New online type II diabetes support

The NHS has announced that it will be offering online support for patients with type II diabetes to help them manage their condition, via a first of its kind service | via PharmaTimes online

A new online portal in partnership with Changing Health will offer people with type II diabetes evidence-based information and support, which will be available at the touch of a button, giving them convenient and quick help to deal with the physical and mental challenges of diabetes.

search-3539523_1920

Patients have already made use of the online courses and information to help reduce their blood glucose levels, a crucial part of managing type II diabetes.

The collaboration with Changing Health will see the largest ever roll out of free digital support for people diagnosed with type II diabetes, which currently costs the NHS around £8.8 billion a year.

The company says that the partnership will allow the NHS to offer its patients highly personalised support to make positive lifestyle changes and crucially sustain them over the long term.

Full story at PharmaTimes online

Latest programme updates

Healthier You: NHS Diabetes Prevention Programme

Healthier You: NHS Diabetes Prevention Programme (NHS DPP) identifies those at risk of developing Type 2 diabetes and offers them a behavioural change programme. 

Current updates:

  • Data for 18/19 shows the Programme received over 212,000 referrals (now over 380,000 in total since launch) and delivered a total of 105,000 initial assessments, superseding it’s Five Year Forward View mandate target of 100,000 on programme per year.
  • Through the Long Term Plan, NHS England have committed to doubling the capacity of the programme to 200,000 people on programme by 2023/24.
  • Framework providers have been appointed to deliver the new framework which will include digital and remote intervention services. They are; Reed Momenta, ICS Health and Wellbeing, WW (formerly Weight Watchers), Ingeus, and Living Well Taking Control. The providers for the online programme are OurPath, Oviva, WW (formerly Weight Watchers), Changing Health and Liva Healthcare.
  • 45% of the country have been awarded contracts to commence onto this framework in August 2019, the remaining 55% will be on boarded in 2020.

To find out more about the NHS DPP visit www.england.nhs.uk/diabetes/diabetes-prevention/

Improving outcomes for people with diabetes

The Diabetes Treatment and Care Programme aims to improve outcomes for people with diabetes.

Current updates:

  • Since the national funding arrangements and criteria for the prescription of flash glucose monitoring were published in March, local teams have been progressing with their implementation plans. Nationally we have developed a set of FAQs to help support this implementation phase, these will be available on the website soon.
  • Work is underway to develop the approach to piloting low calorie total diet replacement programmes within the NHS following the encouraging results seen in those who undertook the Diabetes Remission Clinical Trial (DiRECT) and Doctor Referral of Overweight People to Low Energy Treatment (DROPLET) trials. We are currently in the early development phase of this work programme, ensuring that we are aligned to other work programmes and that processes are in place to implement the next steps. We will be engaging with stakeholders as the work progresses in the coming months.
  • The final transformation fund allocations of 2018/19 were made to lead CCGs in mid-March 2019. Regional and clinical network teams are currently reviewing the progress made during 2018/19 and working with project leads to finalise their delivery plans for 2019/20 and develop longer term sustainability plans.
  • 2019/20 transformation funding has now been confirmed, supporting the current funded sites to continue to deliver improvements over the coming year. Q1 allocations will be made at the end of June 2019.
  • The Q4 transformation data collection through the Strategic Data Collection Service (SDCS) closed on 15 May 2019. This data will be published in the next iteration of the diabetes transformation dashboard which is due for publication in July 2019.

For more information on this stream of the programme visit www.england.nhs.uk/diabetes/treatment-care/

Insulin Safety Week: National campaign promotes insulin safety

Diabetes Times | May 2019 | National campaign promotes insulin safety

This week to mark Insulin Safety Week (20-26 May 2019) over 500 diabetes teams predominantly in hospitals from the UK and Ireland  will promote the message of insulin safety. 

According to the results from the latest National Diabetes Inpatient Audit, extrapolated by the Diabetes Times, two in five people with diabetes on insulin (40 per cent) experience an error related to the administration of the drug while in hospital.

In response, the seven-day awareness campaign in an attempt to reduce incidents of insulin errors as part of Insulin Safety Week.

A total of 343 sites, mainly hospitals and GP surgeries, took part in the first-ever national Insulin Safety Week in May 2019, building on interest generated by successful local campaigns across the country in 2017, including in Leicester, Hastings, Eastbourne and Southampton.

Full, unabridged story from Diabetes Times

Mental health ‘must be considered more’ as part of diabetes care

Diabetes Care | May 2019 |Mental health ‘must be considered more’ as part of diabetes care

A new article in Diabetes Times underlines why mental health must be considered more as part of diabetes care. 

Two diabetes specialists are encouraging healthcare professionals to become “facilitators, not fixers”, as a way of empowering people with long-term conditions.

mental-health-2019924_640.jpg

Dr Charles Fox and Dr Anne Kilvert, consultants from Northampton General Hospital, run a specialist diabetes counselling and empowerment course for healthcare professionals,  which focuses on training participants to work with people to identify ways of improving their own diabetes care.

The announcement comes as Diabetes Scotland urges the government to secure funds so people with diabetes can access psychological support. The charity said people with the condition are twice as likely to experience depression yet, across the UK, 40 per cent of GPs say they are not likely to ask about emotional wellbeing and mental health in routine diabetes appointments (Source: Diabetes Times).

Read the news article in full at Diabetes Times 

Depression in type 1 diabetes and risk of dementia

Paola Gilsanz et al. | Depression in type 1 diabetes and risk of dementia | Aging & Mental Health | Volume 23:7, p880-886

Objective: Depression afflicts 14% of individuals with type 1 diabetes (T1D). Depression is a robust risk factor for dementia but it is unknown if this holds true for individuals with T1D, who recently started living to an age conferring dementia risk. We examined if depression is a dementia risk factor among elderly individuals with T1D.

Methods: 3,742 individuals with T1D aged over 50 were followed for dementia from 1/1/96-9/30/2015. Depression, dementia, and comorbidities were abstracted from electronic medical records. Cox proportional hazard models estimated the association between depression and dementia adjusting for demographics, glycosylated hemoglobin, severe dysglycemic epidsodes, stroke, heart disease, nephropathy, and end stage renal disease. The cumulative incidence of dementia by depression was estimated conditional on survival dementia-free to age 55.

Results: Five percent (N = 182) were diagnosed with dementia and 20% had baseline depression. Depression was associated with a 72% increase in dementia (fully adjusted HR = 1.72; 95% CI:1.12-2.65). The 25-year cumulative incidence of dementia was more than double for those with versus without depression (27% vs. 12%).

Conclusions: For people with T1D, depression significantly increases dementia risk. Given the pervasiveness of depression in T1D, this has major implications for successful aging in this population recently living to old age.

National diabetes audits

The Healthcare Quality Improvement Partnership has published the results of the following audits relating to diabetes:

NPDA
Image source: http://www.hqip.org.uk

  • National Paediatric Diabetes Audit: annual report 2017-18: care processes and outcomes – provides an analysis of data for children and young people with diabetes including information on prevalence of diabetes, diabetes-related outcomes and complications, compliance with health care checks and recommendations for improvements in care
  • National Diabetes Inpatient Audit – measures the quality of diabetes care provided to people with diabetes while they are admitted to hospital.  The results are presented in two reports covering the hospital characteristics survey and serious inpatient harms

Additional links: NHS Digital – National Diabetes Inpatient Audit (NaDIA) – 2018 | NHS Digital National Diabetes Inpatient Audit – Harms, 2018

Additional link: NHS Digital – National Diabetes Foot Care Audit, 2014-2018

A third of type 1 diabetes is misdiagnosed in the over 30s

More than a third of people over the age of 30 who are initially diagnosed with type 2 diabetes actually have type 1, meaning they are not receiving the right treatment, new research has revealed | Diabetologia | via ScienceDaily

A new study, led by the University of Exeter, shows that 38% of patients with type 1 diabetes occurring after age 30 were initially treated as type 2 diabetes (without insulin). The researchers found that half of those misdiagnosed were still diagnosed as type 2 diabetes 13 years later.

Full story at ScienceDaily

The research is published in the journal Diabetologia:

Nicholas J. Thomas et al. | Type 1 diabetes defined by severe insulin deficiency occurs after 30 years of age and is commonly treated as type 2 diabetes | Diabetologia, 2019; DOI: 10.1007/s00125-019-4863-8