Diabetes team helped Hitchin fire officer Daniel Fair stay on top of his diabetes

Daniel Fair, a 31 year-old firefighter from Hitchin, looks a picture of health, but in November 2009 he was diagnosed as having type 1 diabetes.

As Daniel says:

“I was due to go on a three-week trip to Australia and was beginning to feel unwell. Then when I was out there I started to feel very poorly indeed; I was dehydrated all the time, sleeping badly and my vision was affected.

“I put it down to the effect of the long flight, the heat and diet change, but it didn’t get any better when I returned back home. A paramedic checked my blood glucose levels – which are meant to be between 4 and 7 mmol/L before eating; my reading was over 30! I needed to be checked out quickly as I had become dangerously unwell.

Daniel went to the Lister hospital’s emergency department where his condition was stabilised quickly. Shortly afterwards, he was seen by a specialist consultant, diabetes specialist nurse and dietitian. It was confirmed that Daniel had type 1 diabetes and was started on insulin injections straightaway, which meant regular finger prick testing throughout the day, as well as strict new controls on what he ate and when.

“Initially it was all such a shock and my treatment didn’t make sense as I was fitting my food intake around my set insulin doses. Luckily the hospital team got me on to a specialist course fairly quickly, which gave me a much better understanding of my condition, the impact of different types of food and how I could manage my own insulin doses around my lifestyle – although even so, I had to make big changes.

“Thankfully the occupational health team at Hertfordshire Fire and Rescue Service were very supportive – and they have continued to see me every six months. Up until last year, however, I was probably not managing my condition as well as could have been the case. It’s easy to make excuses as to why, but I wasn’t testing my blood glucose levels as often as I should have been – and deep down I knew it was because I didn’t really want to see the results. And that’s probably at the heart of why my condition gradually was getting worse.

“For me a big turning point was the new telehealth project that the Lister diabetes team set up in 2017. Until then, the majority of my contact was with the diabetes nurse at my GP practice, who I see every three months or so. It was a good service, but the additional support provided by the telehealth service has helped me to get control back of my diabetes.

“I chose to stay in touch with the team using text messaging, with the occasional telephone call here and there. It allows me to raise queries, get reassurance and deal with any problems that I may encounter. I also see the team every two weeks as I’m one of several people trialling a new arm patch system that measures blood glucose levels over an eight-hour period. It’s not yet available on the NHS – hence the trial – and it doesn’t tell you your glucose levels there and then, but it does show what’s been happening over time.

“This has really helped me as it showed that despite taking my insulin before going to bed, my blood glucose levels were dipping dangerously low at around 2.00am each night. This helped to explain why often my morning finger prick test returned results that didn’t match with what should be expected. By making simple changes to my treatment with the help of the hospital’s specialist diabetes nurses, we got rid of the problem quickly.

“Prior to getting involved with the telehealth team at the Lister, my diabetes had taken control of my life. Now I’m back in control of it, managing my condition well. Every two to three months, I take a blood test that shows how my blood glucose levels have been over the previous 10 weeks – and my results are now really good and the best they have ever been.”