Building a Better Health Service


HSE Diabetes Education & Self Management Courses Donegal

“At the beginning, the diabetes was controlling me. Now I am the one in control and I have my life back.”

For 64-year-old Donegal man William Russell, his diagnosis of type 2 diabetes was a massive shock to the system and he immediately felt overwhelmed by the information given to him and his lack of understanding of the condition.

But having completed a HSE Diabetes Education & Self- management for Newly Diagnosed (DESMOND) course, he has taken back control and is a new man.

desmond group food game

“It gave me a big shock to hear that I had diabetes and then there were all the changes in lifestyle that you have to make. Plus it makes it that much harder when you don’t really even understand much about the conditions, don’t understand how it came about or what causes it,” he explained.

“If you have somebody that can help you then you feel enlightened and you aren’t in the dark anymore, not in the dark all the time. That is how it felt in the beginning.”

After he was diagnosed with diabetes, he was advised by his local doctor in Derrybegs to attend one of the self-management courses, which take place over two days.

“They taught me a huge amount and I became very positive about dealing with the condition and keeping in control of the diabetes. There was so much information about diet and exercise and what I should be doing. And I do still lead a very normal life now that I have everything in control,” said William.

“In terms of food, I now understand about sugar and what the labelling on the food means. Basically, I now try to avoid processed food that contains so much sugar. It is simple really once you get motivated. So when I made the small changes to my diet and exercise, it made a huge difference and made a big impact.”

William is now living with type 2 diabetes for four and a half years. In that time, he has lost a massive six stone and is feeling ‘on top of the world’.

“I had maxed out the weighing scale at 22 stone. It simply wouldn’t go any higher. And the sad thing was that I didn’t even realise that I was that heavy. It just creeps up on you. I was eating for the sake of eating, not because I was hungry. It was like I was eating from a trough in front of the television – chocolate, crisps, anything unhealthy. And I was eating a lot of fruit in the middle of the day which I learned was playing havoc with my sugar levels. So it was important to space out the fruit across the day,” he said.

“It’s easy to think that there’s nothing that you can eat. But one of the nurses at the course just told me to start eating the food that I used to eat as a child – there were no huge supermarkets and all this processed food back then. So it’s just getting back to basics.


“I am now at 17 stone heading towards 16. I had reached 15 stone but I broke my leg and put back on some of the weight through not being able to exercise.”

Once a 48-inch waist, William is wearing 40-inch waist trousers now and almost fits into the 38 inch ones. “I’m almost there,” he laughed.

The first signs of diabetes for William were when he started sleeping during the day and drinking lots and lots of water.

“I just couldn’t understand what was happening and why I was feeling so lethargic. I just had no appetite.”

When he went to the doctor, he had blood sugar levels of 23.

“I’ll never forget that. They wanted to send me to the hospital because the levels were so high.”

A typical day for William is a cup of tea with a sweetener along with a couple of slices of toast with sugar-free diabetic marmalade. He then walks his dog every morning after breakfast.

11am is a coffee with a Satsuma or whatever piece of fruit is handy.

Lunch is a low-fat cheese spread on a Mediterranean cracker, low in calories, followed by a green tea – his new love- and a pear or a banana.

3pm brings a coffee, occasionally treating himself to a shortbread diabetic biscuit.

“It costs just the same as regular biscuits. I make sure not to pay extra for the special diabetic products that they try to make you think you need.”

For dinner, it is a regular healthy and hearty meal like stew or smoked fish with vegetables and potatoes.

“I still get the munchies in the evening. My wife goes to Slimming World and has lost a lot of weight, fair play to her. But she brings back the Slimming World bars and we would treat ourselves to one of those. It’s important to have the treats too so you don’t feel you are missing out.”

He is quite insistent that he now has control of the diabetes rather than it being in control of him.

“I can now tell when my sugar levels are changing and can take action.

“You just have to understand that you have a problem and unfortunately it was something that you brought on yourself and it was up to you to sort yourself out and get on with it. It takes just a little bit of effort and you can get yourself sorted.

William now finds that he doesn’t need to check his blood as often as he did at the beginning, now checking them once a week.

“I check my levels once a week now but I generally know when there is something wrong. I rarely go above 6. And I take medication three times a day but I am going to meet with my GP in the next few weeks with the aim of reducing that because I really don’t think it’s necessary anymore to be taking that much to control it.”

He was full of praise for the staff in the medical centre in Derrybegs.

“They have been brilliant all the way through. I have had my eyes tested and there’s been no change since I was diagnosed. And I haven’t even had to go up a prescription with the optician. So all is going as it should and that is brilliant.”

He makes sure not to obsess about his weight and let it take over his life.

“I jump on the scales on a Sunday after a shower and the numbers are getting lower each week.”

The free DESMOND course takes place over six hours and is run by trained educators (a nurse and a dietitian) at various locations throughout the county.  This is run as either two three-hour sessions or one six-hour one depending on location.

The programme contains information about what is happening in the body with diabetes, treatments available, complications and how to prevent them, information about food choices and support on how to make lifestyle changes and self- manage diabetes.  This is important as people with diabetes have only a few hours contact with a health professional each year. The rest of the time they care for their diabetes themselves so having the skills to self -manage the condition is important.

The groups are usually no more than 10 people and you can take a family member or friend along for support on the day if they wish.

The course has been run in Donegal since 2010 in a number of locations such as Letterkenny, Downings, Carrigart, Creeslough, Glenties Castlefin, Donegal Town, Gweedore, Milford, Buncrana, Moville, Carndonagh, Dungloe and Falcarragh. In 2017,  201 people in Donegal have availed of the course.

In 2017 another improvement in diabetes care in Donegal was the recruitment of a community dietitian specifically for diabetes. Dietitians have a key role in supporting people to manage their diabetes. As well as education on diabetes and diet, they have the skills to support a person around making long term changes to their lifestyle.  

Marie Boyce, Senior Community Dietitian for Diabetes, has been in post since April 2017 and her role enhances the service already offered by community dietitians in Donegal. A dietitian for the past 16 years, she brings experience from both the hospital and community setting to the role. Marie holds clinics in various locations around the county, reducing the waiting time for a person with type 2 diabetes to see a dietitian in their locality. She also coordinates DESMOND in the county and if you have any queries or wish to be referred she can be contacted on 086-4176677 or