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DiabEasy as 123

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DiabEasy as 123

Sonia Willis RGN BA Hons, PG Certs, NMP etc has extensive experience in providing diabetes education for all levels of HCP’s and people living with it.

Helping others to understand diabetes better, brings me joy. It’s time to pass on all I have learned! As a nurse with special interest, I am absolutely passionate about ensuring people with Long Term Conditions, especially Diabetes, receive high quality care.To do this I have spent years studying throughout my career, developing my personal knowledge and skills so that I am better able to apply them in clinical practice and also to provide high quality education for other healthcare professionals. Since 2007, I worked freelance for "Education for Health" (based in Warwick) to provide education at various levels, from workshops to Level 5 diploma and Level 6 degree level modules in Diabetes as a Cardiovascular Disease. From 2004 I delivered DESMOND courses for people with Type 2 diabetes in Sheffield, where I live, through a Nationally approved Structured Education Programme (DESMOND stands for Diabetes Education and Self Management for Ongoing and Newly Diagnosed). I never got bored of this as I loved the "light bulb moments" when people suddenly realise that managing their diabetes has a lot to do with common sense and it's not rocket science! I have extensive experience of facilitating learning as I also spent 5 years travelling the length and breadth of the country when I was a National Trainer and Assessor of the diabetes educators that run DESMOND courses. I left that role in 2015, when I temporarily held the role of a Diabetes Specialist Nurse in Stockport, covering a maternity leave. I was so thankful I was able to try this role as it was one I had always thought I wanted, but had eluded me. Every thing happens for a reason, as I soon realised I much preferred working in primary care, so at that the end of that contract, I bravely left the safety of my NHS role. I have absolutely no regrets and haven't looked back, as since I created my my own company "Sonia Willis Ltd" in October of 2015, I work totally freelance providing my clinical and educational services, even at the GP surgery I work at every week in Rotherham. I can honestly say I haven't been busier, so much so that I have so far been unable to really develop the idea of "DiabEasy as 123". This ironic concept came to me in my sleep one night a few years ago. Ironic, because although a lot about managing diabetes is common knowledge, (1) taking regular physical activity, (2) eating a balanced, healthy diet, and (3) following a treatment plan if on medication; doing all that every day for the rest of your life is actually NOT that EASY! However, the concept of 1,2, 3, applies in other ways to diabetes, such as the 3 complications that affect the small blood vessels, the 3 complications that affect the large blood vessels. The 3 factors that must be managed well in diabetes, Blood Glucose, Blood Pressure and Cholesterol. So maybe I should have called my second business "Not as DiabEasy as 123"? During lockdown I designed an online Diabetes Foundation course on Behalf of Rotherham Respiratory which is accessible via their website.

25/03/2026

Great question from one of my followers today about a disagreement with a colleague regarding how to code a scenario:
1. What counts as a diagnosis of Type 2 diabetes?
As Per NICE / WHO criteria:
It is HbA1c ≥48 mmol/mol on TWO separate occasions = diagnostic of type 2 diabetes
So clinically, that person has met diagnostic criteria, even if:
• They were never coded
• Nobody explicitly told them
• It wasn’t acted on
Regardless of Coding the diagnosis, the biochemistry still counts.

2. What is “remission”?
The widely accepted definition (e.g. Diabetes UK / international consensus):
• HbA1c

23/03/2026

While I was updating my Diabetes Update slides today I created this image using AI. What do you think? It aligns with the updated NICE guidance.
NEW 2026 NICE UPDATE: SGLT2 inhibitors just got EVEN BIGGER!
Think beyond glucose… think ❤️ + 🫘 protection
Here’s the DiabEasyAs123 way 👇
🔑 SGLT2 in 3 Simple Steps
1️⃣ Does your patient have:
❤️ Heart failure
🫘 CKD
🫀 Established CVD / high CV risk

👉 YES? → Prescribe an SGLT2 inhibitor

2️⃣ Check renal function
✔️ eGFR ≥20 → you’re good to go
⚠️

23/03/2026

I’m currently tweaking my presentation for this Thursday’s online study day. No two courses are ever the same, as things constantly change in the world of diabetes. Whilst these courses always evaluate well enough, what would you really like to see in a diabetes update day, apart from the obvious?

22/03/2026

What is Metabolic Syndrome and why is it important?
It’s a cluster of risk factors You can’t ignore.
It starts with:
A large waist as per my previous post on Central Adiposity.
• Waist ≥94 cm (European men)
• ≥90 cm (South Asian men)
• ≥80 cm (all women)
OR
BMI >30 Caucasian
BMI > 27.5 S. Asian

Remember: Visceral fat is metabolically active, leads to inflammation and insulin resistance
This and any two of the following indicates Metabolic Syndrome.
1: Low HDL (Good Cholesterol - I call it the happy, healthy hoover)
• Men:

21/03/2026

New feature: Weekend lesson!
Have you ever wondered why being overweight, especially around the middle, or being “apple 🍏 shaped,” is a bigger risk factor for developing Type 2 diabetes than being “pear 🍐” shaped?
We use the term “Central Adiposity” or “Visceral Fat” these days as the word “obesity” tends to cause offence. Remember to avoid using it in your consultations.
Carrying weight centrally is one of the strongest drivers of type 2 diabetes and central (visceral) adipose tissue earns the label of the body’s most “Potent Endocrine Organ” essentially because of things:
1: It is highly metabolically active.
2: Hormonally very busy
3: Directly connected to key organs (especially the liver) so its signals have massive systemic effects.

Unlike subcutaneous fat, visceral fat:
Sits around 3 main organs involved in glucose regulation:-
1: liver
2: pancreas
3: bowel
For those that like more detail, my not so explanation follows.
Visceral fat drains via the portal circulation - that means straight to the liver.
1. It secretes powerful hormones called ADIPOKININES.
Remember these from your biology lessons in school? Adipokinines are hormone signals from fat tissue, whereas Free Fatty Acids (FFAs) are fat-derived fuel molecules — they are different, but both influence insulin resistance -(Rusty locks on cells analogy).
Visceral fat is an active endocrine gland, releasing substances that influence appetite, insulin sensitivity, inflammation, and vascular health.
These are:
1: LEPTIN - often called the “satiety hormone” - this tells your brain, “We have enough energy stored, you can stop eating now.”
2: ADIPONECTIN - this tells the body to “use sugar properly and stay sensitive to insulin.” However having T2 diabetes or carrying too much central weight actually depletes the amount produced, which is the opposite to what you might expect.
3: RESISTIN - does the opposite to adiponectin by increasing insulin resistance. In other words it reduces insulin sensitivity by making it harder for glucose to enter cells. It also causes chronic low-grade inflammation and contributes to increased cardiovascular risk

To get even more scientific (not something I’m good at, but sometimes we need to)
Visceral fat releases Cytokines (e.g. TNF-α, IL-6) which also drive inflammation.
The ultimate effect of all this activity from visceral fat means that the body is in a pro-inflammatory, insulin-resistant state.

Not only that, but also this!
2. Direct liver impact (the “portal effect”)
Visceral fat releases free fatty acids (FFAs) directly into the portal vein:
This increases hepatic glucose production (remember my analogy about the leaky liver? It’s like the liver sugar tap is turned on all the time, putting extra sugar into the bloodstream). This raises Triglyceride levels and VLDL cholesterol and reduces insulin clearance - leading to
Hyperglycaemia (too much sugar in the blood) and accelerates atherosclerosis (furring up of the arteries)
3. Overall - The effect of too many adipokines + FFA’s means that
Muscles have reduced glucose uptake,
The liver increases glucose output,
The Pancreas suffers β-cell stress (meaning it is overworked - remember my analogy about the beta cells are the “workers” that go off sick with stress or die of exhaustion)

This all means that CENTRAL ADIPOSITY creates a chronic inflammatory state.
Another analogy is that it’s like a “small fire that never fully goes out – not big enough to cause immediate damage – but constantly producing “smoke” that affects the whole house!”
This and high sugar levels also cause like a “pan-scrub” or “scratching” effect in the arteries leading to endothelial dysfunction and speeds up atherosclerosis.
This is why central fat links strongly to:
1: Cardiovascular Disease (CVD)
2: NAFLD (Non alcoholic fatty liver disease) now known as MASLD (Metabolic dysfunction–Associated Steatotic Liver Disease)
3: Metabolic Syndrome (explained in my next post)
And that’s why we call it “ Our most potent endocrine organ”
It’s not just that it secretes hormone, it’s that:
Location + activity means an amplified effect
• Close to vital organs
• Direct liver access
• Highly inflammatory
• Strong metabolic consequences
I hope you find this helpful?
Please comment if you do.

18/03/2026

Someone asked me recently if I had Type 2 diabetes myself? My answer is no I don’t! But obviously in my role I’ve diagnosed quite a few people over the years. I approach their care in the same way I would hope to be treated myself. It’s how I’ve always nursed.

A person-centred approach at diagnosis of type 2 diabetes is less about what you say first and more about how you build a professional, trusting relationship. The aim is to make the person feel heard, safe, and supported — not overwhelmed with too much information.

Here’s a practical, structured way you can approach the care of someone newly diagnosed with Type 2 diabetes.

1. Start with Elicit (what matters to them?)
Before giving any advice, understand their world.
• “What have you been told so far about your results?”
• “How are you feeling about this diagnosis?”
• “What concerns you most right now?”
This does three things:
• Gauges baseline knowledge
• Surfaces emotions (often shock, guilt, fear)
• Shows you are listening first, not lecturing
REMEMBER: The diagnosis has happened to them, not to you!

2. Practice intentional listening
This is where patients feel cared for.
• Let them speak without interruption
• Use reflective statements:
E.g. “It sounds like this has come as a shock”
“You’re worried about what this means long term”
• Sit with silence (don’t rush to fix)
This builds trust faster than any guideline ever will!

3. Ask permission before giving information
AVOID the “information dump”.
Ask permission: “Would it be okay if I explain what this means?”
“Can I share some options with you?”
This keeps the patient in control and reduces the risk of them feeling overwhelmed.

4. Provide simple, tailored information
Focus on what matters now, not everything.
• What is type 2 diabetes (brief, non-technical)
• Reassurance: “This is something we can manage together”
• Immediate priorities only:
• Lifestyle basics
• Whether medication is needed now
AVOID
• Long complication lists
• Complex targets upfront

5. Shared decision-making (not directive care)
Instead of:
“You need to lose weight and start metformin”
Try:
“There are a few ways we can approach this—would you like to hear them?”
“What feels realistic for you at the moment?”
Then:
Agree 1–2 small, achievable goals.
This increases adherence and confidence.

6. Set personalised goals
“What would you like to be different in 3 months?”
“What’s one change you feel ready to try?”
Examples:
• Walking 10 minutes daily
• Reducing sugary drinks
Goals should feel achievable, not perfect.

7. Acknowledge emotions and reduce blame
Many patients feel guilt or shame.
Say things like:
“This is not your fault”
“There are lots of factors that contribute to diabetes”
This is hugely important for engagement.

8. Safety net and continuity
End with reassurance and a plan:
“We’ll take this step by step”
“You’re not on your own with this”
• Arrange follow-up for the 9 annual care processes (annual MOT)

9. Offer support beyond the consultation
• Structured education
• Written/visual resources
• Signpost support (apps, groups)

Example opening question:
“I’d like to understand how this has been for you first—what went through your mind when you heard the diagnosis?”

The balance to aim for
• 70% listening / 30% talking
• Focus on their priorities, not your checklist
Leave them feeling:
• Heard
• Reassured
• Clear on next steps
I really hope this helps? Please comment if it does?

18/03/2026

Not sure about this, but FB seems to think it’s is a good idea. Thank you all!
Big shout out to my newest top fans! 💎
Samantha Sarah Louise, Dave Bareham, Alice Fay, Jan Burrill, Kerry Millar
Drop a comment to welcome them to our community, fans

18/03/2026

Supporting Diabetes Self-Management Series: No 5
Avoiding information overload!
Healthcare professionals often give too much information at once.
We want to be helpful, so we explain everything we know about a treatment, lifestyle change, or complication. But research consistently shows that people remember only a small proportion of what we say in a consultation.
One simple communication strategy can help.
Try the “30-second rule”
Explain the key point in 30 seconds or less.
Instead of delivering a long explanation about mechanisms or guidelines, focus on the most important message the person needs to understand right now.
For example: (see infographic)
Avoid a long explanation about medication mechanisms, side-effects and sick day rules etc
Instead provide a short explanation:
Then pause and invite the person into the conversation.
Try asking:
“What questions do you have about that?”
“How does that sound to you?”
These are my DiabEasyAs123 keys 🔑 🔑 🔑
Short explanation → Pause → Invite questions
Small communication changes can make a big difference in supporting people to manage diabetes.

16/03/2026

Gorgeous flowers received from my friends and Colleagues at Stag Medical centre. Really cheered me up. Thank you so much team. I’ll get back as soon as I can! ###

16/03/2026

Just finished delivering another diabetes update on behalf of BBO training, with a lovely group of HCP’s. Hope you enjoyed the day. And did it with my leg elevated due to my ankle fracture! (broke it last week… ugh!)

16/03/2026

Supporting diabetes self-management series. No 4.
Ask better questions.
Small changes in how we ask questions within our consultation
can transform the outcome.
Please comment if you find the next infographic helpful.

15/03/2026

The “5 M’s” of Hyperglycaemia!
Why does blood glucose go high?
I’ve posted about how to treat hypos, and then someone asked me to explain why “hypers” happen?
Diabetes is not easy to manage, (my term is quite ironic) so be careful when educating people living with diabetes about this, as you could come across as being critical or judgemental.
In line with my Supporting Diabetes Self-management series, if hyperglycaemia is an issue, explore what they think is doable for them to help reduce it, rather than telling them what you think they should do.
I hope this infographic of the 5 M’s of hyperglycaemia is helpful, please comment if it is.

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DiabEasy As 123 Creation and Delivery of Bespoke Diabetes Education

As a nurse with special interest, I am absolutely passionate about ensuring people with Long Term Conditions, especially Diabetes, receive high quality care.To do this I have spent years studying throughout my career, developing my personal knowledge and skills so that I am better able to apply them in clinical practice and also to provide high quality education for other healthcare professionals. Since 2007, I continue to work freelance with "Education for Health" (based in Warwick) to provide education at various levels, from workshops to Level 5 diploma and Level 6 degree level modules in Diabetes and Cardiovascular Disease Risk. Since 2004, I continue to deliver DESMOND courses for people with Type 2 Diabetes in Sheffield, where I live, through a NICE approved Structured Education Programme (DESMOND stands for Diabetes Education and Self Management for Ongoing and Newly Diagnosed). I never get bored of this as I love the "light bulb moments" when people suddenly realise that managing their diabetes has a lot to do with common sense and it's not rocket science! I have extensive experience of facilitating learning as I also spent 5 years travelling the length and breadth of the UK when I was a National Quality Development Trainer and Assessor of the diabetes educators that run DESMOND courses. I left that role in 2015, when I temporarily held the role of a Diabetes Specialist Nurse in Stockport, covering a maternity leave. I was so thankful I was able to try this role as it was one I had always thought I wanted, but had eluded me. Every thing happens for a reason as I soon realised I much preferred working in primary care, so at that the end of that contract, I bravely left the safety of my top Band 7 NHS role. I have absolutely no regrets and haven't looked back, as since I created my my own company "Sonia Willis Ltd" in October of 2015, I work totally freelance providing my clinical and educational services, even at the GP surgery I work at every week in Rotherham. I can honestly say I haven't been busier. "DiabEasy as 123" is an ironic concept that came to me in my sleep one night. Ironic, because although a lot about managing diabetes is common knowledge, (1) taking regular physical activity, (2) eating a balanced, healthy diet, and (3) following a treatment plan if on medication; doing all that every day for the rest of your life is actually NOT that EASY! However, the concept of 1,2, 3, applies in other ways to diabetes, such as the 3 complications that affect the small blood vessels, the 3 complications that affect the large blood vessels. The 3 factors that must be managed well in diabetes, Blood Glucose, Blood Pressure and Cholesterol. So maybe I should have called my second business "Not as DiabEasy as 123"? I have developed a portfolio of training packages that can be adapted to suit any needs. If what I do sounds of interest to you, please feel free to get in touch on here, and if required we can arrange to speak or meet. Or check out my new website Diabeasyas123.com