2016/17 JSNA Diabetes
Who is at risk and why?, Level of need in the population, Current services in relation to need, Projected service use and outcomes, Users views, Evidence of what works and policy drivers, What are the top five issues/priorities from the needs assessment or analysis and what are we going to do as a result?, Key contacts
Who is at risk and why?
There are two main types of diabetes:
- Type 1 diabetes means your body can’t produce enough insulin
- Type 2 diabetes develops when your body can’t produce enough insulin, or when the insulin that is produced doesn’t work properly
Type 1 (approximately 10% of people with diabetes) is treated either with insulin injections or an insulin pump.
Type 2 diabetes is more common (approximately 90% of people with diabetes), usually develops during adulthood and may be treated with diet and physical activity, tablets, non-insulin injectable or insulin
Lifestyle plays a major part in the risk of developing diabetes, with around one-third of the risk of Type 2 diabetes (90% of the increasing burden of the disease) being attributable to obesity. In Type 1 diabetes, the contribution of genetics is comparatively greater.
Risk factors include:
- A close family member having Type 2 diabetes
- Being overweight or having a waist measurement of over (in inches):
- 31 - Women
- 35 - Asian men
- 37 - White and Black men
- High blood pressure or pre-existing heart or vascular disease
- History of gestational diabetes
- South Asian and Black African-Caribbean heritage
Data from the GP disease registers for Milton Keynes record that in November 2016 there were 13,005 adults living with diabetes i.e. 6% of the adult population.
People with diabetes are at a higher risk of having a heart attack or stroke. In Milton Keynes, people with diabetes are 147% more likely than the general population to have a heart attack and 81% more likely to have a stroke. Death from cardiovascular disease is higher, and premature mortality from CVD is higher in Milton Keynes than in populations with a similar level of affluence.
In Milton Keynes as a whole, fewer people with diabetes meet the standards for diabetic control than in similar populations and consequently the risk of complications is higher. Within Milton Keynes however, the picture is variable, this needs to be addressed through providing additional support, education and training to both patients and professionals, and targeting the groups within Milton Keynes who will benefit the most.
 Public Health England, Cardiovascular Disease Profile June 2017
Primary care provides support for the majority of people with diabetes. There have been a number of improvements in the Diabetes pathway for Milton Keynes. Some of these include:
Access to diabetes care closer to home – a new service now available to people (adults) with diabetes requiring additional support and help with their diabetes management. The Milton Keynes Integrated Diabetes Service (MK IDS) is a multi- disciplinary team with consultants and diabetes specialist nurses working alongside colleagues in primary care to run a series of clinics.
Better outcomes can be achieved through earlier identification of the disease and good self-management. The number of places in nationally accredited Type 2 education programmes has been doubled. Shortly, there will be courses available for existing people who need support to self-manage their Diabetes including culturally adaptive training modules that can support people with Diabetes within Black, Asian and minorities (BAME) communities. Education for Type 1, DAFNE (does adjusting for normal eating) for people with diabetes (adults) is now offered locally by Milton Keynes University Hospital.
During the summer of 2017, the NHS Diabetes Prevention Programme has been rolled out to all 27 GP Practices in Milton Keynes. This behaviour change programme aims to support people (adults) who have a raised blood sugar level with healthy lifestyle options to stop or delay some people from progressing to Type 2 diabetes.
Diabetes UK-MK group continue to provide a platform for people with Diabetes in Milton Keynes to share experiences. Diabetes UK-MK will shortly be offering 1:1 mutual support to empower individuals in managing their diabetes. BAME Diabetes Health Ambassadors, developed in partnership with Milton Keynes Equality Council continue to raise awareness within their communities on prevention and self-management.
If the current trends in demographic and obesity persist the total prevalence of diabetes is expected to rise to 7.5% by 2020 and 8.6% by 2030.
NICE Quality Standard Q56) Diabetes in Adults ( March 2011)
The Diabetes National Service Framework (2001) are the main policy drivers for service development. The strategic objectives contained include:
- Prevention of Type 2 diabetes
- Identification of people with diabetes
- Empowering people with diabetes
- High quality integrated clinical care of people with diabetes
- Management of diabetic emergencies
- Care of people with diabetes during admission to hospital
- Diabetes and pregnancy
- Detection and management of long-term complications
- Children and young people with diabetes
What are the top five issues/priorities from the needs assessment or analysis and what are we going to do as a result?
The priorities are to halt the trend of increasing prevalence of diabetes while ensuring that all local services have the capacity to meet existing demand and offer a consistently high standard of care:
- Identification and referrals to the Diabetes prevention programme for people at high risk of developing Type 2 Diabetes
- Improving achievement of NICE recommended treatment targets in primary care
- Empowerment of all people with diabetes (adults) through patient education programmes and peer support to self manage their diabetes
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Last Updated: 30 November 2017