<<forEachTiddler where 'tiddler.tags.contains(context.inTiddler.title)' sortBy tiddler.title ascending write '"*[["+tiddler.title+"]]\n"'>> <<tiddler AutoRefresh with: force>> At new diagnosis confusion over diagnosis threatens role as fit, breadwinner - alters self image and changes to finances heightened sense of mortality anxiety - glycaemic control, long term meds, finances guilt about smoking and diet and frustrations at need to change worry about complications - eye>heart>kidney>leg>amputation>feet>sex probs Depression being ill, testing and treatment feels life is harder at times - annoyed about having disease and having to live with it work hard at not letting self go to a bad place (psychologically) 2-3 times more likely to be depressed if have diabetes than if don't - therefore screen Often folk find it difficult to accept restrictions on life style - encourage to learn more Diabetes UK, Expert pt programmes, DESMOND (community based education programme - Diabetes education and self management for ongoing and newly diagnosed), community diabetes nurse Employment issues - esp if start insulin Financial - insurance premiums, ability to get a mortgage etc etc Cultural - Ramadan, care when travel overseas Sexual - erectile difficulties 3x more likely in diabetic (50% of male diabetics) Driving (approx) diet alone - no need to notify DVLA unless eye complications drugs not causing hypo - no need to notify DVLA if below are met drugs (sulphonylurea and glinides) - only need to notify DVLA if concerns drugs insulin - need to notify and meet below (unless less than 3/12 use -post MI or gestational ....) awareness of hypoglycaemia only at most 1 severe hypo in last 12/12 glc monitouring every 2 hours (up to 2 hours before) vision ok not be regarded as a danger Moving onto insulin ... Pt reluctance due to loss of control worsening of disease ... needles lack of percieved benefit - better in fact does feel better and improve coping