Diabetes HbA1c Statistics In Your Area

[GrantGam]

Hello guys!

I stumbled across this interesting page on the Diabetes UK site:

https://www.diabetes.org.uk/In_Your_Area/Scotland/Diabetes_in_your_area_Scotland/Grampian/

As you can see, it gives different figures regarding health stats of diabetics by region (in this case, Grampian which is my region).

The thing I find most interesting is just how few T1D's are achieving an A1c of <53mmol/L... In my area it's a mere 7.8% and in Scotland as a whole we're looking at just 10.7%. I wonder what the main cause is for this? Attitude, diet, activity levels, age, education, support facilities?

Another thing to note is the MINUTE percentage of persons using insulin pumps in Scotland. Even though only 10.7% are on target for their A1c's, only 2.5% are pumping. Eligibility and funding still seems to be a huge challenge in Scotland. As I'm sure it is in the rest of the UK.

Would be interesting to see what others have to say on this topic and how their regions compare with mine, whether in Scotland, England, Wales or NI.

All the best
Grant

 

[tim2000s]

@GrantGam1337 - have you read the National Diabetes Audit? If not, have a look at this: http://crick-tech-munch.blogspot.co.uk/2016/01/the-uk-national-diabetes-audit-results.html

The Diabetes UK website doesn't break out results for all areas, so it's quite difficult to make a comparison, but those Grampian values are similar to the UK norms, maybe slightly worse...

As for pumping. Don't get me started - the UK has a terrible showing in terms of pump use. One of the lowest uptakes in the Developed world! I think the last time I checked, we had around 11.7% uptake versus nearly 40% in the US. (This is the last insulin pump audit covering 2013-2015 http://digital.nhs.uk/catalogue/PUB20436/nati-diab-insu-pump-audi-rep-2013-15_R.pdf).

THe other interesting stat in the pump audit is that those on pumps seem to have better Hba1Cs than those not on pumps....

 

[GrantGam]

@GrantGam1337 - have you read the National Diabetes Audit? If not, have a look at this: http://crick-tech-munch.blogspot.co.uk/2016/01/the-uk-national-diabetes-audit-results.html

The Diabetes UK website doesn't break out results for all areas, so it's quite difficult to make a comparison, but those Grampian values are similar to the UK norms, maybe slightly worse...

As for pumping. Don't get me started - the UK has a terrible showing in terms of pump use. One of the lowest uptakes in the Developed world! I think the last time I checked, we had around 11.7% uptake versus nearly 40% in the US. (This is the last insulin pump audit covering 2013-2015 http://digital.nhs.uk/catalogue/PUB20436/nati-diab-insu-pump-audi-rep-2013-15_R.pdf).

THe other interesting stat in the pump audit is that those on pumps seem to have better Hba1Cs than those not on pumps....

Hi Tim,

Thanks for both the links and no, I've not read either of them but will use the rest of my lunch hour doing so

I did wonder why I couldn't adjust the region too easily to check other areas; and you've just answered why.

Yes, the pump stats are shocking... Considering the UK as a whole seems to be lagging (without sounding offensive to those not on target; terribly) in terms of HbA1c results - it would make sense for pumps to be a readily available alternative to MDI therapy. As someone who is warming to the idea of insulin pump therapy, I'd consider paying either the outlay for the pump in exchange for self funding consumables, or vice versa. However, it's my understanding that the NHS are not even considering entertaining this option. All or nothing it would seem?

I'd imagine the trade off between the expense of pumps vs extensive lost revenue through treatment of the various complications induced through poor control would be a no brainer...

Cheers
Grant

 

[catapillar]

@GrantGam1337 im not convinced it's the costs of the pump itself that causes the problems - it's the resource in terms of people (DSNs) at the clinic who are actually trained in/capable of setting patients up on pumps and then supporting them going forward that's the real issue in pump funding/access.

 

[GrantGam]

@GrantGam1337 im not convinced it's the costs of the pump itself that causes the problems - it's the resource in terms of people (DSNs) at the clinic who are actually trained in/capable of setting patients up on pumps and then supporting them going forward that's the real issue in pump funding/access.

Yes, I can imagine that there is significant training involved for those using the pump and those supervising the users.

It's all fine and dandy if you live in and around big cities such as London, but for those in less populated areas there simply may not be enough persons available to give the training/supervision necessary. That along with funding of course, this will always remain an issue with a pressed health service.

Grant

 

[azure]

I agree more people should be able to have pumps, but I think better education would help just as much if not more in improving HbA1Cs. I too find the number of people missing the target absolutely shocking.

 

[GrantGam]

I agree more people should be able to have pumps, but I think better education would help just as much if not more in improving HbA1Cs. I too find the number of people missing the target absolutely shocking.

I also agree. I cannot fault how helpful and knowledgeable my diabetes team have been however. Although that's only one clinic in my region, I'd like to assume that the rest are equally as well trained.

Although proper diabetes management is difficult, it is not unachievable. I wonder if because T1D is commonly found in younger persons, whether age is a dominating factor in this overall poor control statistic. As in, younger people/children are less likely to take the reigns and tighten control because of an unawareness of complications and a lax attitude?

 

[tim2000s]

Although proper diabetes management is difficult, it is not unachievable. I wonder if because T1D is commonly found in younger persons, whether age is a dominating factor in this overall poor control statistic. As in, younger people/children are less likely to take the reigns and tighten control because of an unawareness of complications and a lax attitude?

YoOu also have to bear in mind that kids and teens hormones really affect how easy it is to manage their glucose levels. For most kids, it's the parents that are in control.

 

[azure]

I also agree. I cannot fault how helpful and knowledgeable my diabetes team have been however. Although that's only one clinic in my region, I'd like to assume that the rest are equally as well trained.

Although proper diabetes management is difficult, it is not unachievable. I wonder if because T1D is commonly found in younger persons, whether age is a dominating factor in this overall poor control statistic. As in, younger people/children are less likely to take the reigns and tighten control because of an unawareness of complications and a lax attitude?

It would be interesting to see a breakdown of ages for all the Type 1s in the UK and/or HbA1C by age group.

I know I'm obsessed with carb counting but I blame the lack of teaching on diagnosis for many poor results. I still can't get over the fact that we have so many Type 1s who've not received that very basic help. I'd be adding stern instructions to the NICE guidelines if it was up to me.

 

[GrantGam]

YoOu also have to bear in mind that kids and teens hormones really affect how easy it is to manage their glucose levels. For most kids, it's the parents that are in control.

Yeah it's a roller-coaster anyhow at that age, regardless of diabetes.

 

[CarbsRok]

@GrantGam1337 im not convinced it's the costs of the pump itself that causes the problems - it's the resource in terms of people (DSNs) at the clinic who are actually trained in/capable of setting patients up on pumps and then supporting them going forward that's the real issue in pump funding/access.

But then again if the people with the pumps actually sat down and read the manual on how to set the pump up then they should not need on going support. Oh and the use of common sense and thinking for ones self is a must when using a pump. If any of this is lacking then obviously apron strings need to be used.

 

[catapillar]

But then again if the people with the pumps actually sat down and read the manual on how to set the pump up then they should not need on going support. Oh and the use of common sense and thinking for ones self is a must when using a pump. If any of this is lacking then obviously apron strings need to be used.

Less apron strings, more liability risk. If pump manufacturers aren't confident the use of the pump will be adequately medically supervised, they simply won't supply them. That's why you can't just buy them on Amazon and crack on with it yourself

Also, what's easy, simple, straight forward for you, might not be so for others. If support is needed, it's right that it should be available. Unfortunately there aren't enough nurses available, let alone trained nurses.

That's the same reason why there is a lack of availability for structured diabetes education and if this hasn't been offered possibly relying on common sense is a little over optimistic. Common sense ain't that common.

 

[noblehead]

@GrantGam1337 im not convinced it's the costs of the pump itself that causes the problems - it's the resource in terms of people (DSNs) at the clinic who are actually trained in/capable of setting patients up on pumps and then supporting them going forward that's the real issue in pump funding/access.

Not only that @catapillar, pumps are not for everyone and we often see members on the forum say they are happy and content on MDI and wouldn't thank you for a insulin pump.

 

[catapillar]

Not only that @catapillar, pumps are not for everyone and we often see members on the forum say they are happy and content on MDI and wouldn't thank you for a insulin pump.

Totally agree. Sorry, I was meaning to be talking about problems in accessing the pump for those who are asking for one, in response to Grants suggestion that he would self fund consumables in order to be able to access a pump.

 

[noblehead]

Totally agree. Sorry, I was meaning to be talking about problems in accessing the pump for those who are asking for one, in response to Grants suggestion that he would self fund consumables in order to be able to access a pump.

Ah right thanks @catapillar

Yes you make some good points about resources.

 

[magsiesss]

Oh sh*t ..... I have just looked at my area and the areas surrounding me ... in Gt Yarmouth and Waveney we have some of the worst percentages by far .... looking also at the amputation percentages ....

Why is there such a big difference in areas?