Choice Case Studies Database

A paediatric diabetes clinic in Guildford is putting children in charge of their diabetes right from the start.

The clinic, based at the Royal Surrey County Hospital, looks after 99 children with Type 1 diabetes and two with Type 2. Almost 70% of these are between 10 and 18-years-old. It is run by a consultant paediatrician with a special interest in diabetes and a paediatric Diabetes Specialist Nurse, Nurse N

At diagnosis each child is brought into the hospital ward for a day – and overnight if they wish. Every child is offered a choice between multiple daily injection (MDI) therapy and twice daily insulin. Nurse N tells them about the different types of treatment. Different roles are taken on by CTs in different PCTs, but core tasks include:

Nurse N said: “When you give them a choice they run with it better and respect you for respecting them. I make the child the ‘boss’ right from the day of diagnosis with the aim of empowering them to be the ‘boss’ of their diabetes.”

An example of how this can work came when a seven-year-old was newly diagnosed with Type 1 and decided didn’t want to do her own injections, so her mother did them twice daily. Then, just a few weeks later she went back into the clinic and asked to do her own injections and change to MDI.