Carbohydrate counting groups are available at Falkirk Community Hospital, they are delivered by one of our Diabetes Dietitians.

Who are the groups for?

The groups are suitable for those who take multiple daily injections of insulin and require a refresher in carbohydrate counting and also those who are new to carbohydrate counting.

How many people attend a group and how many sessions do I need to attend?

There are 8 spaces available in each group and these are delivered over 2 sessions, 1 week apart. Each group session lasts 2-3 hours depending on the numbers attending.

What does the education session involve?

This interactive education programme is designed to help you develop practical skills and become confident in carbohydrate counting, to allow you to confidently adjust your food insulin for what you choose to eat. We will ask you to complete a food diary in-between each group session.

The education at the group covers all aspects of carbohydrate counting including:

• Food groups
• Reading food labels
• Weighing foods
• Useful apps for eating out
• Advice on insulin to carbohydrate ratios
• Action of food insulin and timing

How can I attend?

If you are interested in attending a carbohydrate group session you can get in touch with the Diabetes Dietitians by emailing fv.fvdiabetesdietitians@nhs.scot or call 01324 566626. If you are leaving a message please leave your name, date or birth and phone number so that someone can call you back.

We will discuss:

• how to upload your results to LibreView or Clarity;
• how to interpret the results from your Libre or Dexcom device;
• targets for your blood glucose; and
• how you would decide what insulin to change.

The group lasts around one and a half hours, with around 12 people.

Our Pump Assessment groups run regularly throughout the year.

We see up to 10 people with Diabetes in each group.

These groups allow people with T1 DM to learn more about how an Insulin pump works, and the opportunity to visualise and ask questions about available pumps within Forth Valley.

As part of your ongoing education to learn about your new diagnosis of Type 1 Diabetes you are invited to a psychology and consultant led group appointment.

You will be seen with others who have recently been diagnosed with diabetes.

The psychologist will discuss the range of emotions that comes with a diagnosis of diabetes, coping strategies and how to access support.

The doctor will discuss the reasons for good diabetes control, screening and staying healthy with diabetes.

There will be the opportunity to ask questions, so please write these down and bring them to the appointment.

You are welcome to bring a family member or friend with you.

Time

9.30am – 12.30pm

Week 1 – Wednesday appointment

We will:

• Re-cap our discussion when you were diagnosed and answer any questions that you may have
• Check your understanding of diabetes, how to test your blood glucose and discuss the readings that you should be aiming for
• Check you know how your insulin works and how to administer and store it
• Advise you how to order a repeat prescription
• Briefly discuss food
• Check that you know how to treat hypoglycaemia
• Give you the contact details of your Diabetes Team and make sure that your next appointment with us is booked

We may also discuss other topics such as smoking, driving, family planning and employment.

Week 1 – Thursday appointment

We will:

• Discuss food groups and their impact on your blood glucose levels
• Show you how to look at food labelling to help you identify which foods contain carbohydrate
• Explain how matching your dose of insulin will help manage blood glucose levels
• Advise you how to keep a detailed food and drinks diary
• Have time for any questions that you may have and make sure that your next appointment with us is booked

Week 1 – Friday appointment

We will:

• Discuss the causes, symptoms and treatment of hypoglycaemia
• Discuss the effect of alcohol, exercise, hot weather and lumpy injection sites on blood glucose results
• Advise you how to manage high blood glucose results & explain what ketones are and how you can treat them
• You will be offered a blood glucose sensor
• Have time for any questions that you may have and make sure that your next appointment with us is booked

Week 2 Tuesday appointment

We will:

• Re-cap which foods contain carbohydrate, and look at the impact of the food you have eaten on your blood glucose levels
• Teach you how to use an insulin to carbohydrate ratio, and use this to adjust insulin with food
• Show you a bolus calculator app (if suitable for you) and help you set it up with your ratio, correction and target blood glucose levels
• Advise you how to keep a food and blood glucose diary
• Have time for any questions that you may have and make sure that your next appointment with us is booked

Week 3 – Tuesday appointment

We will:

• Re-cap information on carbohydrates
• Look at the information in your diary, and make changes to your ratio or correction if required
• Check how you’re getting on with counting carbohydrates and maintaining blood glucose levels in your target range
• Discuss healthy eating in relation to your diabetes management
• Discuss the effect of exercise on blood glucose, and how to adjust insulin for physical activity
• Have time for any questions that you may have and make sure that your next appointment with us is booked

Week 4 – Consultant review

We will:

• Discuss the impact on your diabetes of any other medical conditions that you may have
• Advise you about screening and why it is carried out
• Check your understanding that achieving blood glucose levels in your target range reduces the risk of long-term complications
• Have time for any questions that you may have and make sure that your next appointment with us is booked

We may also discuss others topics such as the risks of smoking and family planning.

Week 5 – Named nurse appointment

We will:

• Check that you know your blood glucose targets and how to review your own results
• Re-cap how to manage your high and low blood glucose results
• Discuss hypoglycaemia when it requires help from somebody else
• Check that you know how to contact your meter or sensor company if you need any technical support
• Check your understanding of why we ask you to bring your meter and diary to each appointment
• Have time for any questions that you may have and make sure that your next appointment with us is booked

We may also discuss others topics such as traveling abroad and any contact from the DVLA about your recently diagnosed diabetes.

Consultant led group

We will:

• Provide an opportunity to meet others recently diagnosed with diabetes
• Discuss what a healthy lifestyle is
• Discuss what and why screening is carried out and how this helps you to stay healthy
• Check your understanding of an improved Hba1c reduces the risk of the complications of diabetes and that testing at least 4 times a day is associated with improved Hba1c
• Check that you know how to review your home blood glucose results and how to contact your Diabetes Team if you need help
• Have time for any questions that you may have and make sure that your next appointment with us is booked

Psychology led group

We will:

• Have time for any questions that you may have
• Provide an opportunity to meet others recently diagnosed with diabetes
• Explain what a clinical psychologist is and why there is a clinical psychologist within your Diabetes Team
• Discuss the link between physical and emotional well being
• Discuss what coping means
• Discuss different coping styles and strategies and that mood can affect these
• Discuss relaxation techniques
• Reassure you that your Diabetes Team are here to support you now and in the future

STEPup is a 2 day programme designed to help you manage your diabetes and feel more confident with adjusting your insulin.

The group will be facilitated by a Diabetes Specialist Nurse and Diabetes Specialist Dietitian, and will have 6 adults with diabetes in the group.

We will facilitate discussion about living with diabetes, and ask that you respect other people’s views.

You will be expected to attend both days all day.

We will ask you to complete a food diary between day one and day two, and check blood glucose levels regularly (minimum scan 6 times daily). If you do not already have Libre 2 or Dexcom please let us know in advance of this session so we can organise this for you.

Below is an outline of the programme.

Day One

Day Two

In this appointment you will be joined by other people with Type 1 Diabetes. This confidential session will allow you to see what concerns other people have and give you the opportunity to ask questions.

There will be the opportunity to have time with one of the diabetes team individually should you wish to.

Things you might want to discuss:

• Insulin doses and injections
• Using and interpreting your Libre/Dexcom monitor
• Injection sites
• Carbohydrates
• Stresses and worries (why me?)
• Effects of exercise