Interview 02
Professional interviews
Ruth Robinson General Practitioner
What causes Type 1 Diabetes?
The beta-islet cells of the pancreas lose the ability to make insulin due to auto-immune damage, it is not clear why people may develop the condition, likely various genetic factors but possibly environmental triggers in combination with this e.g. viruses.
How is it diagnosed in a hospital?
Symptoms (thirst, fatigue, passing lots of urine, drowsiness) Examination (dehydration, rapid breathing) Blood tests - may be done at a random time of day, may be done ‘fasting’ e.g. before breakfast - look at sugar levels, can also look at markers to see what the sugar levels have been over a period of time. If unwell would take blood tests from the artery in some occasions, to check for condition called diabetic ketocidosis. Also examine urine for sugar and ketones. Can also do blood tests to look for antibodies but would ask a specialist about this.
How is it diagnosed in a hospital?
Often under 20, almost always under 40.
What’s the difference between the diabetic nurse and the diabetic doctor?
If an adult is an inpatient I would refer to endocrinology/Diabetes medical team and diabetic specialist nurses (work together).
How present is modern technology in current treatment. E.g. the use of artificial pancreases which can secrete insulin or the use of chips that monitor blood glucose? If current presence is negligible, are you aware of the use of these increasing in future treatment?
Only what I hear about on the news...I have never looked after a patient with an artificial pancreas as far as I can remember!
Are there any mobile applications, aiding the management of life with the disease, recommended to those diagnosed or their families/carers?
I’m afraid it is outside of my area.
Any other ethical considerations surrounding the disease which should be acknowledged by a mobile app?
I suppose if information was stored in the app, would have to consider relevant law around medical confidentiality and how to keep this data safe. T1DM can be a fatal disease if mismanaged, so would need to take precautions to make sure that advice was very clear and that people did not use the app as a substitute in situations when they should be going to A and E or their GP for treatment for example.
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