Ten things medical students need to know about diabetes when going on placementBMJ 2022; 377 doi: https://doi.org/10.1136/bmj.o609 (Published 07 April 2022) Cite this as: BMJ 2022;377:o609
- Emily Thomson, foundation year 2 doctor1,
- Thomas SJ Crabtree, diabetes specialist registrar and clinical research fellow2
- 1Chelsea & Westminster Hospital, London, UK
- 2University Hospitals of Derby & Burton NHS Trust, Derby, UK
In the UK, an estimated 4.9 million people are living with diabetes,1 and one in five hospital inpatients has the condition. Diabetes is a risk factor for several other conditions, and as such, medical students may encounter people with diabetes during placements in any specialty.1 The opportunities to learn about diabetes and its complications are therefore everywhere. Here are some key points to be aware of, and key opportunities to seek out during your time as a medical student and beyond.
1. There are more than two types of diabetes
Being able to differentiate between type 1, type 2, and other rarer types of diabetes is a key skill. The rarer types are harder to find, but a general awareness of monogenic diabetes (previously known as maturity onset diabetes of the young) or type 3c (diabetes secondary to pancreatic conditions) is useful. During any placement, be familiar with how the various types present, including potential patient factors (age, risk factors, comorbidities), key points from the history (onset of symptoms, family history, weight loss), and useful investigations (antibodies) that are likely to help with differentiating the type of diabetes.
2. Management of diabetes extends beyond drug treatments
Numerous pharmacological treatments are available for diabetes, including some promising newer agents, but it is useful to familiarise yourself with other interventions. These could include social prescribing, peer support services, or educational programmes—a common example being the dose adjustment for normal eating course for people with type 1 diabetes, which is taught by a multidisciplinary team and covers topics such as carbohydrate counting, resilience training, and managing diabetes alongside exercise, eating out, or even a trip to the pub.
3. Treatment goals vary from person to person
Goal setting for people with diabetes is often individualised and target blood glucose ranges may vary, as may target HbA1c levels. Most people with diabetes are aware …