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Found 196 results
  1. Content Article
    Diabetes UK has launched their new ‘10 Year Vision: For diabetes prevention, care and treatment’, setting out a clear plan for the UK government about how it can improve health outcomes and tackle inequality for people living with diabetes by 2035.  The UK government will publish its 10 Year Health Plan in June, which will set out how the health service can make a shift from sickness to preventing ill health. If the government is to succeed with this aim, diabetes must be at the heart of its plans.  The ‘10 Year Vision’ gives the government a clear plan for how it can improve health outcomes and tackle inequalities for people living with diabetes, and how this can be achieved by 2035. This vision involves: Stemming the rise in type 2 diabetes – improving our food environment and delivering high-quality support to help people reduce their risk of type 2 diabetes. Ensuring early and accurate diagnosis - which is key to setting people up to manage their diabetes and, in turn, preventing serious complications. Transforming diabetes care and treatment – to help people with diabetes live well. Most diabetes complications can be prevented with simple interventions like annual checks, access to the right treatments and technology, and a focus on reducing health inequalities. Accelerating innovation – Investing in diabetes research and ensuring new treatments and technologies are available to people with diabetes quickly.
  2. News Article
    Weight loss drugs could at least double the risk of diabetic patients developing age-related macular degeneration, a large-scale study has found. Originally developed for diabetes patients, glucagon-like peptide-1 receptor agonist (GLP-1 RA) medicines have transformed how obesity is treated and there is growing evidence of wider health benefits. They help reduce blood sugar levels, slow digestion and reduce appetite. But a study by Canadian scientists published in Jama Ophthalmology has found that after six months of use GLP-1 RAs are associated with double the risk of older people with diabetes developing neovascular age-related macular degeneration compared with similar patients not taking the drugs. Academics at the University of Toronto examined medical data for more than 1 million Ontario residents with a diagnosis of diabetes and identified 46,334 patients with an average age of 66 who were prescribed GLP-1 RAs. Nearly all (97.5%) were taking semaglutide, while 2.5% were on lixisenatide. The study did not exclude any specific brand of drugs, but since Wegovy was only approved in Canada in November 2021, primarily for weight loss, it is likely the bulk of semaglutide users in the study were taking Ozempic, which is prescribed for diabetes. The study found that those who had been taking semaglutide or lixisenatide for at least six months had twice the risk of developing macular degeneration, compared with similar patients who were not taking the drugs. Patients who had been taking GLP-1 RAs for more than 30 months had more than three times the risk. Marko Popovic, a co-author of the study and physician in the department of ophthalmology and vision sciences at the University of Toronto, said: “GLP-1 receptor agonists appear to have multiple effects on the eye, and in the case of neovascular age-related macular degeneration, the overall impact may be harmful. “Based on our data, I would advise exercising particular caution when prescribing GLP-1 RAs to older [diabetic] patients or those with a history of stroke, as both groups were found to have an even higher risk of developing [the condition].” Read full story Source: The Guardian, 5 June 2025
  3. Content Article
    Managing insulin during care transfers requires improvement. Understanding factors that impact insulin management during this process improves the likely effectiveness of interventions. This study aimed to map the processes involved in managing insulin during transfers of care and the factors that affect them to identify potential areas for safety improvement interventions.
  4. Content Article
    Insulin prescribing in the UK has tripled in the past decade, in particular due to an increase in use among those living with type 2 diabetes, now the largest group of insulin users. As a result, nurses in general practice and the community are increasingly expected to be skilled in supporting people living with type 2 diabetes with insulin therapy and associated glucose monitoring. The management of insulin therapy requires knowledge of the type of diabetes it is being used for and appropriate dosing, as well as correct injection technique, to prevent complications and medication errors. Diabetes nursing specialist Debbie Hicks shares key points on the management of insulin therapy for nurses in primary care.
  5. News Article
    Patients in A&E are being put in potentially life-threatening situations due to missed doses of prescription medicines, according to a new report. The Royal College of Emergency Medicine (RCEM) found people in A&E were not getting their medications on time and were missing doses needed to manage their illnesses – putting them at risk of getting worse. Insulin for diabetes, Parkinson's drugs, epilepsy medicines and tablets for preventing blood clots are all time critical medicines (TCM). If these drugs are delayed or missed, the patient can deteriorate and is at greater risk of complications or death. While patients are advised to remember to bring their medications to A&E and to take them, there is also a responsibility on NHS staff to make sure this happens. Despite the recognised risk of harm, the delivery of TCM is not consistent across emergency departments with long waiting times often contributing to this. The study, which was part of the College's clinical Quality Improvement Programme (QIP) which aims to improve the care of A&E patients, found more than half of these patients were not identified as being on TCM within 30 minutes of their arrival in an emergency department. In addition, 68% of doses were not administered within 30 minutes of the expected time. "The findings contained in this report should serve as a call to action for both emergency medicine staff, as well as patients reliant on time critical medications, to ensure no dose is ever missed in A&E," said Dr Jonny Acheson, an emergency medicine consultant in Leicester who has Parkinson's, led the study. Read full story Source: The Independent, 7 April 2025 Further reading on the hub: Time-critical Parkinson’s medication: the human cost of delays and mistakes HSSIB investigation report: Medication not given: administration of time critical medication in the emergency department Parkinson's UK: Time critical medication guides for health professionals Improving safety for diabetic inpatients: 4 key steps D1abasics: Equipping staff to care safely for inpatients with diabetes
  6. Content Article
    Patient safety is being put at risk in Emergency Departments due to missed doses of vital prescription medicines. This is one of the findings of a study being carried out by the Royal College of Emergency Medicine (RCEM) which revealed that many patients who rely on prescription medication to manage chronic conditions such as diabetes and Parkinson’s, aren’t always getting these vital drugs when in A&E. These types of drugs are known as ‘time critical medication’ (TCM) and, as the name suggests, it is important they are taken at specific times. If a dose is delayed or missed, it can cause a person’s health to worsen. And if this delay is prolonged, the consequences can be severe. The RCEM’s new report – Time Critical Medication QIP 2023-24 is part of the College’s clinical Quality Improvement Programme  (QIP), which aims to improve the care of patients attending Emergency Departments. The three-year QIP examines how time critical medications are dealt with in practice when patients come to the Emergency Department and how clinical methods and patient safety can be improved. This report reflects the findings of the first year of the programme. Across the UK, 136 Emergency Departments collated and analysed data for people living with diabetes and Parkinson’s, who take certain medication such as insulin injections and a drug called levodopa, taken as tablets or capsules. Supported by Parkinson’s UK and Diabetes UK, the QIP found more than half of eligible patients (53.4%) taking TCM weren’t identified within 30 minutes of their arrival in ED. Meanwhile, around 68% of eligible patients’ doses weren’t administered within 30 minutes of the expected time. In response to the findings, the QIP team made the following recommendations: Patients on TCM need to be identified early to start the process of getting all doses whilst in the ED. Systems need to be in place that will facilitate the timely administration of TCM, including self-administration. Local EDs must have a clear governance structure in place to determine who is responsible for the prescribing and administering of TCM in the ED from when the patient arrives, to when they are admitted to the ward or discharged from the ED. Further reading on the hub: Time-critical Parkinson’s medication: the human cost of delays and mistakes HSSIB investigation report: Medication not given: administration of time critical medication in the emergency department Parkinson's UK: Time critical medication guides for health professionals Improving safety for diabetic inpatients: 4 key steps D1abasics: Equipping staff to care safely for inpatients with diabetes
  7. Content Article
    For people living with type 2 diabetes, achieving the best health outcomes requires good self-management and sticking to agreed treatment. While some studies suggest an association between poor medication adherence and lower levels of health literacy, the evidence for this association remains inconclusive. This systematic review aimed to examine the evidence on the association between health literacy and medication adherence among adults from ethnic minority backgrounds living with type 2 diabetes.
  8. News Article
    Popular glucose monitors used to take regular blood sugar readings could be driving poor diets and food restrictions due to inaccurate measurements, according to a new study. Continuous Glucose Monitors (CGMs) take blood sugar readings every five minutes and were originally designed for people with diabetes to assess how their body responds to different foods. But they are growing in popularity and in recent years have increasingly been used by the health-conscious to track their diet and avoid glucose spikes. Carried out in healthy, non-diabetic volunteers, the research compared results from a CGM to the gold standard finger-prick test for blood sugar levels. Scientists found that the CGMs consistently reported higher levels than the finger-prick test. The monitors overestimated the time spent above the Diabetes UK’s recommended blood sugar level threshold by nearly 400 per cent, causing unnecessary concern for people whose blood sugar was actually well-controlled. Professor Javier Gonzalez, from the university’s department of health, warned people should stick with the finger-prick test if they are looking for accurate readings. “Continuous glucose monitors (CGMs) are fantastic tools for people with diabetes because even if a measurement isn’t perfectly accurate, it’s still better than not having a measurement at all,” he said. “However, for someone with good glucose control, they can be misleading based on their current performance." Read full story Source: The Independent, 26 February 2025
  9. News Article
    Pregnant women in prison in England are three times more likely to be ­diagnosed with gestational ­diabetes than those on the outside, according to “alarming” new data. Figures obtained through freedom of information (FOI) requests to NHS trusts providing healthcare to women’s prisons in England found 12% of women receiving care relating to pregnancy in 2023 were diagnosed with the condition, triple the national figure of 4%. Laura Abbott, associate ­professor in midwifery at Hertfordshire University, said these figures were “alarming but not surprising”. “We have known for many years that preterm birth is more common among ­incarcerated pregnant women, and this ­further highlights the severe health risks they face,” she said. “Gestational diabetes increases the risk of high blood pressure and pre-eclampsia, serious conditions that require early detection, good nutrition and careful obstetric management, which is extremely difficult in a prison setting. It can also increase the risk of stillbirth.” There were 215 pregnant women in prison in England between April 2023 and March 2024, according to figures published by the Ministry of Justice. There were 52 births while in custody, 98% of which took place in hospital. The NHS and Prison Ombudsman categorise all pregnancies in prison as high risk. Pregnant women in prison are seven times more likely to have a stillbirth and twice as likely to go into premature labour, according to data from FOI requests in 2022. In 2019, newborn Aisha Cleary died at HMP Bronzefield after her mother, who was in prison on remand, was left to give birth alone in her cell. Read full story Source: The Guardian, 23 February 2025
  10. News Article
    The Food and Drug Administration released an alert notifying patients of a safety concern using diabetes devices such as continuous glucose monitors, insulin pumps and automated insulin dosing systems that rely on a smartphone for delivering alerts. The agency said it received medical device reports in which users reported alerts were not being delivered or heard in situations where the users thought they configured the alerts to be delivered. Some instances may have contributed to serious harm, including severe hypoglycaemia, severe hyperglycaemia, diabetic ketoacidosis and death. The FDA issued recommendations for users and said it is working with diabetes-related medical device manufacturers to ensure that smartphone alert configurations are evaluated prior to use. It is also working with manufacturers to ensure settings for smartphones and mobile medical applications are continuously tested and that updates are communicated quickly and clearly to users. Read full story Source: US Food and Drug Administration, 5 February 2025
  11. News Article
    One in five UK adults are living with diabetes or pre-diabetes as diagnoses have reached an all-time high, new data shows. Charity Diabetes UK called this a “hidden health crisis” and urged the government to act immediately. Some 4.6 million people are now diagnosed with the condition, compared to 4.4 million a year ago. This includes about 8% with type 1 diabetes, which happens when a person cannot produce insulin, a hormone that helps the body turn glucose into energy. Some 90% have type 2 diabetes, which happens when the body does not use insulin properly, while 2% have different and rarer forms of the condition. A further 1.3 million are estimated to be living with undiagnosed type 2 diabetes. The chief executive of the charity, Colette Marshall, said: “These latest figures highlight the hidden health crisis we’re facing in the UK and underline why the government must act now. “There must be better care for the millions of people living with all types of diabetes, to support them to live well and fend off the risk of developing devastating complications. “With more people developing pre-diabetes and type 2 diabetes at a younger age, it’s also critical that much more is done to find the missing millions who either have type 2 diabetes or pre-diabetes but are completely unaware of it. The sooner we can find and get them the care they need, the more harm we can prevent.” Read full story Source: The Independent, 6 February 2025
  12. News Article
    Hundreds of patients are being contacted over potentially incorrect results at a second NHS trust, as more laboratories report concerns over diabetes tests, HSJ understands. Bedfordshire Hospitals Foundation Trust was the first to report an issue over blood tests earlier this year, saying up to 11,000 patients may have received the wrong results – including a misdiagnosis of diabetes. But the Medicines and Healthcare Products Regulatory Agency has confirmed to HSJ that other laboratories across the country have reported concerns over the same device, which measure glucose control. The Hb1AC blood test is used to diagnose diabetes and prediabetes, as well as manage existing conditions. A spokeswoman said clinical care was unlikely to have been affected, but doctors were reviewing individual circumstances and patients would be contacted if they needed a new test. Several field safety notices have now been published for the Premier Hb9210 HbA1c analyser device, manufactured by Trinity Biotech. Dr Janine Jolly from MHRA said the regulator was working closely with the manufacturer to ensure corrective actions were being put in place. Read full story (paywalled) Source: HSJ, 27 November 2024
  13. News Article
    Hundreds of patients are being contacted over potentially incorrect results at a second NHS trust, as more laboratories report concerns over diabetes tests, HSJ understands. Bedfordshire Hospitals Foundation Trust was the first to report an issue over blood tests earlier this year, saying up to 11,000 patients may have received the wrong results – including a misdiagnosis of diabetes. But the Medicines and Healthcare Products Regulatory Agency has confirmed to HSJ that other laboratories across the country have reported concerns over the same device, which measure glucose control. The Hb1AC blood test is used to diagnose diabetes and prediabetes, as well as manage existing conditions. One affected trust is Maidstone and Tunbridge Wells FT, which said around 1,500 patients had been identified for a retest following a technical issue affecting results in July. A spokesman said the problem was escalated to the supplier as soon as possible, and that affected patients would be contacted by GPs. Read full story (paywalled) Source: HSJ, 27 November 2024
  14. News Article
    The number of people with diabetes has doubled over the past 30 years to more than 800 million worldwide, according to a groundbreaking international study. Global analysis published in the Lancet found that rates of diabetes in adults doubled from about 7% to about 14% between 1990 to 2022, with the largest increase in low and middle-income countries. The study is the first global analysis of diabetes rates and treatment in all countries. Scientists at NCD-RisC in collaboration with the World Health Organization used data from more than 140 million people aged 18 or older from more than 1,000 studies in different countries. They applied statistical tools to enable accurate comparisons of prevalence and treatment between countries and regions. The study highlighted growing health inequalities. More than half of global diabetes cases were concentrated in four countries. Of those with diabetes in 2022, more than a quarter (212 million) lived in India, 148 million were in China, 42 million were in the US and 36 million in Pakistan. Indonesia and Brazil accounted for a further 25 million and 22 million cases, respectively. Dr Ranjit Mohan Anjana, the joint first author and president of the Madras Diabetes Research Foundation in India, said: “Given the disabling and potentially fatal consequences of diabetes, preventing diabetes through healthy diet and exercise is essential for better health throughout the world. “Our findings highlight the need to see more ambitious policies, especially in lower-income regions of the world, that restrict unhealthy foods, make healthy foods affordable and improve opportunities to exercise, through measures such as subsidies for healthy foods and free healthy school meals as well as promoting safe places for walking and exercising including free entrance to public parks and fitness centres.” Read full story Source: The Guardian, 13 November 2024
  15. Content Article
    Diabetes can be detected at the primary healthcare level, and effective treatments lower the risk of complications. There are insufficient data on the coverage of treatment for diabetes and how it has changed. This study estimated trends from 1990 to 2022 in diabetes prevalence and treatment for 200 countries and territories. The findings showed that most countries, especially in low-income and middle-income countries, diabetes treatment has not increased at all or has not increased sufficiently in comparison with the rise in prevalence. The burden of diabetes and untreated diabetes is increasingly borne by low-income and middle-income countries. The expansion of health insurance and primary health care should be accompanied with diabetes programmes that realign and resource health services to enhance the early detection and effective treatment of diabetes.
  16. Content Article
    Type 1 diabetes with disordered eating (T1DE), or diabulimia as some experts call it, is a serious eating disorder that people with type 1 diabetes can develop where the person reduces or stops taking their insulin as a way of managing their weight. The condition can be life-threatening. Although studies are limited, it’s estimated that eating disorders affect more than a third of patients with type 1 diabetes. This episode of the Healthcare Improvement podcast looks at diabulimia and a new toolkit published by SIGN, part of Healthcare Improvement Scotland, which sets out recommendations to raise awareness and provide guidance on how best to support people living with the diabulimia. Guests in this episode include: Lawrence Smith, who was diagnosed with type 1 diabetes when he was four years old and went on to develop an eating disorder in his teens. Safia Qureshi, Director of Evidence & Digital at Healthcare Improvement Scotland, who talks about the key recommendations in the toolkit. Dr Louise Johnston, Consultant and Clinical Lead on the inpatient unit for eating disorders, NHS Grampian.
  17. News Article
    The UK's drug safety regulator is asking doctors to be alert for patients who may be misusing obesity injections, such as Wegovy. It follows reports of some people who are not obese becoming sick, after using the jabs for weight loss. The Medicines and Healthcare products Regulatory Agency (MHRA) stresses that the drugs are only meant for treating obesity and diabetes. Health Secretary Wes Streeting has backed the call, saying the drugs are "serious medicines" and not "for people to get a body beautiful picture for Instagram". While most side-effects are mild, some can be serious, says the MHRA. It adds that the drugs should only be prescribed by a registered healthcare professional. When appropriately used, in line with the product licence, the benefits of these medications outweigh the risks for patients, says the regulator. But this benefit-risk balance is positive only for those patients within the approved indications for weight management or type 2 diabetes, as described in the product information. Dr Alison Cave, MHRA Chief Safety Officer, said all medicines carry a risk of potential side-effects: “We encourage healthcare professionals to ensure patients being treated with these medicines are aware of the common side-effects and how to minimise risk." Read full story Source: BBC News, 24 October 2024
  18. Content Article
    Healthcare professionals are reminded to inform patients about the common and serious side effects associated with glucagon-like peptide-1 receptor agonists (GLP-1RAs). Advice for healthcare professionals: Inform patients upon initial prescription and when increasing the dose about the common risk of gastrointestinal side effects which may affect more than 1 in 10 patients. These are usually non-serious, however can sometimes lead to more serious complications such as severe dehydration, resulting in hospitalisation. Be aware that hypoglycaemia can occur in non-diabetic patients using some GLP-1RAs for weight management; ensure patients are aware of the symptoms and signs of hypoglycaemia and know to urgently seek medical advice should they occur. Patients should also be warned of the risk of falsified GLP-1RA medicines for weight loss if not prescribed by a registered healthcare professional, and be aware that some falsified medicines have been found to contain insulin. Be aware there have been reports of potential misuse of GLP-1RAs for unauthorised indications such as aesthetic weight loss report suspected adverse drug reactions to the Yellow Card scheme.
  19. Event
    This webinar for UK healthcare professionals will be delivered by DISN UK Group committee members. It will focus on using diabetes technology–insulin pumps, CGM, POCT–in the hospital. We will discuss and outline the newest JBDS technology guideline and provide the attendees with most up to date information regarding using diabetes technology when a person with diabetes is admitted to hospital. Educational outcomes – 3 points: Recognise different types of diabetes technology Use of diabetes technology in the different scenarios in inpatient setting Effective support for people with diabetes and use of diabetes technology when admitted to hospital Register for the webinar
  20. Community Post
    These comments were made by people with diabetes in response to a Twitter thread asking "Why is a hospital stay scary if you have diabetes?" If you have diabetes, or care for someone who does, please share your experience with us by adding a comment to this community thread, “I was in ICU after a car accident—none of the staff knew how to work my CGM and/or my insulin pump. I had to manage my own care” “For me it was when I went into hospital for surgery and the nurse said 'Type 1... so do you take insulin for that?'... that's not a reassuring thing to hear minutes before you're taken into the theatre!” “Lucky to get out alive.” “DKA 10 years ago, once back in normal range the consultant insisted I didn't need anymore insulin & refused to let me have any. Obvs within 3 hours I was back in DKA, he wouldn't come see me but had a convo with my husband on the ward phone where hubs explained how T1 works.” “I've been given a full day's bolus, through my iv and then told I was wrong when I said that I only bolused when I ate. Massive hypo followed quickly. I was then told it was my fault and I should have said something.” “After being admitted as an emergency, my own insulin ran out. I was given 2 (2!) of the wrong types of insulin and told that 'it would be okay'.” “They were often confused about T2 versus T1 - lots of emphasis about low fat foods and only being allowed a low fat yoghurt for puddings even though I was on a pump! I had a bag of snacks though as it was a planned hospital stay” “After a major medical issue I was denied insulin in the ICU for over 24 hours but was told I could have some pills to treat my type 1 diabetes” “Last time I went to the hospital, they took my pump (forcefully) and refused to give it back. When I protested, they sedated me. I was in and out of sedation having a panic attack bc I couldn’t breathe. They sedated me again and put me on DKA protocol, even tho I wasn’t in DKA.” “it’s so scary right like you know that you’re the expert on your condition and your needs but that power gets totally taken away” “Handing over your care over to a group of nurses who have no idea what they are doing. It’s super scary. I hate it when they lock it all away and you can’t get to it.” “I didn’t feel safe either. Told them on a few occasions I felt ‘low’. Finally Lucozade got wheeled out but it was almost an inconvenience” “Totally understand why they don’t know much about it if it’s not their specialism BUT some are so arrogant that what they were told one afternoon 10yrs ago is the absolutely way to deal with, and that the person living with it doesn’t know what they’re talking about!” Sarcastic responses “You seem to know a lot about it!” “The neurologist told me I am a terrible diabetic.” “I never feel safe because they don’t allow me to dose my own insulin and last time dropped me from 600 to 40 in three hours and then shot me back up so fast when i specifically told them that i would go low and high from that much insulin” Report of being diagnosed with type 1 diabetes while in hospital, despite telling every healthcare professional she had T1. “I smuggled in my own tester and meds and took care of myself.” “I think the biggest thing for me is them not understanding insulin dose when they’re writing up your chart and how you don’t really have a “typical” insulin dose that fits neatly into their charts because of carb counting or correction doses/reduction dose. It’s strange, when I’ve had DKA admissions and I’m on the sliding scale IV it’s fine because there’s clear guidelines but for just day to day injection management it’s soooo difficult.” "Daughter had food and insulin withheld in a mental hospital." “the ward nurses didn’t even know I had T1 until the more mobile lady opposite me went and fetched a nurse who had been ignoring my call button. I was hypo and couldn’t reach my treatment.” "Taken off insulin for two days as no doctor to prescribe." “Particularly bad experience when a nurse left the glucose drip on but turned off the insulin. It terrifies me to think how bad this could have been.”
  21. Content Article
    Despite 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. Outcomes The audit evidenced a need to improve: Access to diabetes specialists; no Mental Health Trust had access to consultant diabetologists. Seven out of nine Trusts had no access to Diabetes Specialist Nurses. Staff and patient education; Mental Health Trusts offered no or irregular education. Policy communication e.g. 76% of mental health wards stated they did not have or did not know of their Trust’s diabetes self-management policy. Patients rated diabetes care as 3.63 out of 5. Since sharing the findings Mental Health Trusts have made improvements, these include: recruiting Diabetes Specialist Nurses and Physicians Associates. sharing self-management policies. offering educational training. creating physical health forums. The team used networking opportunities with key stakeholders such as London Diabetes Clinical Network and Diabetes Inpatient Network and the London Physical Health Leads Network and the Cavendish Square Group (Medical Directors and CEOs of all London MH Trusts) to ensure more than 7,000 stakeholders were aware of the project findings. The Health Innovation Network also produced a report and was successful in gaining both a poster and presentation at the 2023 Diabetes UK Conference which has a national and international audience. The audit revealed that improving diabetes care in mental health settings remains a priority for London Mental Health Trusts and the London Diabetes Clinical Network.
  22. Content Article
    Hampshire 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.
  23. Content Article
    The 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. Key points NHS leaders have identified key levers that the major conditions strategy can use to maximise its impact on healthy life expectancy and reduce inequalities. These fall under three categories: create a healthy society, make the most of existing infrastructure and policy and implementation. The major conditions strategy will allow health services to evolve from a single-disease approach to a multimorbidity approach, which will match how patients need to use the service. Integrated care systems will provide vital infrastructure for the sharing of data, integration of services and creation of a patient-centred approach to health and care provision. A health service designed around multimorbidity would be a step-change for patients and requires a series of shifts to be made in both focus and provision.
  24. Content Article
    There are reports of increasing incidence of paediatric diabetes since the onset of the COVID-19 pandemic. This study by D'Souza et al. compares the incidence rates of paediatric diabetes during and before the COVID-19 pandemic. The study found that incidence rates of type 1 diabetes and diabetic ketoacidosis at diabetes onset in children and adolescents were higher after the start of the COVID-19 pandemic than before the pandemic. Increased resources and support may be needed for the growing number of children and adolescents with diabetes. Future studies are needed to assess whether this trend persists and may help elucidate possible underlying mechanisms to explain temporal changes.
  25. Content Article
    The widespread adoption of effective hybrid closed loop systems would benefit people living with type 1 diabetes by improving the amount of time spent within target blood glucose range. Hybrid closed loop systems (also known as 'artificial pancreas' typically utilise simple control algorithms to select the best insulin dose for maintaining blood glucose levels within a healthy range. Online reinforcement learning has been utilised as a method for further enhancing glucose control in these devices. Previous approaches have been shown to reduce patient risk and improve time spent in the target range when compared to classical control algorithms, but are prone to instability in the learning process, often resulting in the selection of unsafe actions. This study in the Journal of Biomedical Informatics presents an evaluation of offline reinforcement learning for developing effective dosing policies without the need for potentially dangerous patient interaction during training.
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