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)