New Clinical Solutions in Diabetes Care
Welcome to the
Diabetes Care in a Disjointed World
Conference
2016
Conference Planning Team
• Dr Andrew Inglis - GP, Tadcaster
• Dr John Reid - GP, Selby
• Dr Sarah Eaton - GP, York
• Anne Phillips - Senior Lecturer – University of York
• Carl Covill - Senior Lecturer – University of Huddersfield • Paul Pipe-Thomas - Specialist Dietitian – Barnsley
• Catherine Storey – Specialist Lead for Diabetes - Harrogate
• Clare MacArthur – L/P in Diabetes Care-York & Northallerton
• Wendy Youngs - Advanced Nurse Practitioner - Sherburn in Elmet
• Gillian Brearley - Community Nursing Sister, Locala Social Enterprise • Dr Jagannath Gopalappa - Consultant Diabetologist, York
• Kath Speak – Specialist Podiatrist - Harrogate
• Helen Cressey - Practice Nurse, Skipton
• Gill Sykes - Specialist Podiatrist – Calderdale
• Paula Maddison-Green – Diabetes UK
New Clinical Solutions in Diabetes Care
It is estimated that approximately 380,000,000
people aged 16 years and over in England
have diabetes (diagnosed and undiagnosed).
This is equal to 8.6% of the 16+ population
Diabetes Prevalence Model 2016
New Clinical Solutions in Diabetes Care
• Insulin was discovered by
Banting & Best in 1922.
International Diabetes
Federation Global
Estimate 2016
415 M
New Clinical Solutions in Diabetes Care
New Clinical Solutions in Diabetes Care
Of 19 ‘developed’ countries, the UK
has the lowest rates of premature
mortality from diabetes
2013: Global Burden of Disease
New Clinical Solutions in Diabetes Care
A 45 year old woman diagnosed
with diabetes has a life
expectancy 20 years lower than
all women of the same age
UK Prospective Diabetes Study
New Clinical Solutions in Diabetes Care
By 2035 the prevalence of
diabetes in adults across
Yorkshire and the Humber is
estimated to rise to 9.8%
Diabetes Prevalence Model 2016
New Clinical Solutions in Diabetes Care
In 2012 diabetes caused 1.5 million deaths.
Higher-than-optimal blood glucose also caused
an additional 2.2 million deaths, by increasing
the risks of cardiovascular and other disease.
World Health Organisation 2016
New Clinical Solutions in Diabetes Care
We hope you enjoy the conference!
The Conference Planning Team
New Clinical Solutions in Diabetes Care
New Clinical Solutions in Diabetes Care
Across England there are
approximately 22,000 excess
deaths among people with
diabetes each year
National Diabetes Audit 2012/13
New Clinical Solutions in Diabetes Care
Neuropathy affects 60% - 70%
of people with diabetes
YHPHO: Diabetes Key Facts
New Clinical Solutions in Diabetes Care
In 2015/16, diabetic prescriptions
in England cost £956.7 million
(11% rise in net ingredient cost
since 2014/15) NHS IC: Prescribing for Diabetes in England
New Clinical Solutions in Diabetes Care
In 2014/15 there were 1,733
emergency admissions for diabetic
ketoacidosis and coma in Yorkshire
and the Humber.
The NHS IC Indicator Portal
New Clinical Solutions in Diabetes Care
A man diagnosed with diabetes
aged 45 has an 11.5% chance of
dying before his 60th birthday
YHPHO: Diabetes Key Facts
New Clinical Solutions in Diabetes Care
In 2015/16 diabetes accounted
for 11% of all prescription costs
in primary care
NHS IC: Prescribing for Diabetes in England
New Clinical Solutions in Diabetes Care
New Clinical Solutions in Diabetes Care
New Clinical Solutions in Diabetes Care
313,933 adults in
Yorkshire and the Humber have
been diagnosed with diabetes
Quality and Outcomes Framework
2015/16
New Clinical Solutions in Diabetes Care
The global prevalence of
diabetes is likely reach 642
million by 2040
International Diabetes Federation 2016
New Clinical Solutions in Diabetes Care
Are you getting all the diabetes care you need?
• Having the right care is essential for the health and
wellbeing of all people with diabetes
• Type 1 and Type 2 diabetes
• Left unchecked diabetes can lead to serious complications
• Make sure you are getting all the care you deserve
Get your blood glucose levels measured •An HbA1c blood test will measure your overall blood glucose control. •This will help your healthcare team set your own target •This is really important to get at least once a year
Have your blood pressure measured at least once a year •This needs to be recorded as part of your ongoing care •Your doctor should use it to set a target blood pressure that is right for you
Have your blood fats (such as cholesterol) measured every year •You need to be told what your levels are •Make sure your doctor uses this to set a target for you that is realistic
Have your eyes screened every year
•Diabetes can cause damage to your eyes (retinopathy) •A specialist doctor should look at your eyes with a special digital camera – this is not a normal optician’s check •If you think your eyesight is changing between checks then tell your doctor straight away
Have your feet checked annually •Foot complications are a serious risk for people with diabetes •The skin, nerves and circulation of your feet need to be checked •A proper exam will mean you have to take your shoes and socks off
Have your kidney function monitored once a year •There are two tests for the kidneys
•Urine test for protein •Blood test for kidney function
Find out if you need to lose weight •Have your weight checked and your waist measured to see if you need to lose weight
•Having diabetes already increases the risk of heart disease and stroke
•Smoking further increases the risk of you getting sick from these problems
•You can get advice and support on how to quit smoking
Get support if you are a smoker
Receive care planning to meet your individual needs •Diabetes is something you live with every day
•You need to be involved in every aspect of your care
•Individual targets and goals need to be discussed and set with you
Attend an education course in your local area
Receive care from a specialist paediatric team if you are a child or young person
www.diabetes.org.uk/Type-1-essentials
Receive high quality care if admitted to hospital
•Your diabetes needs to be managed when you are in hospital
•Specialised diabetes healthcare professionals need to look after you
•This needs to happen even if you weren’t admitted due to your diabetes
Get information and specialist care if you are planning to have a baby •Your diabetes control has got to be a lot tighter and monitored very closely when pregnant or trying for a baby
•Specialist healthcare professionals should be involved with every stage of your pregnancy
See specialist diabetes healthcare professionals
•Diabetes affects different parts of the body in different ways •Specially trained healthcare professionals should help you at every step of your care
Get emotional and psychological support •Diabetes is a tough long term condition to live with
•Being able to talk to specialist healthcare professionals can be a great help
• Download or order a free checklist pass them around your family and friends
• Watch and share our animation and help us spread the word
• Take our survey and tell us about the
care available across the country
WHAT CAN YOU DO?
For more information visit to www.diabetes.org.uk/15-essentials
or call 0345 123 2399
New Clinical Solutions in Diabetes Care
Conference presentations available on the
University of York health sciences website:
www.york.ac.uk/healthsciences/
diabetes-conference
New Clinical Solutions in Diabetes Care
New Clinical Solutions in Diabetes Care
Life expectancy for someone with
Type 1 diabetes
is reduced by 15 years
YHPHO: Diabetes Key Facts
New Clinical Solutions in Diabetes Care
In the financial year 2015/16,
49.7 million items were
prescribed for diabetes
NHS IC: Prescribing for Diabetes in England
New Clinical Solutions in Diabetes Care
In 2014/15 HbA1c, cholesterol and blood
pressure targets were met for:
19% of people with Type 1 diabetes
41% of people with Type 2 diabetes
National Diabetes Audit 2014/15
New Clinical Solutions in Diabetes Care
24% of adults in England with
diabetes have not yet been
diagnosed.
Diabetes Prevalence Model & Quality and
Outcomes Framework 2014/5
New Clinical Solutions in Diabetes Care
New Clinical Solutions in Diabetes Care
The prevalence of chronic kidney
disease resulting from diabetes,
varies from 18% to over 30% in all
people with diabetes
Diabetes with Kidney Disease: Key Facts
New Clinical Solutions in Diabetes Care
In 2014/15 58.7% of patients with
Type 2 diabetes received eight*
of the nine recommended care
processes
National Diabetes Audit
*eye screening excluded
New Clinical Solutions in Diabetes Care
In 2014/15 only 38.7% of patients
with Type 1 diabetes received
eight* of the nine recommended
care processes
National Diabetes Audit
*eye screening excluded
New Clinical Solutions in Diabetes Care
New Clinical Solutions in Diabetes Care
In 2014/15 there were 11,200 hospital admissions due to ‘diabetes with
hypoglycaemic disorders’ in England
In 2014/15 there were 26,500 emergency admissions for ‘diabetes with
hyperglycaemic disorders’
Source: Hospital Episode Statistics Admitted Patient care
http://www.hscic.gov.uk/hesdata
(Diabetes is from the KB01 & KB02 groups)
New Clinical Solutions in Diabetes Care
In 2014/15 there were 48,581
hospital admissions for Diabetes in
England (40,861 were Emergency
admissions).
The Health and Social Care Information Centre, Hospital Episode Statistics for
England. Admitted Patient Care statistics, 2014-15 .
New Clinical Solutions in Diabetes Care
We hope you enjoy the conference!
The Conference Team
New Clinical Solutions in Diabetes Care
Nationally there are 2.6
amputations per 1,000 adults
with diabetes
Diabetes Footcare Profiles 2016
New Clinical Solutions in Diabetes Care
Of 19 ‘developed’ countries, the UK
has the lowest rates of years of life
lost due to premature mortality from
diabetes
2013: Global Burden of Disease
New Clinical Solutions in Diabetes Care
Every year there are 19.8
episodes of inpatient care for
diabetic foot disease per 1,000
adults with diabetes in England
Diabetes Footcare Profiles 2016
New Clinical Solutions in Diabetes Care
Annually, 161.0 nights are spent
in hospital for diabetic foot
disease per 1,000 people with
diabetes in England
Diabetes Footcare Profiles 2016
New Clinical Solutions in Diabetes Care
38.3% of audited inpatients with
diabetes experienced at least
one medication error
National Diabetes Inpatient Audit 2015
New Clinical Solutions in Diabetes Care
Only 35.5% inpatients with
diabetes had been visited by the
diabetes specialist team
National Diabetes Inpatient Audit 2015
New Clinical Solutions in Diabetes Care
39.1% of insulin treated and 31.2%
of non-insulin treated audited
inpatients with diabetes reported that
the choice of meals in hospital was
‘sometimes, rarely or never suitable’
National Diabetes Inpatient Audit 2015
New Clinical Solutions in Diabetes Care
Patients with medication errors
had twice the rate of severe
hypoglycaemia (15.5% vs. 7.5%)
National Diabetes Inpatient Audit 2015
Conference Planning Team
• Dr Andrew Inglis - GP, Tadcaster
• Dr John Reid - GP, Selby
• Dr Sarah Eaton - GP, York
• Anne Phillips - Senior Lecturer – University of York
• Carl Covill - Senior Lecturer – University of Huddersfield • Paul Pipe-Thomas - Specialist Dietitian – Barnsley
• Catherine Storey – Specialist Lead for Diabetes - Harrogate
• Clare MacArthur – L/P in Diabetes Care-York & Northallerton
• Wendy Youngs - Advanced Nurse Practitioner - Sherburn in Elmet
• Gillian Brearley - Community Nursing Sister, Locala Social Enterprise • Dr Jagannath Gopalappa - Consultant Diabetologist, York
• Kath Speak – Specialist Podiatrist - Harrogate
• Helen Cressey - Practice Nurse, Skipton
• Gill Sykes - Specialist Podiatrist – Calderdale
• Paula Maddison-Green – Diabetes UK
New Clinical Solutions in Diabetes Care
Data in these slides and further information
on diabetes can be found on the National
Cardiovascular Intelligence Network
(NCVIN) website:
www.ncvin.org.uk
New Clinical Solutions in Diabetes Care
New Clinical Solutions in Diabetes Care
New Clinical Solutions in Diabetes Care
Conference presentations available on the
University of York health sciences website:
www.york.ac.uk/healthsciences/
diabetes-conference