Why is the programme required
Two decades ago type 2 diabetes in children and adolescents was unheard of in the UK. Since then there has been a year on year increase in the number of young adults with type 2 diabetes and we now have an estimated 12,000 people under 30 years of age living with type 2 diabetes nationally. A young person presenting with a new diagnosis of diabetes who is aged 20-30 years and living in UK is now more likely to receive a diagnosis of type 2 rather than type 1 diabetes.
The younger individual with type 2 diabetes represents an extreme phenotype. There are likely to be obese, from a black or minority ethnic background, have a strong family history of diabetes, and come from one of the most deprived groups in society. Unfortunately, even if they achieve good glycaemic control and have duration of disease, diabetes complications present early. They are particularly susceptible to the premature development of nephropathy and neuropathy. Furthermore, the constellation of obesity, hypertension, dyslipidaemia and non-alcoholic fatty liver disease frequently seen in younger adults with type 2 diabetes translates into devastating outcomes at an early age, with reported mortality rates at double those seen in comparable type 1 diabetes populations. Type 2 diabetes in younger adults carries substantial costs to the individual in terms of morbidity and mortality and to society in terms of the financial burden to the NHS.
How are we making a difference
We held a successful “Call to Action” workshop in December 2015 to explore with stakeholders what are the key issues related to improving the management of young people with type 2 diabetes aged under 40. This identified a number of priorities which we are looking to make progress including:
- Development of a consensus statement on the clinical management of young people with type 2 diabetes to provide advice to clinicians on appropriate management.
- Extract data from the National Diabetes Audit 2014/15 and pilot an audit within a number of clinical commissioning groups to provide a health needs assessment of young people with type 2 diabetes and to identify gaps in current management. This will be shared with other East Midlands clinical commissioning groups to highlight gaps in provision for young people with type 2 diabetes.
Who to contact for further information
Martin Cassidy, Senior Quality Improvement Lead