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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.

05/10/2026

I’m really hoping that Day One of the Introduction to Diabetes online session today is not too overwhelming? There’s so much to learn and it’s very complex. Doing my best to make it

01/10/2026

TYPE 2 DIABETES: FROM RISK IDENTIFICATION TO DIAGNOSIS

One of the questions I get asked quite often is:
“So… who should we actually test for Type 2 diabetes, which test should we use, and what do we do with the result?”

And I completely understand why this can feel a little confusing!

There are several different stages to the process — and it’s easy to jump straight to the blood test and forget about the risk assessment that comes first.

So I’ve put together this simple pathway to bring it all together. 👇

🔵 1. IDENTIFY PEOPLE AT HIGHER RISK

Start by thinking about the person’s overall risk.

That might include age, family history, central adiposity, hypertension, dyslipidaemia, previous gestational diabetes, PCOS, cardiovascular disease and certain ethnic backgrounds.

And remember…

👉 Adults aged 25 and over of South Asian or Chinese family background with a BMI >23 kg/m² may warrant blood testing even if a formal diabetes risk score hasn’t been used.

There are several validated diabetes risk assessment tools available — including QDiabetes, the Leicester Diabetes Risk Score and FINDRISC.

🟣 2. OFFER THE APPROPRIATE BLOOD TEST

For someone identified as being at higher risk, the next step is a blood test.

This can be:

HbA1c OR fasting plasma glucose (FPG)

The choice depends on local practice and the individual’s circumstances.

And importantly, when we’re talking about diagnosis, we’re talking about an appropriate venous sample — not a finger-prick glucose meter reading.

🟢 3. KNOW WHAT THE NUMBERS MEAN

This is the bit I really want people to remember.

HbA1c:
🟢

30/09/2026

💜11 YEARS OF DIABEASYAS123! 💚💙
Today marks 11 years since I started this little page called DiabEasyAs123.
And honestly… when I started it back in 2015, I had absolutely no idea where it would lead!

Fast forward 11 years and there are now an incredible 6,450 of you following along — and that number is still growing! 😳💙💜💚

But do you know what made me stop and think about the value of this page today?

One of my colleagues from work tried to contact me because she wanted to “pick my brains” about something.

Unfortunately, I was having a day off and didn’t get back to her in time.

But she messaged me later to say she’d found what she needed from a post on my DiabEasyAs123 page.

And honestly… that really got me. ❤️

Because I hadn’t realised just how useful some of the things I share might be to the people who follow the page.

I know I spend a LOT of time reading, learning, checking guidelines, creating courses, thinking about how to explain things and then turning all of that into posts and infographics.

But when you’re doing it week after week, you don’t always stop to think about where that information goes once you’ve pressed “publish”.

Someone might see a post today…

Someone might save it for later…

Someone might share it with a colleague…

Someone might use it when talking to someone living with diabetes…

Or, as happened today, someone might need an answer when I’m not available — and find it waiting for them on the page.

And that for me is pretty amazing!🥰

So although 6,450 followers is an incredible number, I’m actually celebrating something much bigger than a number.

I’m celebrating 11 years of sharing diabetes education, making complicated things a little easier to understand, and hopefully helping people feel a little more confident along the way.

A huge THANK YOU to every single person who has followed, liked, commented, shared, asked questions, challenged me, learnt something from a post or simply enjoyed being part of the DiabEasyAs123 journey.

You have made this little page into something I never imagined it would become.

And after 11 years…

I’m still learning.
I’m still sharing.
And I’m definitely not finished yet!
Here’s to the next chapter! 🥂🎉
💙💜💚
DiabEasyAs123
Diabetes education that gives you the “Keys to a Healthy Heart!” 🗝️❤️

28/09/2026

OMG! I’ve just realised it’s 11 whole years since I became independent and created ! How time flies! Glad I changed my logo though. https://www.facebook.com/share/1HaygUrVPH/?mibextid=wwXIfr

26/09/2026

❤️🔑 LIPID-LOWERING THERAPIES — PART 3 OF 3
In the last two posts we met the lipid-lowering therapies and we’ve looked at primary prevention, so now we’ve reached the final post in this little series…

❤️ SECONDARY PREVENTION

And this is where things change.

When someone already has established cardiovascular disease, we’re no longer trying to prevent their first cardiovascular event.

We’re trying to reduce the risk of another one.

And that means we generally take a more intensive approach to lipid lowering.

❤️ STEP 1 — ESTABLISHED CVD

We’re talking about people with established cardiovascular disease, such as:

❤️ Previous myocardial infarction
🧠 Stroke or TIA
🦵 Peripheral arterial disease

💊 STEP 2 — START WITH A HIGH-INTENSITY STATIN

For people with established CVD, NICE recommends offering:
Atorvastatin 80 mg once daily

And importantly, this recommendation applies whatever the person’s cholesterol level.

Of course, 80 mg won’t be appropriate for everyone.

A lower dose may be more appropriate because of things such as drug interactions, increased risk of adverse effects, tolerability issues or the person’s preferences.

So, we’re looking for the maximum tolerated intensity rather than blindly chasing a particular dose.

🔎 STEP 3 — REVIEW THE RESPONSE

And this is one of those things I think is really important in practice…

Don’t just prescribe it and forget about it! 😂

We need to review:
✔️ Is the person taking it?
✔️ Is it being tolerated?
✔️ Has the expected lipid reduction been achieved?
✔️ Is anything else affecting the result?

Then we can review and optimise treatment where appropriate.

🎯 STEP 4 — KNOW THE TARGET

For secondary prevention, NICE recommends aiming for:

LDL-C ≤2.0 mmol/L
OR
Non-HDL-C ≤2.6 mmol/L

And this is worth remembering because we’re not simply saying:
“Their cholesterol is lower, so we’re done.”

We’re looking at whether they’ve reached the recommended lipid target.

LDL-C is the preferred measure when available, but non-HDL-C can be used when LDL-C isn’t requested or can’t be calculated.

💊 STEP 5 — STILL ABOVE TARGET?

After checking adherence, tolerability and response, ezetimibe may be added or considered alongside the statin.

And if the lipid target still isn’t achieved and the person meets the relevant NICE criteria, this is where specialist lipid management may become important.

Specialist services may consider treatments such as:
💉 PCSK9 inhibitors
Alirocumab • Evolocumab

💉 Inclisiran

This is an important point for those of us working in primary care:
We don’t necessarily initiate all of these treatments ourselves.

Some are initiated or managed through specialist lipid services, and local pathways can vary. Some of you might be initiating inclisiran, but this depends on area.

So our role may be recognising that the person hasn’t reached target, optimising what we can, and making sure they get to the appropriate service when specialist treatment is indicated.

👀 AND DON’T FORGET THE REST OF THE PICTURE…

Even when someone has established CVD and is taking lipid-lowering medication, lifestyle support and self-management don’t suddenly stop!

We still need to support people with things such as:
🥗 Healthy, sustainable eating
🏃‍♀️ Physical activity
🚭 Not smoking
⚖️ Weight management where appropriate
💊 Medication adherence

And, of course, we need to keep looking at the whole cardiovascular risk picture — blood pressure, diabetes, kidney disease, smoking and the other things that contribute to cardiovascular risk.

❤️🔑 SO, WHAT’S THE TAKE-HOME MESSAGE?

Secondary prevention is different from primary prevention.

We’re not simply asking:
“Does this person have a high cholesterol?”
We’re asking:
“What can we do to reduce this person’s risk of another cardiovascular event?”
So think:

REVIEW → OPTIMISE → ESCALATE WHEN APPROPRIATE

And remember our little phrase from the first post:

❤️ RIGHT DRUG
❤️ RIGHT PERSON
❤️ RIGHT TIME

And perhaps most importantly…
Don’t just treat the number.

Treat the risk, support the person, and work together to reduce the risk of future cardiovascular events. ❤️

That’s the end of our little three-part lipid-lowering series.

I hope it’s helped to make what can sometimes feel like a rather complicated subject a little more
DiabEasyAs123! 😊

Based on current NICE NG238 recommendations and relevant NICE technology appraisals.

Copyright 2026 Sonia Willis Ltd

25/09/2026

❤️🔑 LIPID-LOWERING THERAPIES — PART 2 OF 3
In my last post we met the lipid-lowering therapies and had a little look at what they actually do.
Now we’re going to move on to PRIMARY PREVENTION.
This is where things get a little more interesting… because when we’re talking about primary prevention, we’re trying to reduce the risk of someone having a first cardiovascular event.

❤️ We don’t just look at the cholesterol result.

We need to look at the whole cardiovascular risk picture.

🔎 STEP 1 — ASSESS THE RISK

For many people, this will involve using an appropriate cardiovascular risk assessment tool, such as QRISK3, alongside the person’s clinical history and other risk factors.

And this is important…

A cholesterol result on its own doesn’t tell us someone’s overall cardiovascular risk.

Age, blood pressure, smoking, diabetes, cholesterol, family history and other factors all contribute to the bigger picture.

Which is why I like the phrase:

👉 Don’t just look at the cholesterol result!

🥗 STEP 2 — TALK ABOUT LIFESTYLE

Lifestyle measures remain an essential part of self-management and cardiovascular risk reduction.

That might include supporting people with:

🥗 healthier, sustainable eating patterns
🏃‍♀️ being physically active
🚭 stopping smoking
🍷 keeping alcohol within recommended limits
⚖️ weight management where appropriate

And notice I say supporting rather than telling someone what they should do!

We’re looking for changes that are realistic, achievable and sustainable for that individual — not perfection.

And lifestyle and medication aren’t either/or.

They work alongside each other. ❤️

💊 STEP 3 — WHEN IS MEDICATION INDICATED?

For adults with a 10-year QRISK3 score of 10% or more, NICE recommends offering atorvastatin 20 mg once daily for primary prevention, after discussing the benefits, risks and the person’s preferences.
But…

⚠️ DON’T JUST STOP AT THE 10% THRESHOLD!

A QRISK3 score below 10% doesn’t automatically mean “no statin”.

NICE says atorvastatin 20 mg should not be ruled out where the person has an informed preference for treatment, or where there is concern that their risk may have been underestimated.

So, once again, we’re not treating a number in isolation.

We’re having a conversation with a person. ❤️

💊 STEP 4 — WHAT IF A STATIN ISN’T SUITABLE?

If a statin is contraindicated or genuinely not tolerated, NICE recommends ezetimibe as an alternative.

And for some people, if ezetimibe alone isn’t enough, bempedoic acid with ezetimibe may be considered where the relevant NICE criteria are met.

👀 AND A LITTLE TYPE 1 DIABETES NUANCE…

For people living with type 1 diabetes, don’t assume that a QRISK3 score is the only thing that determines whether lipid-lowering treatment should be considered.

NICE specifically says to consider statin treatment for primary prevention in people aged 18–40 with type 1 diabetes, including those who have had diabetes for 10 years or less.

And when starting a statin in an adult with type 1 diabetes, NICE recommends atorvastatin 20 mg once daily.

So, once again…
Context matters. ❤️

❤️🔑 THE TAKE-HOME MESSAGE
Primary prevention is about reducing future cardiovascular risk.

So think:

ASSESS RISK
⬇️
SUPPORT LIFESTYLE
⬇️
DISCUSS MEDICATION WHERE INDICATED
⬇️
REVIEW & OPTIMISE

And remember…

❤️ RIGHT DRUG
❤️ RIGHT PERSON
❤️ RIGHT TIME

In POST 3, we’ll move on to SECONDARY PREVENTION — and this is where the conversation changes because we’re now talking about someone who already has established cardiovascular disease.

We’ll look at the treatment approach and, importantly, the LDL-C and non-HDL-C targets recommended by NICE.

Because, as always…

It’s not just about the number. It’s about reducing cardiovascular risk and helping people live healthier, longer lives. ❤️🔑

Based on current NICE NG238 recommendations and relevant NICE technology appraisals.

Copyright 2026 Sonia Willis Ltd

24/09/2026

❤️🔑 LIPID-LOWERING THERAPIES — PART 1 OF 3

So, this is the first of 3 posts over the next few days looking at lipid-lowering medicines.

And in my style there is a reason I’ve decided to do three posts rather than try to squeeze everything into one infographic — because, quite frankly, there is a LOT to get our heads around! 😂

I often talk about how we can make things simpler for people living with diabetes, and I think the same applies to us as healthcare professionals. Sometimes breaking a subject down into smaller chunks makes it much easier to understand what we’re actually trying to achieve.

So, let’s start with the medicines themselves…

There are quite a few different lipid-lowering therapies around now, and they don’t all work in the same way.

We have:
💊 Statins
💊 Ezetimibe
💊 Bempedoic acid
💉 PCSK9 inhibitors — alirocumab & evolocumab
💉 Inclisiran

And this is really important…

They aren’t simply a medication ladder where everyone works their way from 1 to 5!

They have different mechanisms of action, different indications and different places in lipid management.

So rather than thinking “what drug comes next?”, we need to think about:

❤️ RIGHT DRUG
❤️ RIGHT PERSON
❤️ RIGHT TIME

Where we are in the person’s cardiovascular journey matters too — which is why we’ll look separately at primary prevention and secondary prevention in the next two posts.

And, of course, we mustn’t forget that lipid management isn’t just about prescribing another tablet or injection.

Lifestyle measures remain an essential part of self-management and cardiovascular risk reduction too.

That might include things like:
🥗 Making changes to our eating patterns
🏃‍♀️ Being physically active
⚖️ Managing weight where appropriate
🚭 Not smoking
🍷 Keeping alcohol within recommended limits

And I deliberately say “making changes” rather than “eating perfectly” — because we’re talking about real people, real lives and sustainable changes, not trying to create the world’s most miserable diet! 😂

Medication and lifestyle aren’t competing approaches.
For many people, they work alongside each other to reduce cardiovascular risk.

So, for this first post, let’s simply get to know the different lipid-lowering therapies and what they actually do.

👉 POST 2 will look at PRIMARY PREVENTION — when lipid-lowering treatment may be recommended and where the different therapies fit.

👉 POST 3 will then look at SECONDARY PREVENTION — what changes when someone already has established cardiovascular disease, including the important LDL-C and non-HDL-C targets.

So, save this one as your “Meet the lipid-lowering therapies” guide — and we’ll build on it from here. ❤️🔑

Based on current NICE guidance and relevant NICE Technology Appraisals

23/09/2026

I’m busy today updating my Managing CVD in Primary Care course on behalf of PCDC - bringing it in line with the recently published “CVD Modern Service Framework”
It makes me realise how my career has gone full circle, as in the year 2000 I worked as one of the CVD National Service Framework Facilitators for Rotherham PCG (as it was then- primary care group- not ICB!) That’s when I started getting interested in Diabetes too as they are so intrinsically linked!
Blimey I’m getting so old!

20/09/2026

💊 WHY ARE METFORMIN AND SGLT2 INHIBITORS NOW STARTED SEQUENTIALLY?
Here’s another relevant making post:
If you’re still thinking about treatment for type 2 diabetes as:

“Start metformin → check the HbA1c → add something else if it hasn’t worked…”

…it’s time to rethink that approach. 👀
The 2026 NICE NG28 guidance recommends modified-release metformin AND an SGLT2 inhibitor as initial treatment for most adults with type 2 diabetes, where there isn’t a relevant comorbidity requiring a different approach.

But importantly, they are introduced sequentially.

👉 Start metformin first and establish tolerability.

👉 Once the maximum tolerated dose is confirmed, introduce the SGLT2 inhibitor — without unnecessarily waiting for the next HbA1c.

So why introduce them one at a time?

🔑 1. It helps us identify side effects
Both medicines can cause adverse effects. Introducing one medicine at a time makes it easier to work out which medicine may be responsible if problems occur.

❤️ 2. SGLT2 inhibitors offer benefits beyond glucose lowering
Their cardiovascular, renal and heart failure benefits are an important part of why they are recommended — not simply their effect on HbA1c.

⏰ 3. Sequential does NOT mean slow!
Once metformin is tolerated, we shouldn’t automatically wait months for another HbA1c before introducing the SGLT2 inhibitor.

And remember, starting an SGLT2 inhibitor also means appropriate counselling about ge***al infections, dehydration and sick-day rules.

The key message?

🔑 Sequential means one medicine at a time — not just relying on metformin.

As always, treatment needs to be individualised according to the person’s clinical needs, PREFERENCES and overall risk profile.

📚 For practice nurses and other healthcare professionals:
Are you still finding that the old “wait and see what the HbA1c does” approach is influencing prescribing conversations?

Knowledge empowers better care. 💙💜💚

17/09/2026

🩸 HOW DO YOU INTERPRET A LIPID PROFILE? ❤️🔑

When you look at a blood test report, you might see total cholesterol, LDL, HDL, triglycerides, non-HDL cholesterol and even a TC:HDL ratio.

But what do all those numbers actually mean? 🤔

And which ones should we be paying most attention to?

This is something I talk about regularly when teaching diabetes and cardiovascular risk because it’s very easy to get hung up on one cholesterol number!

🔵 TOTAL CHOLESTEROL

This is the overall amount of cholesterol in the blood — but it doesn’t tell us the whole story.

Think of it as the headline figure. We need to look at the individual components to understand what’s going on.

🔴 LDL CHOLESTEROL

Often called the “bad” cholesterol.

LDL carries cholesterol to the tissues, including the arteries, and higher levels are associated with increased cardiovascular risk.
Think of it as the “lethal or lousy” cholesterol.

In general, lower LDL is better — but the treatment target depends on the person’s overall cardiovascular risk and whether cardiovascular disease is already present.

🟢 HDL CHOLESTEROL

Often called the “good” cholesterol.

HDL is involved in transporting cholesterol back towards the liver. Think of it as the “Healthy / Happy /Hoover”

But we shouldn’t simply look at HDL in isolation and think “the higher, the better”. It’s one part of the overall lipid picture.

🟠 TRIGLYCERIDES

These are another type of fat in the blood.

Raised triglycerides can be associated with increased cardiovascular risk and can occur alongside insulin resistance and other metabolic risk factors.

A fasting triglyceride level below 1.7 mmol/L is generally desirable.

Very high triglycerides need further assessment.

🔵 NON-HDL CHOLESTEROL

This is one I particularly like people to understand!
It is calculated as:
Total cholesterol − HDL cholesterol = NON-HDL cholesterol

It represents the cholesterol carried in the potentially atherogenic particles — including LDL and other particles. (Think of it as “anything that’s not good is considered bad”)

And then we have…

🟣 THE TC:HDL RATIO

This shows the relationship between total cholesterol and HDL cholesterol. (TC divided by HDL)

It is not a treatment target.

However, the TC:HDL ratio is used as one of the factors in QRISK3, which helps estimate 10-year cardiovascular risk.

🔑 AND THIS IS THE REALLY IMPORTANT BIT…

We don’t interpret lipid results in isolation.

We need to consider the whole person:

❤️ Blood pressure
🩸 HbA1c
🚭 Smoking status
⚖️ Weight and lifestyle
🫘 Kidney disease
👤 Age, s*x and ethnicity
❤️ Previous cardiovascular disease
➕ Other cardiovascular risk factors

For people with type 2 diabetes without established cardiovascular disease, NICE recommends using QRISK3 to help estimate cardiovascular risk.

So when you see a lipid profile, don’t just look at the total cholesterol and think “Is that good or bad?”

Look at the whole lipid profile and then put those results into the context of the person’s overall cardiovascular risk.

Because…

🔑 DON’T JUST LOOK AT THE CHOLESTEROL NUMBER.

❤️ LOOK AT THE WHOLE PERSON!

That’s how we move from simply knowing the numbers to actually understanding what they mean.

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