Genetic risk and quality of dietary fat are associated with the incidence of type 2 diabetes, reports BMJ study

Merino, J. |2019|Quality of dietary fat and genetic risk of type 2 diabetes: individual participant data meta-analysis | BMJ |366:l4292

The BMJ has published the findings of a meta analysis of large prospective cohort studies that investigated the association of the quality of dietary fat with the presence of known type 2 diabetes.

While the results indicate an association between known type 2 diabetes risk-increasing alleles as well as dietary unsaturated fats were both associated with the risk of type 2 diabetes; the authors find no evidence of meaningful interactions between genetic risk profile and the quality of dietary fat on the incidence of type 2 diabetes (Source: Merino, 2019).

burger-cheeseburger-chicken-1484669

Abstract

Objective To investigate whether the genetic burden of type 2 diabetes modifies the association between the quality of dietary fat and the incidence of type 2 diabetes.

Design Individual participant data meta-analysis.

Data sources Eligible prospective cohort studies were systematically sourced from studies published between January 1970 and February 2017 through electronic searches in major medical databases (Medline, Embase, and Scopus) and discussion with investigators.

Review methods Data from cohort studies or multicohort consortia with available genome-wide genetic data and information about the quality of dietary fat and the incidence of type 2 diabetes in participants of European descent was sought. Prospective cohorts that had accrued five or more years of follow-up were included. The type 2 diabetes genetic risk profile was characterized by a 68-variant polygenic risk score weighted by published effect sizes. Diet was recorded by using validated cohort-specific dietary assessment tools. Outcome measures were summary adjusted hazard ratios of incident type 2 diabetes for polygenic risk score, isocaloric replacement of carbohydrate (refined starch and sugars) with types of fat, and the interaction of types of fat with polygenic risk score.

Results Of 102 305 participants from 15 prospective cohort studies, 20 015 type 2 diabetes cases were documented after a median follow-up of 12 years. The hazard ratio of type 2 diabetes per increment of 10 risk alleles in the polygenic risk score was 1.64. The increase of polyunsaturated fat and total omega 6 polyunsaturated fat intake in place of carbohydrate was associated with a lower risk of type 2 diabetes, with hazard ratios of 0.90  and 0.99, respectively. Increasing monounsaturated fat in place of carbohydrate was associated with a higher risk of type 2 diabetes. Evidence of small study effects was detected for the overall association of polyunsaturated fat with the risk of type 2 diabetes, but not for the omega 6 polyunsaturated fat and monounsaturated fat associations. Significant interactions between dietary fat and polygenic risk score on the risk of type 2 diabetes (P more than 0.05 for interaction) were not observed.

Conclusions These data indicate that genetic burden and the quality of dietary fat are each associated with the incidence of type 2 diabetes. The findings do not support tailoring recommendations on the quality of dietary fat to individual type 2 diabetes genetic risk profiles for the primary prevention of type 2 diabetes, and suggest that dietary fat is associated with the risk of type 2 diabetes across the spectrum of type 2 diabetes genetic risk.

The full article is available from BMJ

Pharmacists must be integrated into diabetes care

Royal Pharmaceutical Society | July 2019 |Pharmacists must be integrated into diabetes care

The Royal Pharmaceutical Society (RPS) in England is calling for pharmacists to be fully integrated into services for people with type 2 diabetes to increase prevention and detection of the condition and improve the care that patients receive. 

Pharmacists across England can support people with type 2 diabetes get the best from their medicines, improving their health and wellbeing through integrated, collaborative and personalised care services.

health-2082630_640.jpg

Three in five cases of type 2 diabetes can be prevented or delayed by helping people understand their risk of developing the disease and how to reduce it, and by getting an early diagnosis for those known to be at high risk.

The RPS has published  Using pharmacists to help improve care for people with Type 2 diabetes, and outlines a series of recommendations:

Pharmacists work as part of the multidisciplinary team to play a greater role in prevention and detection services for type 2 diabetes

  • Pharmacists should play an active role in optimising medicines, improving the health, wellbeing and safety of people with type 2 diabetes across the NHS
  • Pharmacists in specialist and generalist roles should have access to education and training to support people with multiple conditions
  • The role of consultant pharmacists in diabetes should be embedded to ensure improved system wide management of people with type 2 diabetes (Source: Royal Pharmaceutical Society)

Using pharmacists to help improve care for people with Type 2 diabetes

Diabetes Prevention Programme 2017-18

Health Quality Improvement Partnership | July 2019| Diabetes Prevention Programme 2017-18 

NHS Digital has published a report on the Diabetes Prevention Programme (DPP), it  uses data collected alongside the National Diabetes Audit (NDA) for the period January 2017 to March 2018 in England.

Some of the findings include:

  • Non-diabetic hyperglycaemia populations and Type 2 diabetic populations are similar but a higher proportion of men have Type 2 diabetes
  • 15.4% of people recorded with non-diabetic hyperglycaemia are known to be from black, Asian and ethnic minority groups (BAME)

In future reports on the Diabetes Prevention Programme, deeper investigations will be made as to whether the behaviour change programmes are having an impact on reducing weight, progression to Type 2 Diabetes and other cardiovascular risk factors.

The report is available to download from HQIP

National Diabetes Audit – Care Processes and Treatment Targets, Third Quarter, January 2018 to December 2018

NHS England | July 2019 | National Diabetes Audit – Care Processes and Treatment Targets, Third Quarter, January 2018 to December 2018

NHS England has released the first quarterly release of data from the National Diabetes Audit (NDA) This is the quarter three mid-year data release for the 2018/19 NDA. It shows progress to date covering the period 1 Jan 2018 to 31 Dec 2018

statistic-1820320_640.png

Source: NHS England 
National Diabetes Audit-  Third Quarter, January 2018 to December 2018, England 

Breakthrough technology for people with diabetes available in York

Vale of York Clinical Commissioning Group | July 2019| Breakthrough technology for people with diabetes available in York 

NHS Vale of York Clinical Commissioning group has announced that it will be offering FreeStyle Libre– a handheld device which scans over a sensor applied to the skin to measure interstitial glucose levels – as an alternative to routine finger-prick blood glucose testing. This results in a quick and painless glucose reading, a near-continuous record of measurement and an indication of level trends over time. 

Dr Andrew Lee, the CCG’s Executive Director of Primary Care and Population Health said: “The CCG are delighted to be able to offer FreeStyle Libre in the Vale of York. Over 1600 members of our population live with type 1 diabetes and this new technology offers a chance to revolutionise diabetes self-management and give people even more control over their health.

“Being able to monitor glucose readings digitally and access recordings on demand is an example of the brilliant digital resources we have in the NHS.”

Eligible people will be initiated on to FreeStyle Libre through the Diabetes Specialist Team at York Teaching Hospital NHS Foundation Trust. Local GPs will then issue their patients with a prescription for two Freestyle Libre sensors per month until a six month re-assessment (Source: The Vale of York).

Read the full news story from Vale of York CCG 

2,000 people referred to Type 2 diabetes prevention programme in Wakefield

Wakefield Express |July 2019 | 2,000 people referred to Type 2 diabetes prevention programme in Wakefield

A news story in the Wakefield Express reports that almost 2000 people in Wakefield at risk of developing type 2 diabetes, have been referred to a diabetes preventionprogramme – delivered by the NHS- since 2017.

appetizer-avocado-bread-566566

Coun Faith Hepenstall, Wakefield’s portfolio holder for health, said:

“The public health team working for Wakefield Council want to help these residents live healthier lives.

“In 2017 we were successful in attracting significant funding from the NHS to run a diabetes prevention programme across (West Yorkshire and Harrogate). 

“This involves education on healthy eating and lifestyle, help to lose weight, as well as access to physical exercise programmes, all of which together have been proven to reduce the risk of developing the condition.

Of these, 1051 attended their first session, an uptake of a little over 50 per cent.

She added that the participants (n=741) who have completed the programme, have lost an average of 6lb each (Source: Wakefield Express)

Read the full story in the Wakefield Express

Using pharmacists to help improve care for people with type 2 diabetes

drug-1674890_1280The Royal Pharmaceutical Society (RPS) has published Using pharmacists to help improve care for people with type 2 diabetes.  This document is aimed at policy makers and education/service commissioners within the NHS in England and makes recommendations for how pharmacists can play an increasing role in the prevention, early detection, care and support of people with type 2 diabetes.

To improve care for people with type 2 diabetes, the RPS are calling for:

  1. Pharmacists should work in collaboration with other healthcare professionals to play a greater role in prevention and detection services for type 2 Diabetes
  2. Pharmacists should play an active role in optimising medicines, improving the health, wellbeing and safety of people with type 2 diabetes across the NHS
  3. Pharmacists in specialist and generalist roles should be given access to the most up to date education and training to support people with multiple conditions
  4. NHS organisations need to establish and embed the role of consultant pharmacists in diabetes across the NHS should ensure improved outcomes in the management of people with type 2 diabetes, promote collaborative practice, multidisciplinary team working, quality improvement and research.

Full detail at Royal Pharmaceutical Society

See also: Pharmacists must be integrated into diabetes care | RPS press release