The Hospital - Channel 4

Hi All,

The most recent episode of The Hospital was shown on Channel 4 this week and is also available to watch on 4 on demand. It centres around diabetes in young people and the health professionals that treat them. I was just wondering if anyone else saw it and what they thought of it?

I'm in the 15 - 25 year old age bracket they were discussing, I've only been diabetic for a couple of years, I've got fairly good control, (especially after Dafne) and I've had no complications so far. But I just felt as I watched it that it was really negative. I don't deny that complications can happen in young people, and obviously we do have a responsibility to keep ourselves healthy to the best of our ability, but I came away from watching it feeling completely depressed, and I just really wanted to know if anyone else picked up on this too?

For the moment I haven't shown it to my family and friends, I think it would terrify them even more than me! (It has some very brief surgical scenes). I would really appreciate someone else's perspective on this.

Thanks,
Laura.

I watched it and it has been discussed extensively on the Diabetes UK support forum with some positive and negative opinions...

As a diabetic who is knowledgabe, thanks to DAFNE, I wasnt effected by it in any way...as I know what to do now...

I think that it did show a very real situation that is happening around the country, and that more of these people need the basic eductaion to have good control....

What it didnt do is distinguish between type 1 and type 2, alot of non diabetics may have got the message that we are all over wieght and dont bother to take care of ourselves, resulting in a huge burden for the NHS......

Overall it could of been more effective, and sympathetic to the diabetic population, but that isnt why they made the show, its all about money, the NHS, and how we should all be trying our best to keep costs down.......

As far as the complications go, there was no suprises, as DAFNE illustrated, maybe apart from the pregnancy, but I wont have to deal with that..................

I personally think making the effort to control my condition is without any difficultie.........getting good control on the other hand is another story....

hi im a type 1 and have been for 24 yrs, i did feel quite negatitve after watching it, i thought it was educational for those who dont have good control, hopefully to push them in the right direction. i completely agree with type 1 and type 2, they need to make it clear that type 1's are not associated with being obese!!!

Yep I just gave this a watch on 4OD, after seeing this topic and also being in the 15-25 age bracket (for another few months at least...) I was interested.

I wasn't surprised by the overall theme of the show - I think it was to give young people with diabetes (and their parents) a kick up the backside to better manage their diabetes. That said they could have explained better the difference between Type 1 and Type 2 - I think someone who wasn't diabetic might walk away from the show thinking that there was only one type of diabetes and you only get it if you're overweight.

It also showed all 'young' diabetics as being unruly and unwilling to manage their condition, I bet for every person they showed there are at least 10 who are well controlled, but showing this wouldn't make for good TV.

It may be that a structured eduction course for teens might help this situation. I found with DAFNE that one of the most rewarding parts was sharing experiences and advice with other people with the condition, and I think it has helped me stay on track. Being able to talk to other young people who are dealing with it may inspire/help those who aren't well controlled to think about their diabetes more.

Simon, I don't think a 'kick up the backside' is what people need. I went through a bad period that lasted years and I do blame the doctors for that. They put me on MDI without telling me how to adjust my insulin. The emphasis was all on restricting food as if I was still on 2 injections of mixed insulin. My HBA1C must have been through the roof but they never mentioned it, or my obviously faked blood sugar results in my diary. They booted me out at 15 as my working parents could not take me to the clinic and missed some appointments. There was no continuity of care they just dumped me. I got myself referred to adult clinic but it was so miserable with no support I stopped going and did not see a dr for years. Sadly I do not think my experience is unique. Doctors are appalling at dealing with teenagers or diabetics in general. They expect you to be a machine and if you are human and make mistakes they have not a clue how to support you. They neglect to tell you vital information about how to deal with hypos, adjust insulin...the list goes on. They are happy to just see you once a year and leave you to struggle in between appointments. Teenage years are hard enough for people, for diabetics they are even worse. We need support not criticism. In fact, all the scare tactics people used made me worse - they scared me rigid so I could not even think about my diabetes and avoided testing so I did not see the high results. If I was high I did not know what to do about it due to the doctors not telling me, so I did not bother testing. I think that at least for some of these teenagers their fierce bravado might hide terrible fear and the doctors showing them images or telling them about amputations or blind people and how irresponsible they are just makes that worse, makes them more resistant and obstinate, more terrified to face their condition. Not everyone is irresponsible. Doctors are neglecting their duty of care to find out the real reasons why teens do not check their blood sugar or manage their condition. Blaming the teenagers is lazy and despicable in the part of the doctors in my opinion.

Hi Lizzie. I am straying a little from the 'questions for health care professionals' forums in posting on this thread but I think you are being a little hard on medical staff here and hope we have learnt a bit a bit over the years. Those of us who run clinics for young people can see very clearly how tough it is to manage diabetes on top of coping with being a teenager.
The difficulty is finding the right approach to let young people know they are supported and doing anything in our power to help them manage their diabetes more successfully. Many just hate having diabetes and it is scary to see people stopping their injections and ending up in hospital with dka or running sugars around 30 for weeks on end. I agree we haven't yet learnt the best way to support them but hopefully in clinic no-one is judgmental just exploring the best way to give the right level and type of support. I couldn't agree more that taking people round the kidney unit or showing horrible pictures is completely crass and wrong.
We are currently exploring ways of supporting people with a team of nurses/dietitians who are there for families outside traditional clinic settings. We hope this will offer better support in terms of education (when it is wanted/needed), dealing with family conflict and encouraging even small positive steps for kids to look after their diabetes a bit more effectively. It is challenging however and we will get many things wrong as well as hopefully a few things right. If it got rid of the traditional diabetic clinic which doesn't seem to suit most young people,and replaced it with something more effective, I would be very happy. Simon

Maybe I was a little harsh Simon. I am sure somewhere out there there are doctors who are kind and supportive. But I have not met any and can only speak for my own experiences. Maybe I have been unlucky. I wish I could find a doctor or medical professional who actually cared. I try to be hopeful when I go for appointments but each one just ticks the boxes and gets me out the door again. The last one did not even check my feet or ask to see my diary. He was more interested in pressuring me to have weight loss surgery. This seems to be the favoured solution for my doctors rather than asking about my mental wellbeing and trying to deal with all my many and varied issues involving food, diabetes, and my father's death when I was 18 months old, which have plagued me all my life. Instead of doing what I think is their job and investigating the actual reason why I am struggling with diet and exercise, they would rather I had my stomach removed. Nice, eh?

Yes, your experiences aren't encouraging but I do know docs/diabetes teams in London who have a very different attitude and who were instrumental in developing DAFNE with us. Just as it has been a big struggle to persuade diabetes teams that DAFNE is essential to promoting better diabetes care, we all have a lot to learn about the right way to support young people who would rather not have diabetes.

I know I'm bound to say this since I'm lucky enough to be involved with the DAFNE Management team and have been to the collaboratives and met a number of the HCP's, but there ARE a lot of good and very dedicated medical people out there who work very hard. I'm also very lucky to have a brilliant Diabetes consultant who always has as much time for me as I need and never rushes our consultations. Sure his clinics ALWAYS run late, but you happily accept that because you know you will probably run over your slot. I have on occasion seen newer, younger consultants and one or two have had a lot to learn in terms of patient relationships. I guess thats something they learn with experience and maybe Lizzies consultants still have this road to walk. I'm not clear though Lizzie if you see a GP or a hospital when you talk of 'doctors'. I do find that GP's are no where near as good. They just don't understand the deep details like someone who works in Diabetes full time. I know locally to me the PCT is trying to push Type 1 and 2's into the GP's care which is NOT a good thing.
I think the problem with young people is they want to rebel, we all did at that age. Fortunately for me I wasn't diabetic so my rebellions were not dangerous to my health ( well not in the long term anyway !). I have met many people who went off the rails when they were younger and now with the benefit of hindsight regret it. Maybe, just maybe, shock tactics are necessary to make people take it seriously. I never forget my first visit to the hospital diabetes clinic when I lived in southampton. It scared the life out of me, people with amputations etc. that made me realise I had to take things seriously and ensure I kept my condition under control, I didn't ever want it to be me in a wheelchair. Fortunately since then I have met and become involved with diabetics of 30 and 50 years who are completely fine and complication free. It can be done but not without taking responsibility ourselves for our own treatment. Thats the point of DAFNE, to give us the ability to manage ourselves and NOT rely so much on the Diabetes support team.
Sorry that went on a bit and I haven't seen the TV programme but maybe the negatives will encourage a few to take Diabetes as seriously as they should.

Hi again Marke

I see the clinic. That is another thing that annoys me. The Gp seems to always want in on my diabetes management for some reason, probably to further inflate their already massive paycheques. I am quite happy being monitored by the hospital. But the GP keeps sending me plastic vials through the post and asking me to go to the hospital (some sort of outpatients clinic where they take all sorts of blood samples) and get it done, when I already get it done by the hospital diabetic clinic. I see this as needless duplication of resources and wish they would communicate better. The best they currently manage is for the hospital clinic to hand me a letter to deliver to the GP at my annual review. I don't understand why they are not using the same computer system or cannot send my results electronically to the GP, for example as a secure email attachment or something. It seems ridiculously old fashioned to have to hand deliver a letter.

But anyway. I am seen by the hospital. I see a doctor, usually a different one, for annual appointments and the eye department for appointments and occasional photos and thats it. I have tried asking for other help but they don't seem interested in giving it to me. I suppose it is cheaper and easier their way.

I don't think DAFNE has made me less reliant on the diabetes support team. I don't think that is the point. That to me smacks of cutbacks and moneysaving (hey, diabetics are a big drain on the NHS! How can we save money on them? I know, send them all on a one-week course and that will mean we can save on expensive doctors salaries!). My self management has improved since DAFNE. But it was one week several years ago. It will have less and less of an effect as time goes by. I desperately need the support of my diabetes team to keep me on the right track after the course has finished.