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HLN Meets… Amanda Porch, GP

As the number of people at risk of developing type 2 diabetes continues to rise dramatically following the Covid pandemic, County Durham GP Amanda Porch tells us about her new healthcare initiative, designed to bridge the diabetes care gap.

Written by High Life North
Published 17.02.2022

Amanda’s diabetes care journey

‘I’m a “smoggy” girl by background and spent my formative years growing up in Teesside,’ says Amanda. ‘I always had a keen interest in science and decided to pursue a career in medicine. I was lucky enough to gain a place at Hull York Medical School. I then spent a total of 12 years in the Yorkshire and Humber area training and working in the NHS, including a brief stint working as a Doctor for St. Leonards Hospice in York. After qualifying as a GP, I decided to make the move to the Antipodes and jetted off with my husband (and fellow GP) Paul to New Zealand.

‘It was a big move for both of us. We fancied a change of scenery and the opportunity to see some of the sights that New Zealand had to offer. In New Zealand, we worked hard and played hard. Paul and I ran a GP practice on behalf of Green Cross Health in the coastal rural West Auckland area. We took over the practice from a couple working there for over 30 years, so we had some big shoes to fill. We had only recently completed our GP training, so running things on our own was a leap into the unknown, but an incredibly rewarding life experience for us both.

‘One of the big things we focussed on was diabetes care, which was a major health issue in the area. New Zealand’s diabetes care system is different from the UK. At the time, the choice of funded medications was more limited than here. Appointment times were longer too, which enabled us to fill this gap by helping to support and optimise lifestyle change as the most important tool for managing diabetes. The insights we gained during our time there sparked the idea of setting up Diabetes Lifestyle Doctors on the long flight back to the UK. We wanted to translate the lessons we’d learned from New Zealand into a programme that could help the NHS.

‘New Zealand is an amazing country and still very close to our hearts, but we decided to return home to my native North East to be closer to family. Paul and I are now happily settled in County Durham.’

The inspiration behind Diabetes Lifestyle Doctors

‘I was inspired by my experiences of diabetes care and General Practice in New Zealand, as well as the personal experience I have through my NHS patients in County Durham,’ Amanda continues. ‘The New Zealand diabetes care system very much opened my eyes to the power of lifestyle change for managing pre-diabetes and type 2 diabetes. One of the key things we focused on was early intensive lifestyle and behaviour change. As GPs in New Zealand, we had more time and resources to help and support patients more effectively – a luxury not afforded by the NHS.

‘One of the big issues patients in the UK experience is access to a choice of diabetes care services. The current system is very much a postcode lottery; the services available to patients vary markedly depend on where they live. The right lifestyle interventions and support at an early stage can deliver positive outcomes, but access to this support is limited and is a key barrier stopping patients from getting the help they need. One of the motivations behind our new enterprise is reducing this inequality of access to comprehensive lifestyle interventions for pre-diabetes and type 2 diabetes by providing a fresh option and choice for people.

‘One of the key patient groups we are also keen to help is pre-diabetes: those who are at heightened risk of developing type 2 diabetes. The number of people in this category has grown significantly during the COVID-19 crisis. The endless cycle of lockdowns and working from home means that people’s lifestyles have been less active, and people have frequently turned to food and drink as coping mechanisms. This, combined with increased waiting lists, a shortage of routine appointments, and heightened pressure on NHS frontline services, has created a perfect storm for diabetes care.

Bridging the diabetes care gap

‘Through our new initiative, people can participate in a 12-week personalised programme of support based on diet, lifestyle change and expert medical guidance,’ Amanda explains. ‘The specialised support we can offer includes access to trained medical professionals such as doctors, health and wellness coaches, and dietitians. We also provide access to healthy recipes, a collection of resources including video content, and a community support network hosted on social media. 

‘This aims to redress some of the systemic problems with diabetes care. The NHS spends an estimated £10 billion a year fighting diabetes; however, nearly 80% of it goes to treating complications. By this stage, a lot of the damage is already done and could have been prevented through early intervention.

‘One of the big problems all GPs face is limited resources and a lack of time due to their heavy workload. For patients with type 2 diabetes, this often means that GPs don’t have the time and resources to provide patients with the guidance and support they would like to provide during the initial stages of diagnosis. Early intervention can make all the difference and stop future health problems before they start. Our work aims to bridge the diabetes care gap in the NHS through a medical-led programme of patient-centred support.’

Type 2 symptoms and lifestyle change

 ‘One of the things about type 2 diabetes is that people don’t always exhibit symptoms,’ says Amanda. ‘It’s often a silent health condition that is only picked up by a routine blood test at a GP’s surgery. People may experience general feelings of fatigue, increased thirst and, in some cases, excessive urination. However, these can be attributed to a variety of issues.

‘Moreover, while type 2 diabetes is not always a genetic issue, genetics play their part. It’s a combination of 80% lifestyle and 20% genetics. The environment people are raised in influences their behaviour and lifestyle choices later in life. Having a family history of diabetes and weight-related health problems will also make people susceptible to developing type 2 diabetes at some point in their adult life.

‘The nature-nurture dichotomy makes genetic predisposition and environmental factors difficult to disentangle in practice. Wherever the boundaries may be, lifestyle intervention with type 2 patients can involve undoing poor diet and lifestyle choices decades in the making.

‘Making positive health and lifestyle choices takes time, effort and medically informed intervention to get results. Fad diets and quicks fixes don’t deliver lasting results; addressing the whole person, alongside healthy diet choices and integrating exercise into everyday routine, is required to deliver long-term, sustainable change. It won’t happen overnight, but the right intervention can be life-transforming.’

If you or someone you know has type 2 diabetes or pre-diabetes symptoms and you’d like to find out more about the work of Diabetes Lifestyle Doctors, visit their website and follow them on Facebook and Instagram

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