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Content ArticleThis Health Foundation report explores how patterns of diagnosed ill health vary by socioeconomic deprivation in England. This report is the second output from the REAL Centre’s programme of research with the University of Liverpool. Building on the projections in Health in 2040, this report is one of the first studies to unpack patterns of inequalities in diagnosed illness by socioeconomic deprivation across England and project them into the future. Stark inequalities are projected to stubbornly persist up to 2040, with profound implications not only for people’s quality of life, but also their ability to work and the wider economy. The report also finds that health inequality is largely due to a small group of long-term conditions, with chronic pain, type 2 diabetes and anxiety and depression projected to increase at a faster rate in the most deprived areas.
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Content ArticleThis National Paediatric Diabetes Audit (NPDA) report on care and outcomes 2022/23 found that the prevalence of children and young people cared for in Paediatric Diabetes Units (PDUs) in England and Wales has increased from 33,251 in 2021/22 to 34,371 in 2022/23, despite a fall in the incidence of new cases. It also found that the percentages of children and young people with Type 1 and Type 2 diabetes receiving all six key annual healthcare checks have increased, but there remains much variability between PDUs (and completion rates for those with Type 2 remain lower than for those with Type 1). Other findings include: Percentages of young people with early signs of micro and macrovascular complications for both Type 1 and Type 2 diabetes show very little change in 2022/23 compared to the previous audit year Use of diabetes related technology has increased in 2022/23, with around half of children and young people with Type 1 diabetes using insulin pumps and half using a real time continuous glucose monitor (rtCGM) Around a quarter of all new cases of Type 1 diabetes had diabetic ketoacidosis (DKA) at diagnosis, compared to 25.6% in 2021/22. The report also states that, despite improvements in outcomes and use of technologies across different ethnicities and areas of deprivation, inequalities remain evident. In terms of rtCGM use, the inequality gap by deprivation has reduced, however the difference in use between Black and White children with Type 1 diabetes has widened from 8.6% in 2021/22 to 14% in 2022/23.
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News Article
Diabetes patients to be offered artificial-pancreas technology
Patient Safety Learning posted a news article in News
Tens of thousands of people with type 1 diabetes in England are to be offered a new technology, dubbed an artificial pancreas, to help manage the condition. The system uses a glucose sensor under the skin to automatically calculate how much insulin is delivered via a pump. Later this month, the NHS will start contacting adults and children who could benefit from the system. But NHS bosses warned it could take five years before everyone eligible had the opportunity to have one. This is because of challenges sourcing enough of the devices, plus the need to train more staff in how to use them. In trials, the technology - known as a hybrid closed loop system - improved quality of life and reduced the risk of long-term health complications. And at the end of last year, the National Institute of Health and Care Excellence (Nice) said the NHS should start using it. Prof Partha Kar, NHS national speciality advisor for diabetes, said the move was "great news for everyone with type 1 diabetes". "This futuristic technology not only improves medical care but also enhances the quality of life for those affected," he added. Read full story Source: BBC News, 2 April 2024 Related reading on the hub: How safe are closed loop artificial pancreas systems? -
Content ArticleMore than 3 years after the onset of the Covid-19 global pandemic, a wave of evidence suggests that severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection can lead to postacute sequelae in pulmonary and broad array of extrapulmonary organ systems—including increased risks and burdens of cardiovascular disorders, neurologic and mental health disorders, metabolic disorders (diabetes and dyslipidemia), kidney disorders and gastrointestinal disorders. However, up until now, evidence is mostly limited to the first year postinfection. Bowe et al. built a cohort of 138,818 individuals with SARS-CoV-2 infection and 5,985,227 noninfected control group from the US Department of Veterans Affairs and followed them for 2 years to estimate the risks of death and 80 prespecified postacute sequelae of Covid-19 (PASC) according to care setting during the acute phase of infection. They found that the increased risk of death was not significant beyond 6 months after infection among nonhospitalised but remained significantly elevated through the 2 years in hospitalised individuals. Within the 80 prespecified sequelae, 69% and 35% of them became not significant at 2 years after infection among nonhospitalised and hospitalised individuals, respectively. In summary, while risks of many sequelae declined 2 years after infection, the substantial cumulative burden of health loss due to PASC calls for attention to the care needs of people with long-term health effects due to SARS-CoV-2 infection.
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News Article
Diabetes patients struggling without 'wonder drug'
Patient Safety Learning posted a news article in News
Diabetes patients have told the BBC they are struggling without what they have called a "wonder drug". Experts estimate about 400,000 people with Type 2 diabetes could have been affected by a national supply shortage caused by rising demand. The new generation of medicines - GLP-1 receptor agonists - mimic a hormone that not only controls blood sugar levels but also suppresses appetite. The government said it was trying to help resolve the supply chain issues. NHS England has issued a National Patient Safety Alert for the drugs. The NHS alerts require action to be taken by healthcare providers to reduce the risk of death or disability. The diabetes medicines in short supply are Ozempic, Trulicity, Victoza, Byetta, and Bydureon. They work via injections instead of tablets. The group of medicines has been used by the NHS for diabetes for around a decade but in recent years there has been a growth in private clinics prescribing the same drugs for weight loss for people who do not have diabetes, pushing up demand. Novo Nordisk, which manufactures Ozempic and Victoza, told the BBC it was experiencing shortages of its medicines for people in the UK with Type 2 diabetes due to "unprecedented levels of demand". Read full story Source: BBC News, 26 January 2024 Have you (or a loved one) ever been prescribed medication that you were then unable to get hold of at the pharmacy or in hospital? To help us understand how these issues impact the lives of patients and families, please share your experience and insights in our hub community thread on the topic here or drop a comment below. You'll need to register with the hub first, its free and easy to do. -
Content ArticleSarah Rainey talks to Olivia Djouadi about her experience of type 1 diabetes with disordered eating (T1DE), which is thought to affect up to 40% of women and 15% of men with type 1 diabetes. People with T1DE, sometimes also called diabulimia, limit their insulin intake to control their weight, which can have life-threatening consequences. Olivia describes how the stress of living with type 1 contributed to her developing T1DE, and how when she finally received treatment and support in her 30s, she was able to deal with her disordered eating and see her health and wellbeing improve.
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Content ArticleThis is a safety critical and complex National Patient Safety Alert. Implementation should be co-ordinated by an executive lead (or equivalent role in organisations without executive boards) and supported by clinical leaders in diabetes, GP practices, pharmacy services in all sectors, weight loss clinics, private healthcare providers and those working in the Health and Justice sector.
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Content ArticleThis leaflet aims to help people with type 1 diabetes decide between the different technologies available to manage diabetes. It contains summaries of devices available and infographics outlining eligibility criteria for continuous glucose monitors (CGM), insulin pumps and hybrid-closed loop systems. Diabetes care is one of the five clinical areas of focus for integrated care boards and partnerships to achieve system change and improve care as part of Core20Plus5 for children and young people with the aim to increase access to real-time continuous glucose monitors and insulin pumps across the most deprived quintiles and from ethnic minority backgrounds.
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Content ArticlePeople with diabetes often encounter stigma in the form of negative social judgments, stereotypes and prejudice, which can adversely affect emotional, mental and physical health, self-care, access to healthcare and social and professional opportunities. On average, four in five adults with diabetes experience diabetes stigma and one in five experience discrimination due to diabetes in healthcare, education, and employment. Diabetes stigma and discrimination are harmful, unacceptable, unethical, and counterproductive. Collective leadership is needed to proactively challenge, and bring an end to, diabetes stigma and discrimination. To help achieve this, an international multidisciplinary expert panel conducted rapid reviews and participated in a three-round Delphi survey process. The group achieved consensus on 25 statements of evidence and 24 statements of recommendations. The consensus is that diabetes stigma is driven primarily by blame, perceptions of burden or sickness, invisibility and fear or disgust.
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Content Article
Lions Clubs Message in a Bottle (MIAB)
Patient_Safety_Learning posted an article in Emergency medicine
Lions Clubs Message in a Bottle is a simple but effective way for people to keep their basic personal and medical details where they can be found in an emergency on a standard form and in a common location – the fridge. Message in a Bottle (known within Lions as MIAB) helps emergency services personnel to save valuable time in identifying an individual very quickly and knowing if they have any allergies or take special medication. Find out more about the initiative and how to order a bottle via the link below. -
News ArticleHundreds more middle-aged adults have been dying each month since the end of the pandemic, as obesity and NHS backlogs drive a surge in excess deaths. New analysis of official statistics has revealed that there were an extra 28,000 deaths in the UK during the first six months of 2023, compared with levels in the previous five years. The biggest rise in unexpected deaths has been among adults aged 50 to 64, who are increasingly dying prematurely from preventable conditions including heart disease and diabetes. The Covid inquiry is now being urged to shift its focus from “tactical decisions made by politicians” and to examine the lasting disruption that has kept deaths persistently high since the virus peaked. Experts believe that difficulties in accessing GPs since lockdown and record NHS waiting lists mean that middle-aged patients are missing out on life-saving preventative treatment such as blood pressure medication. Unhealthy lifestyles, obesity and widening health inequalities are also contributing to a rise in avoidable deaths. Professor Yvonne Doyle, who led Public Health England during the pandemic, warned that the official Covid inquiry risks “missing the point” by focusing on the drama and WhatsApps of Westminster politicians. In an article for The Times, Doyle, who gave evidence to the inquiry six weeks ago, says that the tens of thousands of excess deaths since Covid “represent an underlying pandemic of ill health” that should be addressed. Read full story (paywalled) Source: The Times, 13 December 2023
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Content Article
D-Coded is an online resource that presents easy-to-understand summaries of diabetes research studies. It aims to make the latest knowledge and developments accessible to people who don't have a medical or scientific background. In this blog, Jazz Sethi, Founder and Director of the Diabesties Foundation and part of the global team that developed D-Coded, discusses the need for the resource and outlines how it will help people living with diabetes to better understand and manage their condition. -
News ArticleA new risk calculator will help to identify people with type 2 diabetes who are at high risk of developing heart and circulatory diseases with greater accuracy than ever before. By spotting high-risk individuals years in advance, doctors will be able to offer vital preventative treatment that can help save lives by warding off future heart attacks and strokes. The risk calculator is included in the new European Society of Cardiology (ESC) Guidelines advising doctors on the management of cardiovascular disease in people with type 2 diabetes, which were announced at the ESC’s annual Congress in August. There are around 4.5 million people in the UK with type 2 diabetes, and one third of adults with diabetes die from a heart or circulatory disease. The SCORE2-Diabetes risk calculator, published in the European Heart Journal, will allow doctors to estimate the risk of developing a heart or circulatory disease in the next 10 years, with much improved accuracy. Professor Sir Nilesh Samani, our Medical Director, said: “People with diabetes are overall nearly twice as likely to die of heart disease or stroke as those who do not have the condition. "This increased risk can be substantially reduced by interventions such as blood pressure control and statins, but this requires more accurate identification of those at increased risk. “SCORE2-Diabetes is a valuable advance that will allow doctors to tailor pre-emptive treatments for individuals with type 2 diabetes based on their personal risk of heart and circulatory diseases. "Such an approach is vital as clinicians in the UK and across Europe find new ways to reduce the high levels of ill health associated with diabetes.” Read full story Source: British Heart Foundation, 26 November 2023
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Content Article
D-coded diabetes
Patient-Safety-Learning posted an article in Diabetes
D-coded diabetes is a tool that aims to simplify complex research studies about diabetes making the science accessible to everyone living with the condition. It uses simple language and images to explain the methodology and results of studies and trials. D-coded diabetes was created by The Diabesties Foundation, a nonprofit organisation aimed at delivering impact by revolutionising advocacy, education and support for people living with Type 1 Diabetes. -
Content ArticleThis article by the charity DiaTribe looks at the impact of armed conflict and displacement on people living with diabetes. Referencing the situation facing people with diabetes in Gaza, it highlights the safety risks including lack of access to healthcare professionals, insulin and other medications and reliable food sources. As well as signposting to other resources for people living with non-communicable diseases (NCDs) in conflict zones, the article provides advice for patients on being prepared for unexpected disasters, including ensuring they have a good knowledge of self-management, know how to safely store insulin and have a diabetes identification card. It also outlines what healthcare workers, governments and aid organisations can do to support people with diabetes living in or having fled conflict zones.
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News Article
Thousands unaware they have diabetes could be diagnosed at A&E, says study
Patient Safety Learning posted a news article in News
Thousands of people unaware they have type 2 diabetes could be diagnosed and avoid serious complications if screening was introduced in emergency departments, a study suggests. The prevalence of the disease has risen dramatically in countries of all income levels in the last three decades, according to the World Health Organization. More than 400 million people have been diagnosed, but millions more are estimated to be in the dark about the fact they have the condition. A study that took place in an NHS trust in England suggests 10% more cases could be picked up with the use of a simple blood test. Screening could also pick up 30% more cases of pre-diabetes – a serious condition where blood sugar levels are higher than normal. The findings are being presented at the annual meeting of the European Association for the Study of Diabetes (EASD) in Hamburg, Germany. “Early diagnosis is the best way to avoid the devastating complications of type 2 diabetes, and offers the best chance of living a long and healthy life,” said Prof Edward Jude, of Tameside and Glossop integrated care NHS foundation trust. Read full story Source: The Guardian, 3 October 2023 -
News Article
Doctors used to diagnosing men may not spot 35,000 women with diabetes
Patient Safety Learning posted a news article in News
Thousands of women may be missing out on a diagnosis of type 2 diabetes because the thresholds are geared towards men, research suggests. Scientists assessed test results from more than one million patients across the country and concluded that the bar for diagnosis might be set too high for women. They calculated that, if thresholds were lowered slightly, an extra 35,000 women under the age of 50 in England would be diagnosed with type 2 diabetes — increasing the number in this age group with the condition by 17%. Under the present guidelines, those 35,000 women would be given the all-clear and would miss out on the chance of earlier treatment and lifestyle advice, increasing their risk of complications in later life. The team, led by doctors at the University of Manchester and including researchers from hospitals nationwide, stressed that their findings were preliminary, and needed further assessment before their hypothesis was confirmed. But, if proved correct, they believe that about 65 young women may be dying of diabetes each year without a diagnosis. Read full story (paywalled) Source: The Times, 1 October 2023 -
Content ArticleIf you are throwing up, having diarrhoea, drinking less water and/or have a fever, you can become dehydrated. Being dehydrated means your body doesn't have enough fluids. When you're dehydrated, some medications used to treat certain health problems may cause unwanted side effects, such as harm to your kidneys. It is important to have a plan to prevent these side effects in case you should become sick and dehydrated. The authors of this guidance learned about a person who died in hospital as a result of side effects of taking a particular medication while dehydrated. They were taking a diabetes medication called empagliflozin and kept taking the same dose after becoming sick. This medication is helpful for people with diabetes, but it can cause serious side effects if it's taken when the person is dehydrated. This guidance offers advice on how to reduce the risk of side effects from your medications when you are sick and dehydrated.
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News Article
Targeted screening of diabetic patients ‘could double heart condition diagnoses’
Patient-Safety-Learning posted a news article in News
Targeted screening of patients with type 2 diabetes could more than double new diagnoses of heart conditions, a study suggests. When applied at a larger scale, such an approach could translate into tens of thousands of new diagnoses, researchers believe. Conditions such as coronary artery disease, atrial fibrillation and heart failure affect millions of people worldwide, causing a large number of deaths and increasing healthcare costs. Treatments are available that can prevent stroke or acute heart failure, but systematic screening is not currently common practice. Those living with conditions such as type 2 diabetes or chronic obstructive pulmonary disease (COPD) – a group of lung conditions that cause breathing difficulties – are at high risk of such conditions. A team of researchers led by Dr Amy Groenewegen, from the University Medical Centre Utrecht in the Netherlands, has developed a three-step screening process to detect conditions in high-risk people at an early stage. Study author Dr Groenewegen said: “An easy-to-implement strategy more than doubled the number of new diagnoses of heart failure, atrial fibrillation and coronary artery disease in high-risk patients.” Read full story Source: Independent, 29 August 2023 -
Content ArticleDespite the prevalence of diabetes amongst individuals with Serious Mental Illness (SMI), diabetes care is not currently audited within mental health inpatient settings as it audited in physical health settings. This project piloted an audit to assess the diabetes care within London NHS Mental Health Trusts. The Health Innovation Network in partnership with South London and Maudsley NHS Foundation Trust (SLaM) developed and piloted a diabetes audit. Following the SLaM pilot, the audit was completed by all nine London Mental Health Trusts. A diverse approach was taken to spread and adoption. This included piloting the audit within one MH Trust, refining, and then rolling out the audit to eight London Mental Health Trusts.
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News Article
Government reports on 'overdue' major conditions strategy
Patient-Safety-Learning posted a news article in News
The Government must provide the health service with more support to fulfil its ambition of extending healthy life expectancy and reducing premature death, an expert has warned. It comes after the Department for Health and Social Care (DHSC) published an interim report on its Major Conditions Strategy, a 5-year blueprint to help manage six disease groups more effectively and tackle health inequality. The groups are cancer, cardiovascular disease – including stroke and diabetes – musculoskeletal conditions, chronic respiratory diseases, mental health conditions and dementia. The Government said the illnesses "account for over 60% of ill health and early death in England", while patients with two or more conditions account for about 50% of hospital admissions, outpatient visits, and primary care consultations. By 2035, two-thirds of adults over 65 are expected to be living with two or more conditions, while 17% could have four or more. Sally Gainsbury, Nuffield Trust senior policy analyst, said the Government is right to focus on the six conditions, but "will need to shift more of its focus towards primary prevention, early diagnosis, and symptom management". She added: "What's less clear is how Government will support health and care systems to do this in the context of severe pressures on staff and other resources, as well as a political culture that tends to place far more focus on what happens inside hospitals than what happens in community healthcare services, GP practices and pharmacies. This initiative is both long overdue and its emphasis has shifted over time. The Major Conditions Strategy is being developed in place of a White Paper on health inequalities originally promised over 18 months ago." Read full story Source: Medscape, 16 August 2023 -
Content ArticleHampshire and Isle of Wight Integrated Care System (ICS) has achieved great results in supporting access to the NHS Diabetes Prevention Programme. This case study outlines the approach taken by the ICS to improve access, what the outcomes were and key lessons learned.
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Content ArticleThe major conditions strategy is a national framework being developed by the Department of Health and Social Care (DHSC) and the Office for Health Improvement and Disparities (OHID). It will focus on six major groups of conditions: cancers cardiovascular diseases, including stroke and diabetes chronic respiratory diseases dementia mental ill health musculoskeletal disorders This briefing by NHS Confederation examines how the upcoming major conditions strategy can set the conditions to prevent, treat and manage multimorbidity in England.
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News Article
Austerity has led to NHS quality of care declining in key areas
Patient Safety Learning posted a news article in News
The quality of care that the NHS provides has got worse in many key areas and patients’ long waits to access treatment could become even more common, research has found. The coalition government’s austerity programme in the early 2010s led to the heath service no longer being able to meet key waiting time targets, the Nuffield Trust and Health Foundation said. Austerity ushered in “really concerning deterioration across the board” in the overall quality of NHS care, as judged by patients’ experience and prevention of ill-health, not just speed of access. Analysis by the two thinktanks’ joint Quality Watch programme, which monitors more than 150 indicators of care quality over time, found that in England: Fewer people with long-term heath conditions such as cancer, diabetes and depression, are getting enough help to manage their condition. Breast cancer screening rates for women aged 53-74 have fallen. It has become harder for patients to see a named GP. Only 6% of midwives think their maternity unit has enough staff to do its job properly. Read full story Source: The Guardian, 5 July 2023 -
News Article
Covid pandemic linked to surge in child and teen diabetes
Patient Safety Learning posted a news article in News
There has been an unusual rise in the number of children and teenagers around the world diagnosed with type 1 diabetes since Covid, say researchers. A new study in JAMA Network Open journal has collated available data from different countries, including the UK, on more than 38,000 young people diagnosed during the pandemic. The authors describe the increase in cases of diabetes as "substantial". More work is needed to understand why the rise is happening, they say. Some of the rise could be attributed to catch-up - from backlogs and delays when health services were shut - but does not explain all of the newly diagnosed cases, say scientists. Before the pandemic, the incidence rate of childhood type 1 diabetes was already increasing - by about 3% a year.
