On 6 May, 160 nurses and doctors from around the world came together for the very first Interdisciplinary Spotlight Event, a collaborative initiative between the Global Palliative Doctors Network and the Global Palliative Nurses Network. The spotlight theme – Caring for a person with Diabetes Mellitus at the end of life – a palliative care approach
Hosted by St Christophers Centre of Awareness and Response to End of life (CARE) , the session brought together clinicians working across different countries, cultures, and care contexts . From the beginning attendees shared experiences openly through the chat, posed thoughtful questions, and reflected together on the realities they face in clinical practice every day.
Using Mentimeter, participants were invited to answer
“What is your biggest challenge managing diabetes at end of life?”
The responses revealed— despite the diversity of settings represented, many of the challenges were shared universally. In addition to the clinical complexity lay common concerns about the needs for timely communication, being mindful of family expectations, the uncertainty, and the difficulty of balancing medical management whilst a person is in the last stage life.
So we sought to consider: how should diabetes care change when someone is living with advanced illness?
Through a case-based discussion, speakers explored the shift that often needs to happen in palliative care — moving away from tight glycaemic control and toward comfort, symptom management, and preserving dignity. Conversations centred on identifying what matters most to the individual, recognising the person beyond the diagnosis, and navigating the cultural and emotional realities that shape end-of-life care not least the central role of the partner and family care giver .
Understanding the Growing Global Burden
Dr Omar Mustafa provided an important overview of diabetes itself, highlighting the increasing global burden of disease and the growing need for palliative care clinicians to feel confident managing complex diabetes-related issues. As more patients live with multiple comorbidities, diabetes management is becoming an increasingly common part of serious illness care.
Navigating Practical Clinical Challenges
The discussion also explored the practical realities clinicians face when managing diabetes in advanced illness. Topics included the challenges of steroid-induced hyperglycaemia, transitions from oral medications to insulin, and the difficulties of monitoring blood glucose as patients become increasingly fatigued or cognitively impaired. There was thoughtful reflection on how to simplify treatment safely, reduce unnecessary burdens, and maintain comfort-focused care while still responding appropriately to distressing symptoms.
We explored the practical realities clinicians face when managing diabetes in advanced illness. Such as the challenges of steroid-induced hyperglycaemia, transitions from oral medications to insulin, and the difficulties of monitoring blood glucose as patients become increasingly fatigued or cognitively impaired. There was thoughtful reflection on how to simplify treatment safely, reduce unnecessary burdens, and maintain comfort-focused care while still responding appropriately to distressing symptoms.
Balancing Clinical Judgement with Compassion
Dr Emma Hall guided attendees through these complexities with candour and clinical insight, drawing on her extensive experience in palliative medicine. She emphasised the importance of flexible and compassionate symptom management, highlighting the need for realistic and individualised approaches as illness progresses. Her reflections reinforced how symptom control, communication, and careful clinical judgement must work together.
Returning to the Person at the Centre
One of the most powerful moments of the session came when the discussion moved beyond clinical challenges and returned to the person at the centre of care. Terry Emmanuel encouraged participants to reflect on the human dimensions of decision-making: the influence of cultural beliefs, the complexities of family dynamics, the challenge of navigating uncertainty, and the financial pressures that often remain unspoken.
By returning to the simple question, “What matters to you?”, the discussion grounded itself once again in the essence of palliative care — listening deeply, building trust, and understanding and respecting what is most important to the individual and their family .
With Thanks to Our Expert Panel
As the session drew to a close, Dr Shafika reflected on the key themes emerging from the discussion. As in all care goals must evolve as illness advances. Comfort and dignity should guide decision-making. Communication with families requires sensitivity, honesty, and cultural humility. Symptom management must remain practical and person-centred. And perhaps most importantly, interdisciplinary collaboration strengthens care for everyone involved.
The Power of Interdisciplinary Collaboration
What stood out most throughout the event was the value of shared learning . Nurses and doctors from across continents came together not only to learn from the panel, but also from one another. The richness of perspectives reinforced exactly why interdisciplinary conversations like this matter
With huge thanks to our panel for so generously sharing their expertise, insight, and time:
- Dr Omar Mustafa — Consultant Physician in Diabetes and General Medicine, King’s College Hospital and Chair, Joint British Diabetes Societies
- Dr Emma Hall — Consultant in Palliative Medicine, St Christopher’s Hospice
- Terry Emmanuel — Registered Nurse and Programme Manager, Indian Association of Palliative Care
- Dr Shafika Banoo – Speciality Doctor St Christophers Hospice
Looking Ahead:
Feedback following the event highlighted a strong appetite for further in-depth discussions on diabetes in palliative care, alongside growing interest in exploring other complex conditions — such as heart failure — through future interdisciplinary spotlight events.
Please join us through these networks and get connected for future events
Link to the GPNN and GPDN
https://www.stchristophers.org.uk/gpnn/
Marie Cooper Senior Nurse Advisor / Co host of the GPNN – M.Cooper@StChristophers.org.uk
Dr Shafika Banoo Speciality Doctor co host of the GPDN – S.banoo@stchristophers.org.UK
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