type 1 diabetes subgroup · 2020. 2. 12. · type 1 diabetes no diabetes . age 70 loss of life type...
TRANSCRIPT
Type 1 Diabetes subgroup Background and update
Dr Fraser Gibb
Type 1 Subgroup SDG
National diabetes meeting
Stirling 2018
Scottish T1 diabetes mortality Significant loss of life years
DCCT and how we compare Answer: not well
Age 50 Loss of life
TYPE 1 DIABETES NO DIABETES
Age 60 Loss of life
TYPE 1 DIABETES NO DIABETES
Age 70 Loss of life
TYPE 1 DIABETES NO DIABETES
Effect of deprivation SIMD quintiles in our T1 population (RIE)
20 23
28 28
37
28 29
43 42
46 48 47
28
45
37 35
27 24
16
44
27
0
10
20
30
40
50
60
Quintile 1
Quintile 2
Quintile 3
Quintile 4
Quintile 5
Unknown �Total
%
Quintiles of SIMD 2012
%Good
%Med
%Poor
Scottish outcomes T1DM control across the world
Mean HbA1c By Health board and age in Scotland
Diabetes improvement Plan Priority areas
Diabetes improvement Plan Priority areas
Diabetes improvement Plan Aims
Diabetes improvement Plan Aims
Quarterly reporting T1DM
• SCI Diabetes
– Improving recording of key data (DKA / hypo)
– Improving usability
– Paediatric specific measures in SDS
• Survey of diabetes resources across Scotland
• Know the numbers
• Transition policy / Making connections
• DKA prevention
T1 Subgroup Achievements and work in progress
• Big gains in CSII provision
• CGM (and SAP) is the next challenge
– Training HCPs and patients
T1 Subgroup CSII and CGM
Freestyle Libre Role of SDG
?
• Big changes in our models of delivering care required
• Piloting the ‘Clyde Cloud’ model…
T1 Subgroup Supporting innovation
The game changers How do we respond?
Glycaemic control is poor in Scotland
Life expectancy is
lower in T1
Improving control saves
lives
Pumps improve control (save lives)
Education improves control
CGM improves control
77
20
33 7 1
25
37 7
33
14 5
1
59
58
13
STARTEND
68
64
62
40
45
50
55
60
65
70
Pre-DAFNE Post-DAFNE Longer-termFU
HbA1c(m
mol/mol)