new clinical solutions in diabetes care - university of york · pdf filenew clinical solutions...

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


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


• Insulin was discovered by

Banting & Best in 1922.

International Diabetes

Federation Global

Estimate 2016

415 M


Of 19 ‘developed’ countries, the UK

has the lowest rates of premature

mortality from diabetes

2013: Global Burden of Disease


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


By 2035 the prevalence of

diabetes in adults across

Yorkshire and the Humber is

estimated to rise to 9.8%

Diabetes Prevalence Model 2016


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


We hope you enjoy the conference!

The Conference Planning Team


Across England there are

approximately 22,000 excess

deaths among people with

diabetes each year

National Diabetes Audit 2012/13


Neuropathy affects 60% - 70%

of people with diabetes

YHPHO: Diabetes Key Facts


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


In 2014/15 there were 1,733

emergency admissions for diabetic

ketoacidosis and coma in Yorkshire

and the Humber.

The NHS IC Indicator Portal


A man diagnosed with diabetes

aged 45 has an 11.5% chance of

dying before his 60th birthday



In 2015/16 diabetes accounted

for 11% of all prescription costs

in primary care

NHS IC: Prescribing for Diabetes in England


313,933 adults in

Yorkshire and the Humber have

been diagnosed with diabetes

Quality and Outcomes Framework

2015/16


The global prevalence of

diabetes is likely reach 642

million by 2040

International Diabetes Federation 2016

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

http://www.diabetes.org.uk/15-essentials




Conference presentations available on the

University of York health sciences website:

www.york.ac.uk/healthsciences/

diabetes-conference

http://www.york.ac.uk/healthsciences/diabetes-conference






Life expectancy for someone with

Type 1 diabetes

is reduced by 15 years



In the financial year 2015/16,

49.7 million items were

prescribed for diabetes

NHS IC: Prescribing for Diabetes in England


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


24% of adults in England with

diabetes have not yet been

diagnosed.

Diabetes Prevalence Model & Quality and

Outcomes Framework 2014/5


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


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


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


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)




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 .


We hope you enjoy the conference!

The Conference Team


Nationally there are 2.6

amputations per 1,000 adults

with diabetes

Diabetes Footcare Profiles 2016


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


Every year there are 19.8

episodes of inpatient care for

diabetic foot disease per 1,000

adults with diabetes in England



Annually, 161.0 nights are spent

in hospital for diabetic foot

disease per 1,000 people with

diabetes in England



38.3% of audited inpatients with

diabetes experienced at least

one medication error

National Diabetes Inpatient Audit 2015


Only 35.5% inpatients with

diabetes had been visited by the

diabetes specialist team



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’



Patients with medication errors

had twice the rate of severe

hypoglycaemia (15.5% vs. 7.5%)


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


Data in these slides and further information

on diabetes can be found on the National

Cardiovascular Intelligence Network

(NCVIN) website:

www.ncvin.org.uk



Conference presentations available on the

University of York health sciences website:

www.york.ac.uk/healthsciences/

diabetes-conference






new clinical solutions in diabetes care - university of york · pdf filenew clinical solutions...

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