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DIABETES

DIABETES . Dr Rowan Hillson, MBE National Clinical Director for Diabetes. I strongly believe that…. Everyone with diabetes deserves the highest standards of personalised diabetes care, no matter where, when or by whom it is delivered.

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DIABETES

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  1. DIABETES Dr Rowan Hillson, MBE National Clinical Director for Diabetes

  2. I strongly believe that… • Everyone with diabetes deserves the highest standards of personalised diabetes care, no matter where, when or by whom it is delivered. • People providing diabetes care must be trained in diabetes and must know the boundaries of their knowledge. • They must have opportunities to extend these boundaries and to keep up-to-date. • People with diabetes and professionals must have ready access to specialist diabetes expertise.

  3. NHS Diabetes(National Diabetes Support Team) • Within NHS Diabetes and Kidney Care • Promoting service improvement • Knowledge • Communication • Leadership and development • Director (Anna Morton) plus support team • 10 Regional Programme Managers www.diabetes.nhs.uk

  4. Diabetes in numbers

  5. New Diagnoses About 320,000 new cases a year One or two people every 2 minutes National Diabetes Audit 06/07

  6. Diabetes prevalence YHPHO 2005 T1 DM 0.3%, T2 DM 4.1% Men 3.8% Women 5.1%. White 4.3% Black 6.0% Asian 6.9%

  7. Diabetes attributable deaths • 2005 20 – 79 yrs old Diabetes accounts for 26,300 of deaths (11.6% of all deaths) 3 deaths an hour • Varies considerably between PCTs 9% (Bucks) – 17% (Newham)

  8. Vascular risk checks • Everyone aged 40 – 74 yrs not known to have cardiovascular disease or DM • Risk assessment including smoking, BMI, BP, sugar measure, renal measure as relevant • Healthy living advice for all • Targeted advice for high risk • Treatment for new diabetes, hypertension etc

  9. Quality and Outcomes Framework

  10. National Diabetes Audit

  11. Life expectancy • Man, non-smoker, aged 45 • No family or personal history of CV disease • Type 2 diabetes newly diagnosed • HbA1c, Cholesterol + BP within QoF targets • Life expectancy 62 vs 79 yrs all men • Reduced by 17 years • Woman – similar health • Life expectancy reduced by 20 yrs Source YHPHO

  12. Diabetes in hospital • 10 – 20+% hospital beds occupied by people with diabetes • People with diabetes twice as likely to be admitted as non-diabetics • Longer stay • 165,000 diabetes discharges / yr • 1.34 million bed days / yr • £465 million / yr

  13. Diabetes inpatient specialist team • Every acute hospital should have a diabetes inpatient specialist team with • dedicated inpatient sessions • access to all diabetic inpatients on all units • Diabetic inpatient specialist nurses reduce A&E admissions, reduce clinical incidents, shorten length of stay, and improve patient experience. www.diabetes.nhs.uk/news-1/Inpatient%20care.pdfwww.institute.nhs.uk

  14. Diabetes and pregnancy Women with established diabetes have: • 5 x more stillbirths • 3 x more neonatal deaths • 2 x congenital malformations Compared with non-diabetic women Major national project to improve outcomes of pregnancy in women with pre-existing and gestational diabetes www.cemach.org.uk

  15. Children and Young people • Audit of the numbers of children and young people with diabetes in England • Royal College of Paediatrics and Child Health • Sponsored by NHS Diabetes

  16. Education & care planning Healthcare Commission 2006: • Only 10.5% patients had had education (range 1 – 52%) • Care plan: almost always 47%, sometimes 23% DAFNE DESMOND Local courses Year of Care project www.diabetes.nhs.uk

  17. Retinopathy screening • Free to everyone with diabetes • Has been offered to 93% all patients • 76% of those offered photos had them • In total 72% have had eye photos • We must all encourage everyone with diabetes to have their eye photos

  18. Where are we now? • We know more about diabetes in England than we did in 2001 • There have been improvements in diabetes care • We must improve glucose and BP control • We must improve diabetes care in hospital • We must improve the outcomes of pregnancy • We must improve information and education • We must improve uptake of retinopathy screening • We must always ensure that we work closely with people who have diabetes

  19. Thank you rowan.hillson@dh.gsi.gov.uk

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