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Diabetes Week: #TheBigPicture in technology

The COVID-19 pandemic has thrown into sharper focus some areas where the NHS needs to improve; including better care or access for those of lower socioeconomic groups and those from the BAME population. However, it has also highlighted how quickly we can harness the power of digital technology when we absolutely have to.

For the diabetes team specifically, COVID-19 has had a particular impact. Recent data showed diabetes as an independent risk factor for poor outcomes with the virus, as well as differentiation based on types. The pandemic has also affected the way we have been able to deliver services and has challenged us to adapt quickly to ensure we can safeguard continuity of care in these unique times.

As well as identifying diabetes as a risk factor, our data confirmed what we already thought about better glycaemic control leading to better outcomes. Unlike many non-modifiable factors which predispose to worse outcomes such as age, glycaemic control is something patients can work to improve.

This issue is wider than just the COVID-19 pandemic. The recent national diabetes audit showed a stark discrepancy in achievement of HbA1c – which is associated with good outcomes – between the different types of diabetes, with Type 1 diabetes achievements lower overall. Approximately 66% of Type 2 Diabetes patients achieve an HbA1c<58 mmol/mol; while approximately 36% and 31% of Type 1 Diabetes patients achieve HbA1c <58 mmol/mol in children and adults respectively

The need to support people to manage their diabetes effectively is therefore pressing and we have harnessed the power of technology to support patients and local teams to make positive changes.

In this “new world” where virtual contacts and digital interventions are highly relevant as we try to maintain social distancing, this has been the ideal moment for the NHS England Diabetes team to look into modes of self-management and education beyond the traditional means of face to face delivery.

A key focus has been to ensure there are clear and separate strategies for Type 1 and Type 2 Diabetes. Digibete and MyType1Diabetes support those with Type 1; for children and young people and adults respectively. Both services have launched this week and include a wide range of information for people living with Type 1 in various formats including videos, leaflets and eLearning courses. They also include resources for healthcare professionals too.

Both services are available online through desktop, mobile or tablet and Digibete has an app too which allows children and young people to store insulin information as well as care plans, future appointments, notes and receive communications directly from their local clinic.

Healthy Living is for those living with Type 2 diabetes and will provide a similar service via website and app from later this year.

The aim is for these platforms to be available for all across England to enable those living with diabetes to improve their self-management and access help and support as services across the NHS recover from the COVID-19 emergency.

These new services work alongside the other digital services we have already adopted so that diabetes care can go ahead as normal; online appointments and a dedicated helpline for those treated with insulin. The NHS Diabetes Prevention Programme is also being delivered remotely using platforms such as Microsoft Teams to continue to help those at risk of Type 2 diabetes to reduce their risk.

This Diabetes Week, people living with diabetes are being asked to share their ‘Big Picture’; a snapshot of life with diabetes. The triumphs as well as the setbacks; the persistent frustrations and small victories; the laughter and tears.

I hope that these new initiatives will increasingly become an important part of the big picture for those living with diabetes – and help to make life that little bit easier. I also hope they demonstrate our continued commitment to improving diabetes care this Diabetes Week and every week.

Partha Kar

Professor Partha Kar is National Specialty Advisor, Diabetes with NHS England and co-lead of Diabetes GIRFT with NHS Improvement.

He has led and delivered so far on (April 2016- till date):

  • Freestyle Libre being available on NHS -across country
  • NHS Right Care Diabetes pathway
  • Diabetes “Language Matters” document
  • Type 1 diabetes NHS England web-resource – on NHS choices
  • Introduction of Frailty into QoF treatment targets for diabetes care in NHS
  • Availability of CGM to all T1D pregnant patients
  • Diabetes Technology pathway development with multiple stakeholders
  • Setting up pilot projects for diabulimia treatment in London & Wessex
  • Introduction of Low Carbohydrate App into NHS Apps Library

Other work has involved input in updating of driving guidelines in relation to use of technology in those living with diabetes, helping to develop a virtual reality programme to improve hospital safety and starting work on increased mental health access for diabetes patients across the NHS

Dr Partha Kar has been a Consultant in Diabetes & Endocrinology at Portsmouth Hospitals NHS Trust since 2008. He has been the Clinical Director of Diabetes from 2009-2015, being part of a multiple national award-winning department (HSJ Awards / BMJ Awards) due to its services and care provided.

He is the pioneer of the Super Six Diabetes Model which aims to deliver diabetes care differently and is recognised as one of the good examples of integrated care.

An avid user of social media such as twitter (@parthaskar) to engage with patients – and been recognised as a “Social media Pioneer” by HSJ in 2014.

He also writes a monthly blog for the BMJ, has a personal blog (“Sugar and Spice: Wish all things were nice”) and a podcast (“Sweet Talking”)

He has also been:

  • Co-creator of TAD (Talking About Diabetes) – TED talks from those with T1Diabetes
  • Co- creator of Type 1 Diabetes comic (Volume 1 and 2)
  • Setting up Type 1 Diabetes: Rise of the Machines – event on Closed Loops/DIY tech

Follow Partha on Twitter: @parthaskar