Transforming elective care services diabetes

NHS England | January 2019 | Transforming elective care services diabetes

NHS England have created Transforming elective care services diabetes– a handbook to support the improvement of local health and care systems for diabetes elective care services.

This handbook sets the national context and challenges facing elective care services in England. It considers the national diabetes challenge

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Image source: england.nhs.uk/wp-content

The handbook includes:

  • Opportunities for improvement transforming outpatients
  • Opportunities for improvement shared decision making and self- management support

Transforming elective care services diabetes

Over 26,000 diabetes-related lower limb amputations in the last three years

Diabetes UK | December 2018 | 26,378 diabetes-related lower limb amputations in the last three years

New analysis from Diabetes UK  shows there were 26,378 lower limb amputations related to diabetes in England from 2014 to 2017, an increase of almost one- fifth  (19.4%) from 2010-2013.

The analysis reveals that here has been a significant rise in minor lower limb amputations (26.5%), defined as below the ankle, and a more gradual increase in the number of major lower limb amputations (4.1%), defined as below the knee.

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Head of Care at Diabetes UK, Dan Howarth said:

“The shocking number of lower limb amputations related to diabetes grows year on year. An amputation, regardless of whether it’s defined as minor or major, is devastating and life-changing. A minor amputation can still involve losing a whole foot.

“To reduce the number of amputations related to diabetes, we are calling on NHS England to maintain the Diabetes Transformation Fund beyond 2019. Many diabetes amputations are avoidable, but the quality of footcare for people living with diabetes varies significantly across England. Transformation funding since 2017 is working and will help to reduce these variations, but much work still needs to be done.” (Source: Diabetes UK)

Read the full release from Diabetes UK

In the news:

Guardian Record 169 UK patients a week get diabetes-related amputations

New plan announced by NHS Chief to tackle Type 2 diabetes epidemic

NHS England | November 2018 |Very low calorie diets part of NHS action to tackle growing obesity and Type 2 diabetes epidemic

NHS Chief executive Simon Stevens has announced that people recently diagnosed with Type 2 diabetes will be trialled as part of a new NHS long term plan, which will increase the focus on prevention as well as treatment.

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As well as improving the health of patients,this will also save the NHS money that can be reinvested in frontline care. Currently, the health service in England spends around 10% of its budget on treating diabetes.

The scaling up of the NHS DPP scheme, the first in the world to become available country-wide, comes after it proved even more successful than planned with patients losing on average a kilogram more than expected.

The nine month programme helps people to:

  • achieve a healthy weight
  • improve overall nutrition
  • increase levels of physical activity

Online versions of the DPP, which involve wearable technologies and apps to help those at risk of Type 2 Diabetes, will also be provided for patients who find it difficult to attend sessions because of work or family commitments (Source: NHS England).

Full news release available from NHS England 

In the news:

BBC News Type 2 diabetes: NHS to offer 800-calorie diet treatment

ITV News Liquid diet to be prescribed to diabetes patients

Evening Standard Liquid diet for type 2 diabetes patients after trial puts condition into remission

Type 2 diabetes affects 7000 young people in England and Wales, analysis shows

Iacobucci,  G. | 2018 | Type 2 diabetes affects 7000 young people in England and Wales, analysis shows

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Currently, over a third of children in England (34%) are overweight or obese by the time they leave primary school. Diabetes UK warned that thousands more children could have type 2 diabetes diagnosed without decisive support for young people (Source: BMJ)

Read the full BMJ article via Open Athens 

In the news:

BBC News Type 2 diabetes affects 7,000 under-25s in England and Wales 

The Guardian Type 2 diabetes now affects nearly 7,000 young Britons 

NHS to provide life changing glucose monitors for Type 1 diabetes patients

NHS England | November 2018 | NHS to provide life changing glucose monitors for Type 1 diabetes patients

Simon Stevens Chief Executive of NHS England  has announced that thousands of people with diabetes will be able to access Freestyle Libre; a wearable sensor that means those with the condition no longer need to rely on inconvenient and sometimes painful finger prick blood tests, as the device works by relaying glucose levels to a smart phone or e-reader.  This announcement marks an end to the current variation  some people in different parts of the country were experiencing. 

 

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The pioneering technology should ultimately help people with Type 1 diabetes achieve better health outcomes and benefits for patients include:

  • Easily noticing when sugar levels are starting to rise or drop, so action can be taken earlier
  • Giving patients more confidence in managing their own condition
  • Not having to do as many finger-prick checks (Source: NHS England)

Read the full announcement from NHS England

In the media:

BBC News Diabetes glucose monitors ‘available to thousands more’

Plant-based or vegan diet linked to better diabetes control and wellbeing

New research shows that plant-based diets were associated with improvement in several areas for adults with type 2 diabetes including emotional well-being, physical well-being, depression, quality of life and general health | BMJ Open Diabetes Research & Care | via OnMedica

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Research published in BMJ Open Diabetes Research & Care analysed 11 trials of diet interventions, including a total of 433 adults with type 2 diabetes, that had clearly defined health outcomes and were peer-reviewed. The findings revealed that plant-based diets were associated with significant improvement in emotional well-being, physical well-being, depression, quality of life, general health, HbA1c levels, weight, total cholesterol and low-density lipoprotein cholesterol in adults with type 2 diabetes compared with several diabetic associations’ official guidelines and other comparator diets.

Whilst the review authors noted the  limitations of the study, they concluded that plant-based diets can significantly improve psychological health, quality of life, HbA1c levels and weight and therefore the management of diabetes.

Full reference: Toumpanakis A, et al. |  Effectiveness of plant-based diets in promoting well-being in the management of type 2 diabetes: a systematic review | BMJ Open Diabetes Research & Care | published online 30 October 2018

See also:

Making hospitals safe for people with diabetes

Diabetes UK | October 2018 | Making hospitals safe for people with diabetes

The report from Diabetes UK has been created by an alliance of groups and individuals striving to improve hospital care for people with diabetes. Thorough engagement with diabetes inpatient teams, ward staff, people with diabetes and hospital management means we now understand the depth of the challenges facing the NHS in improving diabetes inpatient care. For their report, Diabetes UK visited
hospitals across the country to find out what works.

Making hospitals safe Diabetes UK

Image source: Diabetes.org.uk

The report outlines six points that the UK needs to make hospitals safer for people with diabetes.

  • multidisciplinary diabetes inpatient teams in all hospitals
  • strong clinical leadership from diabetes inpatient teams
  • knowledgeable healthcare professionals who understand diabetes
  • better support in hospitals for people to take ownership of their diabetes
  • better access to systems and technology
  • more support to help hospitals learn from mistakes.

The report outlines these points in more detail and highlights what needs to be in place in all acute hospitals across England to make sure every stay for someone with diabetes is safe.

The report’s recommendations are based on models from across the UK which have been shown to improve patient care (Source: Diabetes UK).