The Board received a presentation from Professor Azhar, Farooqi, Co-Chair Leicester City Clinical Commissioning Group on the work of the Diabetes Delivery Group.
During the presentation it was noted that:-
· Approximately 30,000 people in Leicester were diagnosed with diabetes and a further 60,000 were at risk of diabetes.
· Approximately 8.7% of the population in Leicester were either diagnosed with diabetes or were at risk of diabetes. The rate was 3 times higher in BAME communities.
· Diabetes shortened life expectancy; a person diagnosed with diabetes at age 60 years was likely to lose 4-5 years in life expectancy. A person diagnosed at 40 years old could expect to lose 7 years of life expectancy.
· Diabetes could be brought on by a wide range of factors including political and socio-economic conditions as well as medical conditions.
· The national Diabetes Prevention Programme was designed to empower patients to take control of their condition and to reduce or prevent the onset of Type 2 diabetes in individuals at risk from developing diabetes. Leicester was one of the highest referrers into this scheme. There was some initial evidence that it was having effect, especially in weight reduction.
· Newly diagnosed Type 1 diabetes patients were referred to a 5 day structured training course to learn from experiences and shared group work.
· Type 2 patients were also offered the opportunity to attend a 4 hour course designed to help people understand their condition and its effect on their body as well as make achievable changes to the food they eat in their daily life. These courses were available across the whole LLR footprint.
· The CCG had invested in a primary care diabetes enhance service education programme for healthcare workers and it was considered that it was now one of the best diabetes trained workforces in the country with some staff attained degree level qualifications in diabetes.
· This was already showing reductions in hospital admissions for patients with hyperglycaemia and diabetic ketoacidosis, reduced outpatient department referrals (50% less) and better achievement of 3 treatment target and care processes and an holistic One Stop care for patients.
· The youngest patient in Leicester diagnosed with type 2 diabetes was is 10 years old and was a reflection of obesity and lifestyles such less physical activity and junk food.
· Approximately half of GP practices (mainly the larger ones) were signed up for the enhanced diabetes service and but work was progressing to provide embed specialist nurses in smaller practices. It was hoped that by next summer all GP practices would offer enhanced services. Each practice would advise patients of the enhanced service available and arrangements would be put in place to consult with hospital staff for the patient’s after care following discharge from hospital.
Members of the Board commented that:-
· Public health programmes were escalating in being embedded in schools for healthy eating programmes. 36 school had signed up last year. Schools were also engaged in keeping active and healthy programmes and positive outcomes were already being seen in some schools in relation to educational and health outcomes and behavioural changes in some instances.
· Whilst it was recognised that schools and children’s centres had been engaged around healthy eating and increased activity for some years, it was somewhat surprising that there was an increase in diabetes and there was a need to understand the impact these initiatives had in relation to diabetes and moreover what more could be done to reduce diabetes in young children.
· There were good communications between ambulance staff attending patients with hyperglycaemia and notifying GPs to prevent further episodes in the future.
· There was a view that in some groups, especially the elderly, blood sugars were managed very well to maintain normal levels and this in itself could lead to instances of hypoglycaemia should levels drop for any reason. It could therefore be beneficial to maintain blood sugar levels at a slightly higher level in some instances to avoid hypoglycaemia should levels drop unexpectedly.
That Professor Farooqi be thanked for his informative presentation and the work of the Diabetes Delivery Group be supported.