s College London and King’s College Hospital are collaborating as part of King’s Health Partners (KHP) the newly launched Academic Health Sciences Centre in South London. 

Dr Khalida Ismail, who directs the service, comments: ‘Our diabetes team has  pioneered a gold standard service which delivers mental health care tailored to the needs of its patients. We have a liaison psychiatrist, clinical psychologists and diabetes nurses trained to deliver expert psychological treatments who work closely and integrated with the diabetes team so we work as one team.’

Consistent evidence of higher rates of psychological problems in people with diabetes include, depression, eating disorders, psychological stress around living with diabetes and needle phobias all of which can lead to poor diabetes self-care, high blood glucose levels and subsequent medical complications such as blindness, heart disease, amputation, stroke and kidney failure. Treatments such as cognitive behavioural therapy for psychological conditions can lead to reduced psychological distress and improved diabetes outcomes.

Diabetes UK Head of Healthcare and Policy Bridget Turner said: ‘Living with diabetes can be challenging and the emotional stress of having to deal with this complex condition on a daily basis means specialist psychological services are crucial.  People with diabetes need easy access to emotional support and some need more specific psychological support.’

The service at King’s Health Partners is focused on training healthcare professionals to improve care skills in areas such as recognising and managing depression, eating and needle phobias.  The service managers liaise closely with different healthcare professionals and carers to provide patient support in offering events like case conferences to encourage a collaborative approach where the patients can discuss their treatment and individual tailored treatment. 

Dr Ismail comments: ‘We have a dedicated team that consists of a liaison psychiatrist, clinical psychologists and diabetes nurses which  provide assessment and treatment service for depression, anxiety disorders, eating issues. We offer psychological treatments such as cognitive behaviour therapy, interpersonal therapy and mindfulness based groups as well as advice and monitoring of antidepressant medication.’

‘Some of our nurses are specially trained to counsel people in making behaviour and finding more constructive ways of coming to terms with diabetes. We train and supervise the diabetes team and we are developing case management type models of multi-disciplinary working in collaboration and equal partnership with the patient. Our data suggest that of those referred to our clinic who then attended their appointment did better than those who did not.

‘In one study we found that diabetes nurses trained to deliver motivational therapies and CBT were more effective than routine outpatient care in improving blood sugar control in people with type 1 diabetes. We are about to start a similar study in GP practices for type 2 diabetes.’

Stephanie Amiel, Professor of Diabetic Medicine at King’s College London and consultant diabetes physician to the King’s Diabetes Service, said: 'Diabetes teams have long been aware that psychological health is important to achieving good diabetes outcomes. Having professional support within the team to diagnose and manage issues ranging from difficulties coming to terms with having diabetes to frank depression has had major benefit for individuals affected by them, the diabetes team itself and the services we can offer.’

A preliminary audit of the service at King’s Health Partners has shown that sufferers using the service have benefitted following treatment and further a publication in the Annals of Internal Medicine 2008 has highlighted that nurses trained with the same techniques have seen significant improvement in patients being able to control their Diabetes following treatment of the KHP service.



Notes to editors

King's College London
King's College London is one of the top 25 universities in the world (Times Higher Education 2008) and the fourth oldest in England. A research-led university based in the heart of London, King's has more than 21,000 students from nearly 140 countries, and more than 5,700 employees. King's is in the second phase of a ?1 billion redevelopment programme which is transforming its estate.

King's has an outstanding reputation for providing world-class teaching and cutting-edge research. In the 2008 Research Assessment Exercise for British universities, 23 departments were ranked in the top quartile of British universities; over half of our academic staff work in departments that are in the top 10 per cent in the UK in their field and can thus be classed as world leading. The College is in the top seven UK universities for research earnings and has an overall annual income of nearly £450 million.

King's has a particularly distinguished reputation in the humanities, law, the sciences (including a wide range of health areas such as psychiatry, medicine and dentistry) and social sciences including international affairs. It has played a major role in many of the advances that have shaped modern life, such as the discovery of the structure of DNA and research that led to the development of radio, television, mobile phones and radar. It is the largest centre for the education of healthcare professionals in Europe; no university has more Medical Research Council Centres.

King's College London and Guy's and St Thomas', King's College Hospital and South London and Maudsley NHS Foundation Trusts are part of King's Health Partners. King's Health Partners Academic Health Sciences Centre (AHSC) is a pioneering global collaboration between one of the world's leading research-led universities and three of London's most successful NHS Foundation Trusts, including leading teaching hospitals and comprehensive mental health services. For more information, visit: www.kingshealthpartners.org.



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