Diabetes nurses improve outcomes for kidney transplant patients
Two hospital trusts have teamed up to improve the health of kidney transplant patients whose history of diabetes is leading to post-surgical problems including infections and complications with their transplants.
Imperial College Healthcare NHS Trust, which runs a busy kidney dialysis unit at Northwick Park Hospital treating up to 250 patients a week, asked the hospital’s diabetes team to help after noticing poor health outcomes after transplant.
Sharon McCarthy, Diabetes Nurse Consultant at LNWH, said: “The round-robin of medication and managing blood sugar levels can be especially difficult to manage for patients who have other health considerations, including people waiting for a transplant.”
“It is also important to remember that diabetes can be a cause of kidney failure.
"Many of these patients attend the dialysis unit several times a week which means they miss diabetes appointments’ so we decided to send our nurses onto the unit while they were being treated.”
The three-month pilot focused on ten patients which included education about diabetes self-care, reviewing medication and provision of remote monitoring continuous glucose devices.
As a result, they showed improvement in patients reaching their targets, a reduction in hypoglycaemia (low glucose levels) and an increase in diabetes knowledge.
Jayeshkumar Patel, 56, recently celebrated getting a kidney transplant after a three year wait which involved several four-hour visits to the dialysis unit every week to remove excess fluid and waste that his failing kidney couldn’t process.
The 56-year-old admits he was ‘stuck in his ways’ and had trouble changing a diet that comprised largely of takeaways and online food deliveries.
Jayeshkumar said: “I wasn’t the ideal patient but one thing that did work for me was the new glucose monitor I was given by the visiting nurses. The patch stays on your arm for a fortnight before you replace it and you take blood sugar readings from it with the help of a phone app.
“It’s been useful for me because I take readings after eating certain types of food. It really illustrates what is and isn’t good for me and that helped me cut down on portion sizes and think more about what I ate.
“My original readings showed I was at a good level 40% of the time and not so good for the rest. I completely flipped that once I started using the monitor.”