DESMOND for people with Early Onset Type 2 Diabetes (EOT2D)
As the prevalence of EOT2D increases it is imperative that our diabetes education services adapt to ensure they are fit-for-purpose. Evidence is still emerging as to how best to do this, and the team at Leicester Diabetes Centre are leading the way with their M3 trial and also clinically with their T2Day clinical service. With this in mind at the 2024 Award event we spoke to delegates about how DESMOND services can be adapted and considerations for logistics to ensure we can offer evidence-based structured self-management education for this group and the following describes their thoughts. Additionally, watch this space for more opportunities to get involved with research studies from Leicester including the DANA study which will test uptake to an adapted MyDESMOND programme for people with EOT2D. You can find out about the development of this adapted programme here - MyDESMOND for people with EOT2D
GROUP DELIVERY ADAPTATIONS/CONSIDERATIONS:
Offering dedicated age group sessions
Virtual groups
Evening sessions 1630-1930 or weekends
Ensure can signpost to relevant local psychological support
Consider how you can set up/offer ongoing peer support - this could include signposting to MyDESMOND chat forum.
Incentivise where possible
For face-to-face sessions make sure they are accessible and in venues younger participants would be familar with.
Highlight confidentiality.
Integrate technology inc. using slides rather than magnetic board, set up polls instead of asking open questions to the group.
Integrate lived experience to highlight key topics/messages.
Be aware of the following topics potentially having more prevelance during discussions:
Sexual health
Pregnancy/Fertility
Shifts and work impact on diabetes management
Mental health
Remission (signpost to national services)
Importance of medication and appointment adherence
Social life - alcohol, uni life, driving
Diversity (one size does not fit all)
Tech support (e.g., CGM access)
Culture
Ensure food items include diverse mix of items, plus food that is more appealing to younger population.
OPERATIONAL/PROMOTIONAL CONSIDERATIONS:
See above regarding alternative times/delivery modes for sessions
Offer MyDESMOND as first line offer and groups second
Monitor uptake - it may be that shorter sessions may be needed to fit around busier lifestyles - if something you want to consider/pilot do get in touch via desmondnationalprogramme@uhl-tr.nhs.uk and we can provide guidance about splitting the curriculum up differently.
Consider the language used throughout to help reduce stigma.
Look at offereing self-referral if not already available.
Direct to patient promotion:
Use social media - targetted Facebook marketing, TikTok, Instagram - see if there is an Influencer who could help promote service/message
Look at whether your GP practices can run a search and send a text message to those eligible - include details of how they can self-refer
Sports centres, clubs, libraries, coffee shops, colleges, universities
Hold events/stands to talk directly to people and help spread the word
Consider role of volunteers with lived experience in helping to promote - this may be attending stalls, but also in testimonial videos, social media posts, blogs etc.
Venues
you may want to consider if creche facilities are available
Watch this space for updates to this list as well as opportunities to test and offer our adapted programmes. If you are considering offering dedicated groups to people with EOT2D, we would welcome the opportunity to work with you to evaluate its success. Do get in touch via desmondnationalprogramme@uhl-tr.nhs.uk for more information or to organise a catch up with the Central Office team.