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.

Professor Partha Kar

Professor Partha Kar is National Specialty Advisor, Diabetes with NHS England and co-author of the national Diabetes GIRFT report.

He has been a Consultant in Diabetes and Endocrinology at Portsmouth Hospitals NHS Trust since 2008- and pioneer of the Super Six Diabetes Model which is recognised as one of the good examples of integrated care.

He has helped to expand use of technology in Type 1 Diabetes- namely use of Flash Glucose in Type 1 Diabetes and CGM in Type 1Diabetes pregnancy along with online digital self-management platforms- while recently leading on real world data collection on Closed Loops for subsequent NICE review. He has worked subsequently with NICE on updating relevant guidelines in non-invasive glucose monitoring access in Type 1 and Type 2 Diabetes.

His other work has involved introduction of frailty into QoF treatment targets, Diabulimia pilot projects in the NHS; championing “Language Matters” and helping to create an overview of Diabetes care in Primary Care Networks. Recent work has focussed on transitional care models- as well as tackling inequalities in technology access based on deprivation and ethnicity.

He is one of the leading users of social media in diabetes care – and writes a monthly blog for the British Medical Journal.

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 to 4)
  • Co-creator of DEVICES (Virtual Reality educational modules in diabetes)

Beyond diabetes, he also recently taken a role in tackling issues of racial disparity in the medical workforce as the Medical Workforce Race Equality Standard lead for NHS England. He has also been named as one of the most influential BAME individuals in healthcare in 2020,2021 and 2022.

Follow Partha on Twitter: @parthaskar