I have been reflecting on my final report as Chair of ABCD as I hand over the reins to Professor Ketan Dhatariya this summer. I am proud to see ABCD delivering exciting programmes and attracting new members to help ensure that we continue to thrive and grow. The Association celebrated its 25th Anniversary last June and remains in good standing.
My term of office was overshadowed by COVID-19. I am very proud of the achievements of the members of our committee and wider membership, who stood up to the challenges of the pandemic and became the vanguard for best practice and care in managing people with diabetes (some of whom presented with extreme pathology). Our popular and widely respected COncise adVice on Inpatient Diabetes (COVID:Diabetes) resources led the way in delivering optimal care during the pandemic for all our patients. A survey of our members at the height of the pandemic confirmed that the guidance was helpful and that it informed practice. We adapted the organisation to be able to deliver ongoing rapid and responsive education via virtual means throughout the pandemic. Our respected webinar programme continues to this day to deliver topical education programmes to meet learning needs.
Thankfully, the storm of COVID has passed, and whilst its legacy lives on through NHS backlogs and people suffering from long covid and mental health problems, we are now able to enjoy face-to-face high-quality patient care delivery and personally enriching interactions with colleagues and friends. ABCD has been able to deliver educational and training programmes to facilitate all these.
We will be running more meetings than ever before in 2023, ranging from a lifelong learning programme for diabetologists from SpR curriculum courses to advanced techniques and management for emerging experts. My sincere thanks to everyone involved with these programmes. I am delighted to have chaired a dedicated ABCD session at the Diabetes UK conference in April.
The ABCD Diabetes Technology Network (DTN) is a fantastic resource for the multidisciplinary team involved in the delivery of care for people with diabetes. Make sure you take some time to have a look at the educational resources on offer – from a virtual showroom demonstrating devices and their use to expert views on devices, educational resources for patients, a virtual academy and a series of videos on virtual consulting. Our thanks go to Professor Pratik Choudhary for his vision and enthusiasm in driving this thriving network. He has recently handed over to Dr Alistair Lumb, who will I am sure continue to enrich the network and activities.
Our hugely successful nationwide audit programmes are still led by Dr Bob Ryder and Emma Wilmot. Last year, in collaboration with Diabetes Care Trust (ABCD) Ltd, we launched a new research grant awards programme targeted at new and aspiring researchers, with total grant funds of £100,000 per year. The research call was successful, with 17 applications received. The successful grant applicant was Dr Rajna Golubic at the University of Oxford for a project to improve inpatient detection and management of glucocorticoid- induced diabetes. The research grant programme continues this year, with a closing date of 1st June. For further details see see https://abcd.care/research-grants. Later this year we will launch an exciting small grant awards forum based on the BBC TV show Dragons Den where applicants pitch for grant funding to a team of research experts.
The Joint British Diabetes Societies for Inpatient Care Group (JBDS-IP) continues to work tirelessly to ensure that its valuable guidelines are always up to date. JBDS-IP is also embarking on an ambitious project to identify the right number of staff to deliver an ideal, ‘state of the art’ inpatient diabetes service in the UK. We are delighted to contribute to this work and host the outputs of the work on our website.
I am extremely pleased to report that our membership continues to grow. We now have nearly 750 members. We have a strong voice and presence with policy makers and stakeholders in the diabetes community, including the NHSE, the RCP, NICE, CaReMe, JBDS and many more. We have more recently supported the formation and administration for the Obesity Management Collaborative (OMC) as we appreciate that obesity management needs more focus from multiple professional stakeholders. Our participation in these organisations helps us to ensure that the voice and expertise of the specialist diabetologist are central and considered in forthcoming guidance, programmes and reports.
Our own flagship journal, The British Journal of Diabetes continues to grow and mature. Please follow our dedicated BJD Twitter account (@BJDiabetes) to be the first to hear about publication of our ahead-of-print articles. Do send us your original research, audits, case studies and general diabetes news. I am always pleasantly surprised at hearing positive comments from colleagues outside the UK who access the journal; they respect the clinical content and appreciate its ABCD affiliation.
We hope you enjoy our fortnightly newsletters which help keep you abreast of new developments, news, events and other diabetes-related information. If you have news to share with the membership please drop us a line at info@abcd.care.
As chair of the ABCD committee I would like to take this opportunity to sincerely thank the ABCD executive and committee for their support and loyalty during my term in office.
We could not perform our activities without corporate sponsor support for ABCD and DTN. Current sponsors include AstraZeneca, Lilly, Sanofi, A Menarini Farmaceutica Internazionale SRL, Abbott Laboratories Ltd, Dexcom, GlucoRx Limited, Insulet International Ltd, Ypsomed Ltd, Air Liquide Healthcare Ltd, Medtrum Ltd Menarini Diagnostics and Roche Diabetes Care.
My gratitude to Tricia Bryant and the impressive Red Hot Irons team who serve as our secretariat, helping to plan, action and deliver our programmes. Special thanks to Claire Harris, who has provided tremendous support with our governance and committee work.
As I pass on the baton of executive chair to Ketan, I look back and reflect proudly on how we, as a healthcare community, came together and navigated the COVID pandemic and contributed to multiple national workstreams.
It has been a real honour and a privilege to serve this organisation. I wholeheartedly encourage other members to apply to join our talented and diverse steering committee and to come forward to connect with our workstreams. I suspect there are many UK subspecialty experts and rising stars of whom we are unaware; please get in touch to see how we can support you.
I have no doubt ABCD will continue to innovate, support members and thrive over the next 25 years. Thank you to everyone who has provided me counsel and support over the last three years.
I wish you all a wonderful summer and hope you have a chance to unwind. I look forward to seeing you all at one of our events. Please do join us for our main ABCD & DTN conference which takes place in Edinburgh in September.
Dipesh Patel, ABCD (Outgoing) Chair
JBDS News (Ketan Dhatariya)
New ABCD chair
Professor Ketan Dhatariya will take over as ABCD chair from June 2023. Professor Dhatariya is a consultant in diabetes & endocrinology and Honorary Professor of Endocrinology & Diabetes, at Norfolk and Norwich University Hospitals and Norwich Medical School, University of East Anglia.
New JBDS-IP chair
Dr Omar Mustafa, current co-chair of JBDS, will take over as new chair of the JBDS-IP from June 2023. Dr Mustafa is a consultant in diabetes and internal medicine at King’s College Hospital in London.
New position statement on the staffing needs for a good inpatient diabetes care
JBDS has produced a position statement which will help teams across the country to calculate their staffing need to be able to provide good-quality inpatient diabetes care. It can be found at: JBDS_19_Optimal_Staffing_Calculator_19042023.xls (live.com)
The full guideline will be available soon on our ABCD website.
Rowan Hillson Inpatient Safety Award 2023
The Rowan Hillson Inpatient Safety Award ‘Best innovation to improve patient safety when discharging from hospital’ has attracted innovative entries. The project was led by Umesh Dashora and Erwin Castro. The winners will be announced at the annual ABCD meeting in Edinburgh in September 2023.
At a recent JBDS meeting it was agreed that the scope of the award may be widened to allow more innovations and entries.
ABCD Worldwide EndoBarrier Registry (Bob Ryder)
The most recent data were presented orally at the last EASD see: https://youtu.be/_VfIoaMn4GQ
The data have been published in the current issue of Diabetes Care. They can be found at https://diabetesjournals.org/care/article-pdf/46/4/e89/700530/dc221952.pdf
Offerings from MywayDigital Health for health professionals working in diabetes and people with diabetes (Dr Debbie Wake and Dr Alex Bickerton)
There are fantastic educational opportunities available from MyWayDigital Health for healthcare professionals working in diabetes and for people with diabetes.
MyWayDigital Health's mission is to provide the highest standard of education and support to people with diabetes and healthcare professionals working in diabetes. They offer a suite of FREE educational resources, including:
Massive Open Online Courses (MOOCs)
1- or 2-day QISMET accredited online courses (text, videos, quizzes, moderated comment sections, live Q&A sessions).
Courses:
Understanding Type 1 MOOC: Comprehensive type 1 diabetes self-management course delivered over two days. This course ran on 17th/18th May
Understanding Type 2 MOOC: Comprehensive type 2 diabetes self-management course structured over two days. This course ran on 14th/15th June
Diabetes and Ramadan MOOC: Ramadan-focused diabetes self-management course for people with diabetes and healthcare professionals, including information on fasting and associated health risks.
Peer-reviewed publications of patient-reported outcomes:
Mackenzie et al. Diabetic Medicine, 2022. Mackenzie et al. BMJ Innovations, 2021.
My Type 1 Diabetes
(https://www.mytype1diabetes.nhs.uk/)
Coming soon: T1DM and physical activity.
Feedback from healthcare professionals on the eLearning courses: “The information was very informative, and patient-led.” “An excellent way of learning.” “Lots of good examples and case studies from people living with type 1 diabetes.” “Clear info and examples to work through are great for patients’ understanding.” “The video accounts from people with type 1 diabetes were particularly insightful.”
Feedback from people with diabetes on the eLearning courses: “It was so much more than I expected. Every element was useful, hearing other T1Ds talk about their experience was so informative. Thank you for creating this. I've been diabetic for 42 years and the last 12 months I have found all these resources and my DSN team. Just fantastic.” “The content was very informative, and has increased my understanding of calculations made when taking into account variables such as exercise and drinking.”
Understanding Type 1 Diabetes 17th and 18th May, 2023
Delivered in partnership with NHS England. Day 1 content was released on Wednesday 17th May. Day 2 content was released on Thursday 18th May.
Live Q&A sessions with diabetes experts ran on both days of the course over Zoom from 6-7pm BST. Diabetes experts moderated the discussion boards and replied to comments directly on the site over the 2-day course.
Day 1 focused on all things type 1. This included what T1DM is and how it is diagnosed and treated. It also covered blood glucose monitoring and gave people everything they need to know about insulin.
Day 2 focused on the complications of diabetes and how it can impact the rest of the body. It also covered topics related to what it is like living with T1DM, including travelling and driving, and how lifestyle factors can make a transformational impact on improving inpatient care and creating the change people living with diabetes need and deserve.
Everyone who completed the course received a personalised certificate for CPD. The course was QISMET accredited.
A new diabetes pre-operative pathway in Somerset (Louise Lewis)
A new diabetes pre-operative pathway piloting in Somerset is achieving significant improvements in glycaemia optimisation for patients awaiting elective surgery.
The unique pathway, commencing optimisation of diabetes from the point of referral, has been developed by Somerset NHS Foundation Trust and is bringing primary and secondary care colleagues together to work collaboratively in developing plans of care and delivering health education to patients.
Preliminary results demonstrate that 96% of patients on the pathway have reduced their HbA1c after three months. Patients and primary care practitioners have also reported increased confidence in diabetes management.
Further data are now awaited to evaluate whether the development and maintenance of improved diabetes self-management throughout the surgical pathway can result in longer-term improvement in treatment targets.
A new diabetes care accreditation programme (Daniel Flanagan, the Clinical Lead for DCAP and Eva Lynch, Diabetes Project Manager for DCAP)
The Royal College of Physicians and Diabetes UK are launching the Diabetes Care Accreditation Programme (DCAP) on 31st May, 2023. First of its kind, DCAP aims to improve inpatient care across the UK by setting out quality standards and measuring service performance through external peer assessment. Accreditation acts as an assurance mechanism to service users, managers, referrers and commissioners about the service provided. The ambition is for DCAP to make a transformational impact on improving inpatient care and creating the change people living with diabetes need and deserve.
Start your accreditation journey today and find out more about DCAP by visiting www.dcap.org.uk.
Primary care recovery plan launched on 1st May, 2023
This plan will become central to how Primary Care Networks will operate moving forwards, essentially improving care navigation within the system through:
The future of QOF and Investment & Impact Fund (IIF) will be consulted on during the summer. Criticisms of the plans have focused on the timing and continued delay in a workforce plan for the NHS. The primary care plan should have been supplementary to a workforce plan for the NHS.
https://www.england.nhs.uk/publication/delivery-plan-for-recovering-access-to-primary-care/
Hewitt Review into ICSs published in April
The review was commissioned by Chancellor Jeremy Hunt shortly after his accession to the role and was led by Chair of NHS Norfolk and Waveney Integrated Care Board and former Health Secretary, Patricia Hewitt. It comes one year after the legal establishment of ICSs. It considers the oversight and governance of ICSs, examining the balance of greater autonomy and robust accountability of these emerging systems, and making a number of recommendations. The review is a clear signal from Government that integration is still on the agenda. However, the Department of Health and Social Care has not given any indication of when it would respond to the review and which recommendations it would accept. The review lays out some of the ongoing challenges faced by ICS structures and provides insight into the state of the emerging coordinating bodies; one example is the reference to specialised commissioning. Hewitt noted "during this review, several clinical and other leaders expressed concerns about the place of specialised services within the new landscape of ICSs” but noted that it was “not possible in the timescale of this review to con-sider this issue in detail.”
https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/1148568/the-hewitt-review.pdf
Type 1 Diabetes Grand Challenge
A ground-breaking partnership between the Steve Morgan Foundation, Diabetes UK and JDRF UK announced funding of three major research projects, kicking off the race to a cure for T1DM. Three leading UK researchers at the University of Dundee, the University of Exeter and Imperial College London have been awarded Fellowships totalling £5 million. The three ambitious research projects will focus on two key research areas:
https://type1diabetesgrandchallenge.org.uk
NICE recommendations for children with T2DM
For the first time new guidance from NICE recommends the use of real-time continuous glucose monitoring (rtCGM) or intermittently scanned glucose monitoring (isCGM) devices for some children living with T2DM who are currently using finger prick testing and insulin therapy. “Recommending new technology is a clear step towards giving children on insulin therapy the ability to manage their own condition in a less invasive way, and to live happier and healthier lives,” said Dr Judith Richardson, programme director in the Clinical Directorate at NICE. The guideline committee has recommended the technology should be offered to children and young people with T2DM if they: 1. have a need, condition or disability (including a mental health need, learning disability or cognitive impairment) that means they cannot monitor their blood glucose by finger prick testing; 2. would otherwise be advised to self-measure at least 8 times a day; 3. have recurrent or severe low blood sugar levels; and 4. have impaired blood sugar awareness.
Those eligible should speak to their diabetes team to access real-time or flash monitors on prescription.
Entries for QiC Diabetes Awards 2023 now open
Applications are now being taken for this year’s Quality in Care (QiC) Diabetes Awards, an established accolade “at the forefront of sharing best practice” that recognises outstanding people working on the frontline of healthcare. Winners have implemented a new care initiative over the last year which has improved the lives of those living with diabetes. Now in their 13th year, the awards will have a new category for 2023, entitled Peer Support. In total, there are 10 awards available to win, including three nomination prizes, such as Outstanding Educator in Diabetes, Diabetes Professional of the Year and The People’s Award. Entries are invited from anyone working in the diabetes arena throughout the UK and Ireland.
https://qicdiabetes.awardsplatform.com/
Green Award – have you been involved in a project to reduce carbon emissions?
A pharmaceutical company will recognise outstanding healthcare initiatives which have benefited the environment in a new award which launched at the Diabetes UK Professional Conference in April. Sanofi has created a Green Award to celebrate and applaud teams, organisations and individuals who work in health care and have led a project which has reduced carbon emissions. Registrations for the Sanofi Green Award opened on 27th April and will close on 25th August. Shortlisted entries will be unveiled on Friday, 15th September, and the winner will be announced at the QiC Diabetes Awards ceremony on 12th October. For more information and to see the entry criteria please use this link.
https://forms.office.com/e/n4wScRMSda
A rapid-fire collection (extract) of interesting recent developments in diabetes
The last few months have seen plans for multiple courses coming together. The YDEF DTN technology course scheduled for the 12-14th of June and the YDEF obesity course for the 19-20th of June. Both courses were heavily oversubscribed once more, showing the interest of the trainees in these areas.
YDEF Day is taking place on the 7th of July in Leeds and will be covering several aspects of the diabetes and endocrine (D&E) curriculum. We also look forward to welcoming to YDEF Day the new winners of the Marjorie Prize, who submitted their reflections on diabetes and endocrine healthcare provision in conflict or emergency settings. We are organising a one-day diabetic foot course (on 16th October in Sheffield), which is a new initiative tailored to the needs of D&E trainees, and there are plans in place for the popular YDEF ABC of D&E; more details will be announced in due course.
We would like to congratulate Patrick Divilly on winning the Young Diabetologists & Endocrinologists Forum travel award at Diabetes UK Professional Conference 2023 for his presentation, which explored sensor-detected hypoglycaemia.
YDEF has recently welcomed its new committee members, including Abidullah Khan (ST6 trainee in Mersey Deanery) and Matthew North (ST6 trainee in North West Thames Deanery), and pre-specialty trainee representatives including Medha Agrawal (IMT2 in Wales Deanery), Alice Hughes (IMT1 in Peninsula Deanery), Rama Lakshman (upcoming IMT1 in Belfast) and Angelica Sharma (ACF ST1 in Endocrinology in East of England Deanery). Congratulations to all those who passed the latest D&E SCE. However, if you are a trainee who did not pass the exam, we could offer some financial support for a resit. Please contact healthcare@diabetes.org.uk to find out more. The admin team at Diabetes UK will process all requests, which will remain confidential.
There are lots of exciting activities coming up in the future; watch this space! You can visit our website (https://www.youngdiabetologists.org.uk/) and follow us on Twitter @youngdiab so that we stay connected and explore new opportunities together.
Dr Alexandros Liarakos
on behalf of YDEF Committee
Contact: alexandros.liarakos@gmail.com
YDEF is dedicated to all diabetes and endocrine trainees and is open for new members to register on our website. Take advantage of our regular newsletters and up-to-date advertising of a wide variety of courses and meetings to complement your training. As always, we are continuously looking to develop and propagate our specialty so do not hesitate to contact us if you have any suggestions or questions!
DTN is pleased to announce a change of leadership, which took place at the Diabetes UK Professional Conference in Liverpool. Dr Alistair Lumb is taking over as Chair from Professor Pratik Choudhary. Pratik has been an excellent Chair for DTN who has achieved a huge amount during his term. He led us through the expansion of access to Freestyle Libre: here DTN provided resources to support the first-class work led by NHSE. Pratik also led us through the COVID-19 pandemic, during which DTN arranged the temporary extension of pump warranties and championed remote technology starts. Pratik also drove the development of the Glooko Academy education resource. Fortunately, Pratik is going to remain as part of the committee and so we will still have access to his incredible energy and expertise.
Alistair is very pleased to be taking over at such an exciting time for diabetes technology across the UK. The hotly anticipated NICE technology appraisal for hybrid closed-loop systems has the potential to widen access to diabetes technology significantly, and DTN has been working closely with NHSE to plan for the expected roll-out. A Best Practice Guide for Hybrid Closed-loop Therapy, produced by a group led by Dr Thomas Griffin and Dr Sufyan Hussain, has been published in Diabetic Medicine and is available via the DTN website. We are in the process of producing further educational resources for HCPs and people with diabetes to use.
DTN is also pleased to announce that two superb diabetes educators have joined the committee following a very competitive appointments process. They are: Amy Jolley, a specialist dietitian from Salford, and Anne Marie Frohock, a paediatric specialist dietitian from Oxford. They are bringing a huge amount of expertise and energy to the committee, and we are sure that you will see their influence very soon.
The programme for the DTN Day 2023 has been announced. We look forward to seeing you in Edinburgh at the Royal College of Physi-cians of Edinburgh on Tuesday 5th September 2023 for our flagship educational event for HCPs. You can now register via our website at https://abcd.care/dtn/events.