Intended for healthcare professionals

Rapid response to:


Living with type 1 diabetes as a medical student

BMJ 2022; 377 doi: (Published 07 April 2022) Cite this as: BMJ 2022;377:o920

Rapid Response:

Re: Living with type 1 diabetes as a medical student

Dear Editor,

Thank you for this interesting read. I would like to respond regarding Dr Smith's tips to healthcare professionals.

As a junior doctor also living with type 1 diabetes mellitus, I can relate and align with some of the matters written by Dr Smith, especially with the demands that are present when living with a chronic condition.

I was diagnosed at the age of 22 whilst in my first year of medical school. I spent a significant amount of my time adapting to my new lifestyle and learning what worked best for me. However, I also spent a proportion of my time sharing my experiences of living with diabetes, tackling stigma and educating colleagues about type 1 diabetes. Therefore, I find Dr Smith's advice to healthcare professional's about Type 1 diabetes interesting and agreeable.

I find it hugely frustrating and concerning that I have interacted with some healthcare professionals that are unable to differentiate between hyperglycaemia and hypoglycaemia, as well as insulin regimes and technology available. Whilst type 1 diabetes mellitus is an ever-adapting condition in terms of management and technology, and, to keep up to date, may be demanding, however, not understanding the condition can put patients at risk. I appreciate and agree to all points raised by Dr Smith, however, I believe there is a concerning lack of understanding of technology in the inpatient setting of type 1 diabetes and this needs to be raised.

Insulin pump and continuous glucose monitors are now at the forefront of type 1 diabetes care, and, with the fantastic work by Dr Partha Kar, are becoming first line management. Continuous glucose monitors allow constant blood glucose measurements to be sent to devices, as well as working with some insulin pumps in a 'closed loop system' to creat ean artificial pancreas.

However, in the acute setting, most hospital guidelines do not include the management of such technology, and as such, can have adverse affects on patients. For example, a research study conducted by myself and the Endocrinology team at Barnsley Hospital NHS foundation trust identified that only 22.58% of healthcare professionals could correctly identify technology used in type 1 diabetes and that 58% participants did not know how to manage an insulin pump during Diabetic ketoacidosis. This was presented at the Advanced Technologies and Treatments for Diabetes 2022 conference in Barcelona.

Therefore, with this response to Dr Smith, in addition to her excellent tips, I would like to raise the need of better education to healthcare professionals with regards to technology (in addition to basic education surrounding diabetes) used in type 1 diabetes care. We need to encourage healthcare professionals to ask questions about diabetes but tackle stigma when faced by it. Knowledge as a whole could be increased via e-learning, undergraduate teaching sessions or interactive teaching in NHS trusts.

I hope this response sparks food for thought and that, as management of this chronic condition keeps adapting, knowledge by members of the multi-disciplinary team will increase.

Dr George West
Foundation year 2 doctor, Sheffield Teaching Hospitals

Competing interests: No competing interests

22 September 2022
George West
Foundation year 2 doctor
Sheffield teaching hospitals
Northern General Hospital, Herries Road, Sheffield, S5 7AU