Summary
Overview
Dr. Chris Van Tulleken and Dr. Xand Van Tulleken speak with Dr. Tammy Hibbert, a GP working in Newham, one of the UK's most deprived areas, about type 2 diabetes. The conversation explores Tammy's personal journey into diabetes care, the profound impact of social determinants of health on diabetes prevalence, and her innovative approach using group consultations to empower patients. The discussion highlights how environment, food access, and community support shape diabetes outcomes, while offering hope through lifestyle interventions and culturally sensitive care.
Tammy's Journey into Diabetes Care
Dr. Tammy Hibbert's interest in diabetes began during her own pregnancy when she was tested for gestational diabetes due to her weight and Black Caribbean ethnicity. Though her test was normal, this experience led her to work in Newham, where she discovered that one in four residents has diabetes and over 50% of hospital inpatients are living with the condition. This shocking prevalence drove her to specialize in diabetes care and conduct research on gestational diabetes outcomes.
- Tammy underwent glucose tolerance testing during pregnancy due to her weight and Black Caribbean ethnicity
- In Newham, one in four residents has diabetes and over 50% of hospital inpatients have the condition
- Tammy's research found that 50% of women diagnosed with gestational diabetes developed type 2 diabetes within five years
- 90% of diabetes patients are seen and managed within general practice, not specialist clinics
" I came into general practice of course this is the lion's share of my work, looking after probably 90% of the patients with diabetes, most of the clinical context most of the day it's a lot of diabetes. "
" 50% of the women who were diagnosed with gestational diabetes within five years went on to develop type 2 diabetes. "
The Serious Consequences of Unmanaged Diabetes
Dr. Hibbert outlines the grave complications that can result from poorly managed diabetes, emphasizing that this is not meant to frighten but to underscore the importance of seeking care. Diabetes affects every organ system, and untreated cases can lead to blindness, heart attacks, strokes, increased infections, and kidney failure requiring dialysis. About 25% of patients on renal dialysis have diabetes as the underlying cause, making regular monitoring and management critical.
- One of the commonest causes of blindness is untreated diabetes
- Diabetes increases risk of heart attacks and strokes
- 25% of patients requiring renal dialysis do so because of poorly managed diabetes
- Patients with diabetes are more prone to infections and skin changes
" This is not to scare anyone, but if there are people listening who are thinking, oh, diabetes is not that serious and they put off seeing the GP because they're busy, because they don't really want to get any bad news, it is manageable, and if it's unmanaged, the consequences can be from blindness to life-threatening conditions. "
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