Archive for the ‘Diabetes’ Category

C8 MediSensors New Non Invasive CGM Device – WOW.

Posted in Diabetes, Insulin Pumps, tagged Accu-Chek, Animas, Bayer, C8Medisensors, Cellnovo, Diabetes, eyes, Fitbit, Glooko, iBGStar, insulin, Lifescan, Medtronic, Menarini, Mendor, retinopathy, Roche, Sanofi on September 3, 2012| 2 Comments »

The Power of Light

For decades, researchers, scientists and people living with diabetes have searched for a non-invasive way to continuously measure glucose.

Enter the power of light: C8 MediSensors’ optical glucose monitoring technology is a breakthrough in glucose monitoring science. Completely non-invasive, this new technology promises a new glucose monitoring experience.

As you are probably already aware CGM or continuous Glucose Monitors have been available to us for quite a while now and range from individual devices to combined insulin pumps with built in CGM.

I was very lucky to have received an invite from C8 MediSensors to view their new Non Invasive CGM along with some fellow bloggers from Input, Insulin Independent, Every Day Ups and Downs – A Diabetes Blog all of course are certainly worth reading.

So the day started in London at a Consultancy Company who were great and had everything prepared for us bloggers (Nice sandwiches mmmm) as we can be hard work sometimes ha ha, we were all very excited to see this new CGM device and find out just how it works – not forgetting how much it costs. All the guys were very open and the day in my mind was for us bloggers to provide feedback on what we thought of the CGM which will also be operated using a smartphone app with various functions/log books etc so we all put our pennies worth into this as well.

I have been lucky enough to trial the Medtronic Enlite CGM Sensor and the Animas Vibe CGM Sensor of which both work in conjunction with the Insulin Pump which is great but still not perfect but they are certainly getting there. Both these devices use a wireless CGM sensor that in invasive ie literally goes into your skin that I found a little uncomfortable sometimes but you did get used to it very fast, I also struggled sometimes to find space on my body to insert the sensor as I was also wearing a canular for the insulin pump. All this said the technology on these devices is incredible and gives you a good trend on your blood sugar levels however you will still need to take regular finger prick tests to calibrate the CGM and this is the same for all CGM’s at the moment.

The product itself is a non-invasive optical CGM and is currently classed as a ‘investigational device’, so not yet available for sale anywhere but hopefully this will change very soon – even this year but you all know what red tape is like. C8 MediSensors will hopefully receive European CE mark approval towards the end of this year and plan to launch in the UK and Europe first so that is good news for us.

The Power of Light: Using Raman Spectroscopy to Measure Glucose

Our technique involves shining a monochromatic light source into the skin and detecting the scattered light. The colors generated by Raman scattering are very specific to the exact chemical structure of the molecules in the sample. The molecules’ various shapes, sizes, atoms, and types of chemical bonds will generate unique Raman spectra, a unique Raman “fingerprint” that can be used to non-invasively read and measure glucose.

I managed to find this info video on YouTube which I found very helpful but of course the best info would be found on the C8 MediSensors own website

C8 MediSensor info which I hope you will find useful.

CGM uses an optical light which was taken from Raman spectrometer which in its orignal state would be the size of an oven but the team have managed to minimise this to the size of a matchbox which is truly amazing.
The device needs to go against the skin which needs to be clear of hair or anything that would obstruct the optical light, the device would update you on your smartphone if the light is broken.
There is no separate control for this CGM as it is all done through your smartphone using te C8 MediSensors App which is still being fine tuned to meet our needs, you should be able to view you BG level, log books and lots of other useful info which is still to be confirmed.
At the moment the CGM is designed for use only by adults but I am sure this will change in the future as we never know what is around the corner.
The C8 MediSensor is about the size of a match box and similar in weight to a small mobile phone, there is also a separate battery pack to power the CGM of which both items are worn in a very non sexy looking material band – please remember this is brand new so like everything I am sure the C8 team will be working on revamped accessories etc.
A huge plus point for me is the fact you can put it on and off whenever you want as it is non invasive – even if it is worn a=in a rather large band.
As this device uses optical light it can be affected when you are in very bright areas or even sunshine but the guys have a special material light shield which fits over the CGM to eliminate any sunshine issues – but to be honest you possibly would not want to be wearing this device on the beach, well not yet anyway.
The CGM can store a rolling 4 months worth of data which should be more than enough info for most of us.
Initial calibration is between 45-60 minutes and when placing the CGM Sensor onto your skin it can take 15 minutes to warm u.
COST – well a typical CGM Sensor alone could cost thousands of pounds per year but we were given an indication that the C8 MediSensor will retail at US$4,000 (approx £2,500 at today’s exchange rate). The shelf life would be up to 4 years so this one-off payment should in theory be it – this compared to invasive CGM would be far cheaper in comparison.

I hope the above has answered some of your questions and I must apologise if I have missed anything – please leave me a comment if you have any further questions ?

The Science Inside

Optical glucose monitoring leverages decades of technical innovation in optics, wireless, digital cameras, miniaturization and lessons learned from dozens of attempts at measuring glucose non-invasively. Utilizing a patent-protected process, our design will transmit a painless pulse of light into the skin to detect glucose levels. Paired with Bluetooth technology, the glucose reading will be transmitted wirelessly to an easy-to-use display application on an ordinary Android smartphone.

It was a real pleasure to meet the guys from C8 and Andrew from STWEM who arranged the event, it was quite refreshing to be speaking to a team that was open to the majority of our probing questions and they were free with the info, I hope that we as bloggers have given the team some valuable information to help enhance the device and I hope this will be a continued relationship with C8 – thanks again guys.

A New Experience Awaits

After eight years of research and development, we hope to make optical continuous glucose monitoring a reality for people with diabetes. Currently an investigational device and not available for sale, we plan to pursue regulatory approval and make this new technology available in Europe in 2012.

To stay apprised of product availability, sign up for our regular updates.

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Diabetes and new Technology.

Hi,

As you are possibly aware I have had Type 1 Diabetes all my life which is in fact 40 years – hard to believe I know 🙂

Since I was first diagnosed as a baby the technology has changed so much for products to assist people manage their Diabetes easier, I still remember having large stainless steal with glass syringes that needed to be sterilised each time you used it (Thanks to my Mum) and even checking your Glucose Levels involved urine in a tube which you added a fizzy tablet that changed the colour of the urine – oh my god.

Back to 2012 and some absolutely amazing new products to me which over the next few weeks I hope to have some more in depth Blogs about but some items that have caught my eye have been :

1 Mendor Discreet – All in one BG Meter which is amazing.

2. C8Medisensors – a new non invasive CGM due for release this year all being well, I was lucky to attend a product demo in London a few days ago – WOW. More details to follow.

3. Glooko – this is a cable the attaches to your iPhone in conjunction with an App that allows you to sync your BG results to your phone with lots of other useful add ons. I love it and Blog coming soon.

4. Cellnovo – Insulin Pump, come on guys we have been waiting such a long time for this to be released and I must say this again is technology at its best, I am looking forward to a trial of this patch pump/handset soon.

5. Sanofi – iBGStar BG meter that is tiny and actually can be used on its own or is really created to clip to the bottom of your iPhone to work again in conjunction with an App – Amazing.

Please forgive me if I have missed anything out but these are a few items I have been looking at recently, not forgetting all the Diabetes companies which have literally changed my life such as Medtronic, Animas, Lifescan, Roche, Bayer, Everymed and Sanofi (iBGStar) to mention a few – THANKS TO YOU ALL.

Thanks very much for reading and don’t forget to follow me on Twitter @MyPump1 or info on http://www.mypump.co.uk & http://www.mypumpblog.com.

Have a good weekend
Andrew

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Menarini Diagnostics – Glucomen BG Meters.

Posted in Diabetes, Insulin Pumps, tagged Abbott, Advanced Therapeutics, Animas, Cellnovo, Diabetes, Glooko, Glucomen, iBGStar, Input, insulin, Medtronic, Menarini, my pump, Omnipod, Roche, Sanofi on August 28, 2012| Leave a Comment »

Hi,

I just wanted to share some info regarding blood glucose meters and a superb company called Menarini Diagnostics who have a range of blood glucose meters called GlucoMen (LX PLUS and GM) which I have been using for a while now and found them easy to use, the customer support team have also been very helpful.

Here is a little bit of company info about Menarini:

Menarini Diagnostics was established in the UK during 1987. The company is now established as one of the fastest growing diagnostics companies in the UK with annual growth in excess of 20%. To date Menarini has already placed more than 700 analysers of various types in the UK market. MDUK are market leaders in the field of diabetes diagnostics, with leading edge systems for HbA1c, blood glucose and continuous glucose monitoring.

Nearly 60% of all HbA1cs in the UK are performed on our lab systems. That’s more than 1 million people relying on MDUK HbA1c systems every year. Over 1 million self tests are performed on GlucoMen blood glucose meters every day across Europe.

MDUK’s goal is to work closely with all Diabetes Specialist Nurses and patients, and continue to do the right things to support the growing number of people who choose to rely on the
GlucoMen LX systems to help manage their diabetes at home.

I have been using the Glucomen LX PLUS for a while now and when I first received the meter it was in a lovely gold box so also a little bit of bling (ha ha), anyway sorry back to my thoughts…..

MDUK’s GlucoMen LX PLUS is a blood glucose meter that incorporates a 2-in-1 blood glucose and ketone testing facility.

The ketone testing is particularly useful for insulin users and those who may wish to test their blood ketone levels.

GlucoMen LX PLUS meter advantages

The GlucoMen LX PLUS is a no coding meter that provides:
** Pain free with a unique lancet introducing comfort zone technology
** Blood test results in 4 seconds
** Coloured covers to personalize your device – hmmm funky.
** 0.3 microlitre sample for easy and comfortable testing
** Meal markers for controlling your diabetes
** The device has a rubber grip, which makes it easy to use and prevents it sliding off surfaces.

Alternative site testing is available for blood glucose tests however ketone testing should be done on the fingers alone.

The GlucoJect Dual S lancing device that comes with the meter has Comfort Zone technology designed to reduce pain when testing, this is one the best lancing devices I have tried.

A number of different coloured skins (10) are available for use with the meter.

More information on GlucoMen LX PLUS along with diabetes education and videos can be found on the company website www.glucomen.co.uk. They also have a facebook page with latest news and updates.

At the end of the day it’s down to your personal choice but this is certainly a meter that is worth trying.

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Driving and diabetes: changes you must be aware of!

Posted in Diabetes, Insulin Pumps, tagged Bayer, Bayer Contour, Diabetes, Glucose, Hba1c, Hypo, insulin on August 10, 2012| Leave a Comment »

Please find below a very useful informative mail shot I received from the team at Bayer Diabetes Care

Having problems reading this email? Click here to view this newsletter online

We are writing to remind you of changes in standards introduced by the Driver and Vehicle Licensing Agency (DVLA), which mean that people with Type 1 diabetes can now be considered for a licence to drive lorries and buses.

The DVLA has removed the ban for people on insulin driving these kinds of (Group 2) vehicles, providing they undergo an individual medical assessment to prove they are fit to drive vehicles in this category.

In Northern Ireland the same change is likely to happen this year.

It’s a welcome change, but it does mean that you need to be well prepared before you can get going.

People wishing to drive larger vehicles will need to demonstrate:
That they have not had a severe hypoglycaemic event in the last 12 months
That they have full hypoglycaemic awareness
That they have an understanding of hypoglycaemia
That they have control of their diabetes by regular blood glucose monitoring at least twice daily and at times relevant to driving
That they have a fast acting carbohydrate in the vehicle at all times when driving

You will need to have used a blood glucose meter with a memory function to measure and record your blood glucose for at least three months prior to submitting your application.

Equally, there have also been recent changes which affect assessment criteria for people applying for a licence to drive cars and motorbikes.

All the details, including the D2 application form, can be found on the Department for Transport’s DVLA web pages. www.dft.gov.uk/dvla/medical

It sounds quite onerous, but in fact providing you are well organised it doesn’t mean you need to feel restricted or be limited in what you can do. The key is to make the most of all the tools you have at your disposal, and be totally consistent and regular in your testing and monitoring routine.

So how can we help?
Using Bayer’s CONTOUR® USB meter will enable you to test, monitor and upload all the regular reports you will need to demonstrate your fitness to drive.
Use your CONTOUR USB meter with our GLUCOFACTS® DELUXE diabetes management software to analyse your reports, modify your routine and better manage your diabetes. Doing this routinely should help you understand what affects your blood glucose and so help you avoid hypoglycaemic episodes – and of course the records you keep will be able to demonstrate this.
Your CONTOUR USB has the memory function you need, and you will easily be able to store and download your last three-month results using our software.
Remember too that using our new My Reports feature on our website, you will be able to check your results and look at your reports any time, anywhere, from your smart phone or tablet.

All the information on the new standards are on the DVLA’s website, and if you would like more help on how to make the most of your glucose meter and monitoring equipment, just log onto www.bayerdiabetes.co.uk.

You will also find useful information on driving and diabetes at www.diabetes.org.uk. Remember to contact your diabetes healthcare professional if you have any questions about your diabetes management.

Please do check the bayerdiabetes.co.uk website, and if you would like to ask any specific questions regarding our diabetes products, please get in touch with us!

Ros Barker
Bayer HealthCare

Contains public sector information licensed under the Open Government Licence v1.0.

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INPUT Insulin Pump Exhibitions 2012 – Nottingham 14th July 2012

Posted in Diabetes, Insulin Pumps, Uncategorized, tagged Abbott, Advanced Therapeutics, Animas, Cellnovo, Diabetes, Input, insulin, Medtronic, my pump, Omnipod, Roche on July 9, 2012| 1 Comment »

INPUT Insulin Pump Exhibitions 2012
Any (insulin pump) Question Answered

Have you heard about insulin pumps and wondered how to find out more about them? Do you have questions about what it’s like using a pump? Would you like to see in real life the makes and models of pumps you’ve heard about? Or do you have questions or concerns about NHS funding for pumps? Your chance to chat with pump users and pump company representatives about all these topics (and more) could be just around the corner at an INPUT roadshow!

Current Venues and Dates (further information on venues below). More dates and venues being added soon.

Who: open to all people with diabetes and their family members or carers who want to learn about the principles and practical aspects of pump therapy over a cup of tea or coffee.

We have invited the following companies to exhibit:

Abbott (Freestyle Navigator)
Advanced Therapeutics (Dana & Dexcom)
Animas
Cellnovo
Medtronic
Roche
Ypsomed (OmniPod)

View my Blog about the superb previous Input Roadshow I attended in Luton.

www.mypump.co.uk
www.mypumpblog.com
****

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Diabetes and Jelly Belly Beans mmmmm.

Posted in Diabetes, Insulin Pumps, tagged BG, Diabetes, Glucose, Hypo, insulin, jelly beans on May 31, 2012| Leave a Comment »

Hi all,

Over the past few years I have been comuting to and from work by cycle which is about 4 miles so not too bad, well apart from when it is raining – cold – windy in fact I hate it (only joking).

The one problem I have is my blood glucose levels plummet once iget to work or arrive home and I have tried numerous different products including dates and bananas which do definitely help. My problem is I am normally in a rush so prefer to pop something easy into my mouth and get going as soon as I can.

I am sure I am not the only person with Diabetes to have this issue and I have discovered jelly beans well Jelly Belly Beans which I must say do taste a little bit to nice as I struggle to put them down ha ha. A colleague of mine had read an article about people with Diabetes using jelly beans when running or swimming so I thought I would give it a try.

The great thing for me Is that each bean is approx 1g of carbohydrate and I tend to have between 10-15 beans before cycling which certainly does do the trick. What is do like is the fact they do not stay in my system for hours and hours but enough to cover my exercise which is usually about a 20 minute cycle. I have also tried Jelly Belly Sport Beans which do not taste quite so yummy but they do last far longer in your system and contain more carbohydrates per bean so better for longer bouts of exercise.

So down to my favourite flavours well all of them (Possibly not cinnamon). Cherry is so lovely, Top Banana is also a yummy bean and not forgetting Coconut.

Anyway I hope this has helped a little bit but if you have not tried Jelly Belly Beans before give them a try as they have helped me on more than one occasion but moderation is the key mmmmm.

Take care.

Andrew

http://www.mypump.co.uk
http://www.mypumpblog.com

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Input Diabetes Roadshow Event

Posted in Diabetes, Insulin Pumps, Uncategorized, tagged Advanced Therapeutics, Animas, Cellnovo, Diabetes, Input, insulin pump, Medtronic, Roche on May 2, 2012| 2 Comments »

I decided to attend the Input Roadshow held at Hilton Garden Inn – Luton on Saturday 14th April running from 1.00pm – 4.30pm and it was great to see Lesley and Anna from Input for a catch up.

I was pleasantly surprised to see so many people with Diabetes attend to ask questions and see what Insulin Pumps are currently available. The companies who attended were Animas, Roche, Medtronic, Cellnovo and Advanced Therapeutics all showing off their latest pieces of Diabetes kit.

I arrived at 1.00pm and was greeted by the Input team that put this super event together so well done to the Input team for a great event. My main objective was to say hi to some of my contacts from the Insulin Pump companies and to see what new technology is available.

I am already very familiar with the Medtronic Veo and Animas Vibe which are both superb Insulin Pumps which offer integrated CGM but I didn’t get a chance to chat with the team from Advanced Therapeutics (sorry guys) which I was a little annoyed at but purely because they were busy and I run out of time unfortunately. I did however get to speak with Jill from Animas who I have met a few times and Justin from Medtronic who again I know very well so it was good to have a chat. I wanted to know more about the Accu-Chek Combo pump as i had not seen it before and how it works so spoke with Sue who also gave me a demo of the system which was great as everything you need can be done by the handheld BG Smart Meter very easily, I also like the software which gave some great reports and was easy to understand. Next I spoke with Carol from Cellnovo which is a new pump shortly being released and certainly looks amazing with its iPhone looking handset to the small patch pump, unfortunately I don’t know a huge amount about the Cellnovo pump as it is very new. Cellnovo is basically a patch pump with an amazing smart handset that can do everything from testing your BG with a built in blood glucose meter for test strips to monitoring exercise due to the patch pump having a built in accelerometer – wow.

My next task is to try and convince Cellnovo to let me try their pump so I can physically see how it works day to day as seeing it in your hand is different to sleeping, working or even excersining wearing the patch pump.

All in all a very enjoyable afternoon and superbly organised by Input so well done guys. Check out the Input web site for more info on forthcoming events as it is well worth a visit.

Andrew Borrett

My Pump
My Pump Blog

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Animas Vibe Insulin Pump & CGM trial

Posted in Diabetes, Insulin Pumps, tagged Abbott, Advanced Therapeutics, Animas, Cellnovo, Diabetes, Input, insulin, Medtronic, my pump, Omnipod, Roche on April 5, 2012| 8 Comments »

Hi,

I can’t believe I have already been on an Insulin Pump for 4 years which means my current pumps warranty is up for renewal and at the moment I use an Animas 2020 pump which has been great.

So I am currently using the New Animas Vibe and hope my blog shares some information that you may find useful.

The Animas Vibe insulin pump and CGM system combines state-of
the-art Dexcom G4 Sensing technology with high-performance Animas pumping. That means it gives you the features Animas® pumps are known for, like waterproof durability¥, fine-tuned dosing and a high-contrast, self-illuminating colour display. It’s also designed to streamline the whole CGM experience for you, while giving you a full-colour view of how your glucose is behaving.

Animas Vibe is designed to give you a more complete picture of your glucose*. In addition, its packed with a unique combination of features designed to help you perform at your best.

I didn’t realise that the pump needed to be replaced after 4 years and was a little worried that it may not be funded again but my hospital at High Wycombe are very good and sorted everything out for me very easily. I had been speaking with Caroline and Jill from Animas about renewing my Animas 2020 pump and that I would like to try the Animas Vibe with CGM which they arranged for me.

My day started at High Wycombe Diabetes Centre with Caroline, Jill and Una (DSN) on Monday 30th January 2012, as you can imagine I was very excited indeed. My old pump was really difficult to read the screen which had put me off the Animas pump but what I discovered was that the screen on my old pump had burnt out so needed replacing (That was a relief and of course Animas said they would replace it). We went through the functions of the new Animas Vibe pump which is pretty much the same as the Animas 2020 apart from the fact it has CGM so I already had a head start, I love how easy the Vibe is to use and the fact you have a nice clear colour screen especially when looking at the CGM trend graph as pictured above. The team at Animas and Una were really great and went through everything with me especially on how to use the CGM and inserting it, I am just so frustrated that I can’t get funding from the PCT for CGM.

The actual insertion of the sensor is very easy and didn’t really hurt at all but more of a scratch which I was pleasantly surprised with, the sensors are recommended to be placed on your tummy and not on your back which makes it easier to insert. I did however have an issue with the first sensor which must have hit a blood vessel as a couple of hours later the CGM alarmed to say it was not working, I spoke to Animas who said to change the sensor as when I was with them it looked as though it had possibly hit a small blood vessel. The setting up of the CGM was very easy once the sensor had been inserted and I actually managed easily on my own. The sensor last for 7 days and alarms to let you know once the 7 days has finished, I like the fact you can wear it for 7 days without changing. The second sensor I used went in perfectly and I had no problems at all and again was like a sharp scratch so no pain really.

In regards to the results given by the CGM please remember that the CGM is really to be used to give trends rather than exact blood glucose readings, at the end of the day pricking your finger is still the most accurate. My results compared to finger prick testing were out by quite a way to be honest (not all the time though) but I had been suffering with a nasty chest infection for over a week then travelled to Sweden for a few days, this probably didn’t help with the results so I do hope I get another chance to test the CGM now I am well – we shall see. I have one sensor left as of today Monday 27th Feb and plan to use this after my next Diabetes check up and I will then have used my months trial and can upload my results for my DSN.

So would I use CGM if it was funded by the PCT – yes most definately as it made me feel a lot less worried whilst travelling knowing it would alarm if my BG level was too low.

I hope this helps and hopefully I will get the chance to try some more sensors while I am feeling well but watch this space. Please email or comment if you have any questions at all.

Many thanks

Andrew Borrett
www.mypump.co.uk
www.mypumpblog.com

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INPUT Insulin Pump Exhibitions 2012

Posted in Diabetes, Insulin Pumps, Uncategorized, tagged Abbott, Advanced Therapeutics, Animas, Cellnovo, Diabetes, Input, insulin, Medtronic, my pump, Omnipod, Roche on March 15, 2012| 3 Comments »

INPUT Insulin Pump Exhibitions 2012
Any (insulin pump) Question Answered

Current Venues and Dates (further information on venues below). More dates and venues being added soon.

Luton – 14th April 2012
Chester – 19th May 2012

Time: 1pm – 4:30pm
Who: open to all people with diabetes and their family members or carers who want to learn about the principles and practical aspects of pump therapy over a cup of tea or coffee.

We have invited the following companies to exhibit:

Abbott (Freestyle Navigator)
Advanced Therapeutics (Dana & Dexcom)
Animas
Cellnovo
Medtronic
Roche
Ypsomed (OmniPod)

****

Luton – Saturday 14th April 2012
Venue: Hilton Garden Inn Luton North Hotel, LU2 8DD

***

Chester – Saturday 19th May 2012
Venue: Macdonald New Blossoms Hotel, Chester, CH1 1HL.

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‘Feet first’ for diabetes patients – By Barbara Young, Diabetes UK chief executive

Posted in Diabetes, Insulin Pumps, tagged BBC, blood glucose, Diabetes, diabetic, feet, insulin, insulin pump, my pump, NHS on March 8, 2012| Leave a Comment »

‘Feet first’ for diabetes patients

As a new study highlights major variations in diabetes-related foot amputation rates, Barbara Young, chief executive of Diabetes UK, explains why action is needed to cut rates of preventable amputations.

If I were to tell you about a place where thousands of feet were amputated every year as a result of poor healthcare, you would assume I was talking about somewhere in the developing world.

Well you’d be wrong. The fact is that here in the UK, thousands of people with diabetes have amputations every year.

Not only does an amputation dramatically reduce quality of life, but the likelihood of dying within five years is greater than for breast, bowel or prostate cancer.

And yet an estimated 80% of the 5,000 diabetes-related amputations a year in England could be prevented through better healthcare and improved management of the condition.

The fact that so many people are needlessly having their feet amputated is a national disgrace. And yet despite the large numbers, awareness of the problem is worryingly low even among people with the condition.

But it does not have to be like this.

The scandal of preventable amputations is one we hope to bring to an end with our Putting Feet First campaign. Over the next five years, we want the number of amputations in people with diabetes to reduce by 50%.

Raising awareness of the issue will be a big part of this.

‘Insufficiently thorough’
The 2.8m people in the UK who have been diagnosed with diabetes should know how important it is to manage blood glucose levels, cholesterol and blood pressure well, as well as checking feet regularly and making sure shoes fit properly.

But they also need to know what healthcare you should expect – because all too often it falls short of what people are entitled to.

Firstly, everyone with diabetes should get an annual foot check.

These are important for identifying problems at an early stage, but many thousands of people are not getting them. And when they are being done, they are sometimes insufficiently thorough.

I have even heard of foot checks where the patient is not even asked to take their shoes and socks off!

Also, at the end of the check patients should be told what their risk status is, so if this does not happen then you should ask.

Secondly, if you have a foot ulcer then you need to be seen by a diabetes specialist foot care team as soon as possible.

It should certainly be within 24 hours, as an ulcer can deteriorate in a matter of hours.

Some areas are already doing well in terms of getting diabetes-related ulcers referred to these specialist teams within 24 hours.

But there are also poorly-performing areas where this does not happen.

Tragically, that omission can be the difference between someone keeping their foot and losing it.

If people with diabetes are not offered this level of care, they should insist on it and complain if they don’t get it.

But the point is that decent healthcare is something everyone should get as a matter of course.

For this to happen, we need to address the reason that large swathes of the country are doing so badly.

We know from speaking to health professionals that many of them are desperate to give people with diabetes the best possible foot care but feel unable to do so under the existing system.

This is why the government needs to show leadership on this issue by insisting that all areas of the country offer the same standard of care that is already available in the best areas at the moment and monitoring and managing standards to ensure that they are being delivered.

This greater political will is the only way to bring an end to the tragic postcode lottery of amputations and in doing so create an NHS that really does put feet first for people with diabetes.

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