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News Article
Insulin access still “severely limited” in low-income countries, report finds
Patient Safety Learning posted a news article in News
Efforts by pharmaceutical companies to tackle global insulin inequity are “fragmented” and “falling short,” with many people with diabetes around the world still not having access to the drug. A report by the Access to Medicine Foundation examined access schemes run by the three main insulin manufacturers—Eli Lilly, Novo Nordisk, and Sanofi. It found that despite the programmes they run, access to the treatment is still severely limited or lacking in many low and middle income countries (LMICs). By 2030, the number of people with diabetes worldwide is expected to reach 643 million, with the numbers rising most rapidly in LMICs. The analysis reported that over the past decade pharmaceutical companies have carried out a “patchwork of approaches” that were often focused on a small number of countries or based around particular types of products or specific patient populations. It noted that most of the strategies had not guaranteed “sustained access for insulin dependent patients requiring ongoing, lifelong treatment” and most of the affordability schemes have been primarily focused on human insulins, with only a few for analogue products. Read full story (paywalled) Source: BMJ, 11 October 2022 -
News Article
Children with Down Syndrome at up to 10-fold higher risk of diabetes
Patient Safety Learning posted a news article in News
New research led by Queen Mary University of London (QMUL) and King's College London (KCL) has shown that children with Down Syndrome (DS) are up to 10 times more likely to be diagnosed with diabetes. Although elevated rates of both type 1 diabetes and obesity in DS were already recognised, this is the first time that the incidence of these comorbidities has been mapped across the life span, in one of the biggest DS cohorts in the world. The authors concluded: "Our study shows that patients with DS are at significantly increased risk of diabetes at a younger age than the general population, with more than four times the risk in children and young adults and more than double the risk in patients aged 25–44 years." They added: "The underlying mechanisms for this increased susceptibility for diabetes in DS still need further investigation. A combination of factors, including genetic susceptibility, predisposition to auto- immunity, mitochondrial dysfunction, increased oxidative stress, and cellular dysfunction, are thought to contribute to this risk." Corresponding author Andre Strydom, professor in intellectual disabilities at KCL, said: "This is the largest study ever conducted in Down Syndrome patients to show that they have unique needs with regards to diabetes and obesity, and that screening and intervention – including a healthy diet and physical activity – at younger ages is required compared with the general population. "The results will help to inform the work of NHSE's LeDeR programme to reduce inequalities and premature mortality in people with Down Syndrome and learning disabilities." Read full story Source: Medscape UK, 5 October 2022 -
News Article
Women with type 2 diabetes have 60% increased chance of early death
Patient Safety Learning posted a news article in News
Women in the UK with type 2 diabetes have a 60% increased risk of an early death and will live five years less than the average woman in the general population, early research suggests. Scientists have also found that men with the disease have a 44% increased risk of dying prematurely and live 4.5 years less. Results also suggest that smoking shortens the life expectancy of people with type 2 diabetes by 10 years, while diagnosis at a younger age cuts life expectancy by over eight years. The findings, presented at the European Association for the Study of Diabetes in Stockholm, Sweden, are based on a cohort of nearly 12,000 patients at the Salford Royal Hospital in Salford. “A woman with type 2 diabetes, for example, might live five years less than the average woman in the general population, while someone diagnosed at a younger age might lose eight years of life expectancy. “It is vital that the groups at the highest risk are made aware of not just the increased risk that they face but also the size of the risk." “Doing so may make the health advice they are given seem more relevant and so help them make changes that can improve their quality – and length – of life.” Read full story Source: The Independent, 21 September 2022 -
News Article
Reasons for hospital admissions in people with type 2 diabetes are changing
Patient Safety Learning posted a news article in News
The most common reasons why people with type 2 diabetes (T2DM) are admitted to hospital with greater frequency than the general population are changing, with hospitalisation for traditional diabetes complications now being accompanied by admissions for a diverse range of lesser-known complications including infections (i.e., pneumonia, sepsis), mental health disorders, and gastrointestinal conditions, according to an analysis of national data from Australia spanning seven years. The findings, being presented at this year's European Association for the Study of Diabetes (EASD) Annual Meeting in Stockholm, Sweden (19-23 Sept), reveal that just four traditional diabetes complications (cellulitis, heart failure, urinary tract infections, and skin abscesses) were ranked in the top ten leading causes of hospitalisation in men and women with T2DM. "Although traditional complications such as heart failure and cellulitis remain a substantial burden for people with T2DM, infections less commonly linked with diabetes and mental health disorders are emerging as leading causes of hospital admissions, and have substantial burdens that sometimes exceed the top-ranked well-known complications," says lead author Dr. Dee Tomic from the Baker Heart and Diabetes Institute, Melbourne, Australia. She adds, "The emergence of non-traditional diabetes complications reflects improvements in diabetes management and people with diabetes living longer, making them susceptible to a broader range of complications. Increasing hospitalizations for mental health disorders as well as infections like sepsis and pneumonia will place extra burden on healthcare systems and may need to be reflected in changes to diabetes management to better prevent and treat these conditions." Read full story Source: MedicalXpress, 1 September 2022 -
Content ArticleThis report by the National Paediatric Diabetes Audit (NPDA) is based on data from 33,251 children and young people receiving care from a paediatric diabetes unit (PDU) in 2021/22 in England and Wales. It found that the increase in incidence of Type 1 diabetes observed in the first year of the Covid-19 pandemic was followed by a continuing increase in the numbers of children newly diagnosed with the condition in 2021/22. Other key findings include: Almost all of those with Type 2 diabetes were overweight or obese, and almost half had a diastolic or systolic blood pressure in the hypertensive range. Despite reductions in the percentages recorded as requiring additional support between 2020/21 and 2021/22, over a third of children and young people were assessed as requiring additional psychological support outside of multidisciplinary meetings. Inequalities persist in terms of the use of diabetes related technologies in relation to ethnicity and deprivation.
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Content ArticleThe Diabetes Record Information Standard defines the information needed to support a person’s diabetes management. It includes information that could be recorded by health and care professionals or the person themselves that is relevant to the diabetes care of the person and should be shared between different care providers. It was commissioned by NHS England and developed in partnership with the Professional Record Standards Body (PRSB). The Diabetes Self-Management Information Standard defines the information that could be recorded by the person themselves (or their carer) at home (either using digital apps or medical technology, for example, continuous glucose monitors or insulin pumps) and shared with health and care professionals.
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Content ArticleCovid-19 infection may lead to acute and chronic sequelae. Emerging evidence suggests a higher risk of diabetes after infection, but population-based evidence is still sparse. In this study, Naveed et al. evaluated the association between COVID-19 infection, including severity of infection, and risk of diabetes. They concluded that Covid-19 was associated with a higher risk of diabetes and may have contributed to a 3% to 5% excess burden of diabetes at a population level.
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Content ArticleTechnologies to assist with diabetes treatment and care have evolved rapidly over the past two decades. With each new innovation coming to the market, there are hopes that technologies will solve the numerous, complex issues related to diabetes. However, although it has been demonstrated that overall, these technologies—when available—bring major benefits to people living with diabetes, they do not make the condition disappear. This article in Diabetes Epidemiology and Management discusses the interconnections between technologies and diabetes distress, an often under-acknowledged consequence of the continuous demands of diabetes.
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Content Article
Diabetes UK: Diabetes and Ramadan
Patient Safety Learning posted an article in Diabetes
This Diabetes UK webpage has information for people living with diabetes who are thinking about fasting for Ramadan. Ramadan in 2023 will run from on or around Wednesday 22 March for 29 or 30 days, ending with Eid al-Fitr, a religious holiday celebrated by Muslims worldwide. Download factsheets about diabetes and Ramadan, which include fasting and managing your diabetes during this time, which have been developed in partnership with the Muslim Council of Britain’s Diabetes Advisory Group. -
Content ArticleThis report by the National Paediatric Diabetes Audit (NPDA) looks at diabetes care for children in England and Wales in 2021-22. The effectiveness of diabetes care is measured against NICE guidelines and includes treatment targets, health checks, patient education, psychological wellbeing, and assessment of diabetes-related complications including acute hospital admissions, all of which are vital for monitoring and improving the long-term health and wellbeing of children and young people with diabetes. In 2021/22, 100% of paediatric diabetes teams participated in the NPDA.
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Content ArticleFew centres in the UK within adult and paediatric diabetes units adopt digital technology, telemedicine or social media within their services. Perhaps this is due to both lack of investments and to some extent clinical leadership to champion and drive change. This paper presented at the 2018 Mary MacKinnon Diabetes UK lecture aims to show how health outcomes, education and patient engagement can be significantly improved using novel digital and technology strategies as effective means of driving change and delivering good quality of care within a paediatric diabetes service.
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Content ArticleContinuous glucose monitors (CGM) are devices that offer an alternative to finger stick blood glucose testing in adults and children with any type of diabetes. This practice guide in the BMJ offers guidance on CGM for primary care providers and aims to reduce uncertainty and improve prescribing rates of CGM.
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Content ArticleIn this National Health Executive article, Dr Tom Milligan, Clinical Lead for Diabetes in Humber and North Yorkshire, discusses how ICB-led text messaging could dramatically increase patients' participation in programmes where other methods of patient outreach have already been tried.
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Content Article
Diabetes Type 1: S.T.I.G.M.A. (Revolve Comics)
Patient Safety Learning posted an article in Diabetes
Type 1: S.T.I.G.M.A. is the third issue in the type 1 diabetes comic series. Here, the focus is on stigma and on the risk that can be posed to people with type 1 diabetes if blood sugar levels fall too low… Supported by the NHS. -
News Article
Children to be screened for diabetes risk in UK early detection trial
Patient Safety Learning posted a news article in News
Scientists are launching a trial screening programme for type 1 diabetes in the UK to detect the disease earlier and reduce the risk of life-changing complications. About 20,000 children aged between 3 and 13 are being invited to take part in the Early Surveillance for Autoimmune Diabetes (Elsa) study, with recruitment opening on Monday. The aim is to assess children’s risk of developing type 1 diabetes at the earliest stage possible to ensure a quick and safe diagnosis, and reduce the number being diagnosed when they are already seriously ill. Parth Narendran, a professor of diabetes medicine at the University of Birmingham, said: “As general population screening programmes for type 1 diabetes emerge around the world, we need to explore how best to screen children here in the UK.” Dr Elizabeth Robertson, the director of research at Diabetes UK, which is co-funding the study with the not-for-profit organisation JDRF, said: “Identifying children at high risk of type 1 diabetes could put them and their families on the front foot, helping ensure a safe and soft landing into an eventual diagnosis, avoiding DKA and reducing the risk of life-altering complications.” Read full story Source: The Guardian, 14 November 2022 -
News ArticleThe COVID-19 pandemic has dramatically curtailed the provision of health services for non-communicable diseases, says a survey of 155 countries by the World Health Organization conducted over three weeks in May. In the survey poorer countries were the most likely to report disrupted services, but some 94% of responding countries had reassigned health ministry staff from work on NCDs to dealing with the pandemic. Hypertension treatment has been partially or completely disrupted in 53% of the countries surveyed, diabetes treatment in 49%, cancer treatment in 42%, and cardiovascular emergency responses in 31% of countries, the survey found. In the Netherlands, new cancer diagnoses have fallen by 25% since the pandemic lockdown began. In rural India, 30% fewer cardiac emergencies reached health facilities in March 2020 than the previous year. Rehabilitation services, which are often key to a healthy recovery after severe COVID-19, have been disrupted in 63% of countries surveyed. Screening campaigns have been put on hold in more than half. WHO’s director general, Tedros Adhanom Ghebreyesus, said, “The results of this survey confirm what we’ve been hearing from countries for a number of weeks now. Many people who need treatment for diseases like cancer, cardiovascular disease, and diabetes have not been receiving the health services and medicines they need since the COVID-19 pandemic began. It’s vital that countries find innovative ways to ensure that essential services for NCDs continue, even as they fight COVID-19.” Read full story Source: BMJ, 3 June 2020
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News Article
Quarter of people who die from coronavirus in England have diabetes
Patient Safety Learning posted a news article in News
More than a quarter of all NHS patients who have died after being infected with COVID-19 had diabetes, according to new statistics from NHS England. Between 31 March and 12 May, a total of 5,873 patients with diabetes died in hospital from COVID-19, 26% of all coronavirus deaths. It is the first time data on hospital deaths and underlying health conditions has been revealed by the NHS. People with diabetes have previously been described as being at moderate risk from the virus and were not part of the groups told to shield themselves in their homes due to fears they were at extreme risk. The NHS England data does not specifically say whether type 1 or type 2 was more prevalent among deaths. It said work was underway to understand the deaths data to include examining the type of diabetes, ethnicity and weight of those who died. NHS England said it was working with Diabetes UK to provide support and advice to patients via its helpline which will include volunteer clinical advisers. Read full story Source: Independent, 15 May 2020 -
Content ArticleYoung people with type 1 diabetes experience higher rates of psychological distress, periods of burnout and feelings of being unable to cope with the daily burden of living with diabetes, than those who are diagnosed as adults. This article in The BMJ considers approaches to reduce anxiety and stress in young people with diabetes including: family, peer, and psychological support and education on living with diabetes. psychological screening assessment tools at diagnosis and annually. ensuring there are adequate local mental health support pathways. psychological and behavioural interventions, such as solution focused therapy, coping skills training, motivational interviewing and cognitive behavioural therapy.
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Content ArticleThe National Paediatric Diabetes Audit (NPDA) is performed annually in England and Wales and aims to provide information that leads to improved quality care for children and young people affected by diabetes. The audit is funded by the Department of Health through the Healthcare Quality Improvement Partnership (HQIP). Key messages in this 2020-21 annual report on care processes and outcomes include: There was an increase of an increase of 20.7% in the number of children aged 0-15 diagnosed with type 1 diabetes compared with 2019-20. Completion rates on recommended health checks were lower than in previous years due to the impact of the Covid-19 pandemic. There was wide variation between paediatric diabetes units in the completion rates of all key annual health checks. A smaller percentage of newly-diagnosed children and young people started insulin pump therapy compared to previous years. The national median HbA1c (a measure of blood glucose control) reduced from 61.5 mmol/mol to 61.0mmol/mol between 2019/20 and 2020/21, following several years of year on year decreases (improvement) in the national median. Children from ethnic minorities were less likely to be using insulin pumps and continuous glucose monitors (CGMs) than white children. However, the highest percentage increase between audit years in the use of CGMs was seen in black children and young people with type 1 diabetes.
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Content ArticleDiabetes UK are calling on government for a recovery plan to tackle 'devastating’ diabetes care delays – before it’s too late Diabetes is serious and people living with diabetes have been ‘pushed to the back of the queue’ during the coronavirus pandemic and a national recovery plan is needed to support front-line healthcare teams in getting vital services back on track. Diabetes UK warn that despite the tireless efforts of the NHS through the pandemic, many people living with the condition are still struggling to access the care they need, putting them at risk of serious complications, which can lead to premature death. This new report published by Diabetes UK as part of our Diabetes Is Serious campaign, shows the scale of the problem and sets out a series of calls to UK Government to tackle it.
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Content ArticleAlthough research has focused on safe disposal of sharps in healthcare settings, the issue of disposal by patients in the home setting has not often been addressed. This US study in the journal Diabetes Spectrum aimed to evaluate methods of disposal and patient demographic factors associated with correct disposal of diabetes-related sharps in the community.
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Content ArticleThe efficacy of injection therapy in diabetes depends on correct injection technique. The aim of the Insulin Injection Technique Questionnaire was to understand how people with diabetes inject, so that guidance can be tailored towards improving injection technique. This article in the Journal of Diabetes analyses the results of the 2008-2009 survey and identifies areas where improvements have been made since the last survey, and areas where there is still progress to be made.
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Content ArticleThis article in the Journal of Diabetes Science and Technology reviews the literature from various geopolitical regions and describes how a substantial number of patients with diabetes improperly discard their sharps. Data support the need to develop multifaceted and innovative approaches to reduce the risks associated with improper disposal of medical sharps into local communities.
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Content Article
In this blog, Lotty Tizzard, Patient Safety Learning’s Content and Engagement Manager, looks at the difficulties people experience in disposing of needles and injection devices safely at home. Variation in services across the UK can lead individuals to dispose of sharps incorrectly, posing a risk to refuse workers and the wider public. -
Content ArticleThis guidance document for healthcare professionals highlights language that can discourage a person with type 1 diabetes, and what kind of language can motivate them. The project produced by The Diabesties Foundation and Diabetes India, and was adopted from the Language Matters guidance produced by NHS England. The guidance is available to download in English, Hindi and Tamil.
