Another Dr involved heavily in providing Diabetes care and who spent a few years trying to improve services across half a county. A slightly different perspective perhaps…
Yes – by far the most common issue we see in people with poorly controlled type 1 or 2 (or even type 1 1/2 … don't ask… ) is failure of the patient to develop "an internalised locus of health control" – in other words to understand that only by them taking control and responsibility for lifestyle factors, insulin adjustment etc etc will things improve. Checking that your partner's sister has made that step is priority number 1. Without that everyone is doomed to fail.
However:
1) Approaches such as DAFNE can be evry helpful and there is now better evidence that they can help achieve tighter control. But they are not universally available.
2) There is beginning to be better evidence for Insulin pumps.
3) Diabetes Specialist Nurses (DSNs) are often stretched very thinly, and not always targetted at the patients who need them most.
4) Sometimes people with type 1 diabetes escape without top-up education, or adjustement/modernisation of their threapy for years – and this is particularly likely in my experience when patients are attending hospital clinics where they see a different junior Dr each attendance, there may not be a proper database system, and there are tight time constraints.
5) Non- Diabetes hospital teams in A&E and as inpatients often really mismanage Diabetes, and do not identify where change/education is needed.
So in answer to the OP – complaining at this stage is clearly totally out of order, but the first step is for your relative to join DUK and to get an idea of what she should be repsonsible for, and what her expectations of her local diabetes services should be.
