The Scalpel's Blog

24.09.18

How are we faring in the fight against diabetes?

Almost 3.7 million people in the UK have been diagnosed with diabetes and a further 12.3 million are at increased risk of getting type 2 diabetes. Without the very best care, support and treatment, this fast growing health crisis is set to affect more than 5 million people in the UK by 2025, writes Professor Gillian Leng, deputy chief executive and director of health and social care at NICE.

The enormity of diabetes goes far beyond the parameters of ‘type 1’ or ‘type 2.’ It can cause life-changing and life-limiting complications, from sight loss and serious foot problems to cardiovascular disease and stroke. It poses a major health risk to a large proportion of our society, as well as a significant cost to the NHS: currently estimated at almost £10bn a year.

At NICE, diabetes has always been a key focus of our work. Over the years we’ve produced a wide range of evidence-based guidance and resources to help prevent, manage and treat diabetes. The current portfolio includes eight guidelines, four quality standards and 10 technology appraisals. To highlight how our guidance has been implemented, we’ve just published a diabetes impact report, which highlights progress made so far across the health and social care system.

One area the report explores is how the system is working to prevent type 2 diabetes, and we’re taking some very positive steps forward. For example, our new impact report shows that in 2016, there was a real move to drive up referrals to behaviour change programmes with the introduction of the NHS Diabetes Prevention Programme (NHS DPP). This programme was based on evidence provided by NICE, and identifies those at risk of diabetes and encourages lifestyle changes such as eating more healthily and being more active. This is important because the research evidence demonstrated that behaviour change programmes reduce the risk of people developing diabetes.

A year after its launch, NHS DPP it’s now available to 75% of people in England and early results show that it is making good progress on weight loss and take-up.

Management of type 1 and type 2 diabetes is another key area of our impact report. We know that uncontrolled diabetes can lead to serious complications, but through structured education and receiving NICE recommended care, people can manage their condition more effectively.

For this reason, NICE recommends that adults with diabetes should participate in annual care planning that leads to documented agreed goals and an action plan. The basis of this care plan is nine care processes, which range from cholesterol measurement to foot examination.

Our impact report shows that improvements have been made in a number of these care processes over the last four years. For example, the proportion of people with diabetes aged 12 and over receiving a blood pressure measurement increased between 2014 and 2017. However, our report also found that not all people with diabetes are receiving all nine care processes and wide variation still exists.

So although the report reflects some really promising work, there is clearly significant room for improvement.

We have the guidance and processes needed to tackle diabetes head-on. There are huge opportunities available to us – professionals and patients alike – to improve prevention, diagnosis and management of the disease. But while we’re making steady progress, only an ongoing commitment to really step up this work will truly safeguard our nation and the future of our NHS from the impact of diabetes and the series of complications it brings.

 

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