Summary

The Diabetes 101 project is a virtual diabetes MDT service, set up on Twitter in March 2020 in response to the COVID-19 pandemic and first national UK lockdown. At this time people living with diabetes were extremely anxious. Misinformation was a problem, and capacity in specialist diabetes teams was overwhelmed. The account disseminated reliable information, stability and support to people living with diabetes. It was staffed voluntarily by 19 multi-disciplinary healthcare professionals. The account has more than 6,000 followers, with resources shared around the world. Novel formats of education delivery have been successfully trialled and a website has been developed.

Results

The Twitter account has more than 6,000 followers, 35,572 ‘likes’ and 9.7 million impressions. The account is a mainstay of the diabetes online community and is routinely tagged when Twitter users have questions about diabetes. The account is cited in publications for PLWD as a reliable source of diabetes information.

The 22 education sessions have had more than 1.8 million Twitter impressions. This was particularly important as many of the topics are not delivered routinely in general diabetes care (e.g. dental care, sexual dysfunction, specialist psychological techniques). The account’s YouTube videos have been viewed more than 6,000 times, and the website has received over 6,000 visitors, with 16% downloading educational presentations. An online evaluation survey, launched in May 2020, received 459 responses, primarily from PLWD. The majority found the education sessions either quite useful (36%) or very useful (39%). There have been no costs associated with this project as it was run voluntarily. Funding may be needed in the longer term to support the curators’ time.

User Feedback

Feedback and account traffic data were collected continually via the Twitter account. This allowed the team to make improvements and identify which features were popular. ‘Meet the team’ Zoom meetings provided user feedback and development ideas. In the online survey 92% indicated that they would recommend the account to others.

Dissemination and Sustainability

A centralised NHSE communication sent links to the account and account resources to the whole of primary care in England, and team members wrote guest blogs for NHSE. Infographics were shared across UK diabetes services, primary care and third sector networks. They were also shared around the world, including to Australia, where the infographic ‘Managing Worry and Diabetes’ was translated into 26 languages and made into a national TV campaign. The project was presented at high profile conferences, it has been featured in the BMJ, Diabetes Update, Nursing Times, Desang and the Diabetes Times, and was shortlisted in the 2020 Nursing Times awards. The website (www.diabetes101.co.uk) was launched in January 2021 to host the tweetorials, videos, infographics and account information. Members of the team have consulted with HCPs from other disciplines who are interested in setting up equivalent accounts.

Method

The team came from multiple ethnic groups, working in primary and secondary diabetes care, paediatric and adult services. This helped to ensure that all aspects of diabetes care would be covered equally. Many members of the MDT either lived with diabetes or had children with diabetes. Communications met Language Matters guidance. Using Twitter gave free and accessible support to users in the UK and beyond. Users could choose text size, colour schemes, plus a voice reading interface. The translate function meant that tweets could be understood by users anywhere. The diabetes101.co.uk website brought wider reach. Infographics in multiple colour schemes improved readability for individuals with visual difficulties. They were translated into many different languages. The #RunDMC25k exercise club covered guidance for managing exercise and insulin, and signposted to exercise resources for all physical capabilities. The MDT, who had a range of physical challenges, also did the exercise challenges. The Diabetes101 team recruited NHS HCPs from different ethnic backgrounds to record messages on the importance of getting vaccinated for its YouTube site, publicised via the Twitter account. Seventeen videos were created in many languages, garnering over 23,000 impressions on YouTube.