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JDRF welcomes the news that all eligible under eighteens with type 1 diabetes in Scotland will now have access to insulin pumps. The Scottish Government has said it is committing funding of at least £1 million to help NHS Boards deliver pumps to under eighteens who need them, as well as tripling the amount of pumps available to all people with the condition in Scotland.

Health Secretary Nicola Sturgeon made the announcement saying, ‘Insulin pumps mean freedom from having multiple insulin jabs a day - giving Scotland's youngest diabetics a normal childhood. By the end of March 2013, this treatment will be made available to the 480 children and teens struggling with type 1 diabetes who could benefit from it. Over the next three years, NHS Boards will also increase the number of insulin pumps available to all Scots to 2,000, tripling the current amount.

‘Diabetes is a growing problem for Scotland - around 10 per cent per cent of overall hospital expenditure relates to diabetes treatment and complications. Not dealing effectively with diabetes can cause long term health problems and we need to make sure that the youngest people with type 1 diabetes get the best possible treatment as early as possible.’

Karen Addington, Chief Executive of JDRF said: ‘This is good news for young people with type 1 in Scotland. Insulin pump therapy can help people manage their condition more effectively and reduce the risk of the devastating long term complications of type 1.

JDRF is focused on improving lives, until we find the cure, and we have been campaigning for some time for improved access to pumps. We are delighted that Scotland is taking the lead in providing excellent treatment for people with type 1 and we hope to see similar improvements across the rest of the UK in the future.’

You may have read in yesterday’s newspapers reports that children of women who have diabetes are more likely to be born with a birth defect.

These articles discussed a new study by the researchers at Newcastle University. This study showed that  that seven out of every 100 babies born to women with either type 1 or type 2 diabetes were born with birth defects. These defects occur in about two in every 100 babies born to women who do not have diabetes, so this means women with diabetes 3.8 times more likely to have babies with birth defects.

The researchers looked at the records from 401,000 women who gave birth between 1996 and 2008 to see if birth defects were more common in people with diabetes.

Previous research has highlighted this increased risk for women with diabetes, but has also shown that this risk can be significantly reduced by keeping HbA1c levels low at the time of conception. The current research study provides further evidence of this effect:  fewer babies with birth defects were born to women with lower HbA1c levels.

This research highlights the importance of specialised care for pregnant women with diabetes, as careful glucose control is very important during this time. The National Institute for Health and Clinical Excellence (NICE) recommends that women who are planning to become pregnant should aim for an HbA1c level of 6.1, if this can be safely achieved.

Rachel Connor, Head of Research Communication at JDRF, said, ‘This study is helpful because it shows that while there are increased risks for women with type 1 diabetes who are planning a family, it is possible to reduce those risks significantly. By working with specialist diabetes teams, and potentially making use of glucose control technologies such as insulin pumps and continuous glucose monitors, women with diabetes can minimise any risks to themselves and their developing babies’.

Professor Simon Heller, a member of JDRF’s Scientific Advisory Committee has just launched a trial to answer some of the questions he discussed in an interview with Type 1Discovery magazine two years ago…

In Type 1 Discovery issue 50, we interviewed Professor Heller about hypoglycaemia and ways people with type 1 can manage their condition to maintain good control and avoid hypos as far as possible.

In the article Professor Heller talked about both the Dose Adjustment For Normal Eating (DAFNE) programme and the role of technology in treating type 1. He also discussed how complex it is for doctors and people with type 1 alike to weigh up the advantages and disadvantages of different ways of treating type 1 for different individuals.

Most research around starting to use an insulin pump in adulthood has been done comparing people who start using a pump with people who continue to use multiple daily injections, without any additional training. This means there is a gap in the research evidence. It is possible that the training people receive when they begin using a pump, particularly around carb counting, may be at least partly responsible for the improvements in control that studies on pump use suggest.

The Relative Effectiveness of Pump Therapy Over MDI and Structured Education (REPOSE) trial seeks to find out if this is the case. Volunteers to the study will be randomly assigned to one of two groups. One group will participate in the DAFNE course, while the other group will participate in DAFNE and begin using an insulin pump. Both groups will be followed up for two years, and the researchers will collect information on how glucose control in both groups changes during the trial. They will also collect a range of information about how people in the trial feel about their type 1 treatment, their quality of life, and importantly their fear of hypoglycaemia.

The results of the trial will help doctors and decision makers within the NHS to understand how information and training can work alongside different technical ways of treating type 1 diabetes. If the trial demonstrates an added benefit of insulin pumps above injections then the hope is that diabetes teams may be more willing to refer people for pump therapy which is relatively underused in the UK.

The trial is completely funded by the NIHR Health Technology Assessment programme. It is currently recruiting volunteers all around the country: if you are over 18, do not use a pump and have never done the DAFNE course, why not get in touch with the REPOSE team to see if a hospital near you is involved in the study?

Please contact:
Diana Papaioannou, REPOSE Trial Manager 
email: d.papaioannou@sheffield.ac.uk phone: 0114 222 0766
or 
Lucy Wraith REPOSE Trial Support Officer 
email: l.wraith@sheffield.ac.uk phone:  0114 222 0866

JDRF-funded researchers working as part of the Artificial Pancreas Consortium at Montpellier University Hospital in France and at the Universities of Padova and Pavia in Italy ran experiments with two patients in parallel.

Both patients attained near-normal glucose levels after spending a night outside hospital while their diabetes was automatically managed by a prototype artificial pancreas system. The patients were each asked to test the system by eating a meal in a restaurant and then spending a night in a hotel, all while using the device.

Eight more patients enrolled in the trial will begin outpatient testing in the coming weeks in Montpellier, France and in Padova, Italy.

Rachel Connor, Head of Research Communication at JDRF commented ‘This is brilliant news for people with type 1. Testing this system outside the hospital for the first time is an important milestone in the journey toward making the system available to people with type 1 around the world.’

Access to insulin pumps improves in Scotland

JDRF is delighted that the government in Scotland has recognised the need for the greater uptake of insulin pumps. We feel it’s vital that people with type 1 diabetes have access to the medicines and equipment that help them to stay healthy and manage their condition effectively whilst we search for the cure.

Health Secretary Nicola Sturgeon said, ‘The pumps can mean freedom from having multiple injections a day, and, for the youngest diabetics, can go some way to giving them back a normal childhood. I want to see insulin pumps made available to 25 per cent of children and teens with type 1 diabetes by 2013. We will also increase the number of pumps available to all Scots to over 2,000 - almost tripling the current amount over the next three years. 

‘Diabetes is a growing problem for NHS Scotland. It’s now thought that around 10 per cent per cent of overall hospital expenditure relates to the treatment of diabetes and its complications.

‘The consequences of not dealing effectively with diabetes can cause long term health problems and we need to make sure that the youngest people with type 1 diabetes get the treatment that’s right for them as early as possible.’

These plans were announced as part of the Diabetes Action Plan, which was published in August of this year. You can read the full report here.

JDRF works hard to raise awareness of the issues people with type 1 diabetes face and to ensure they have access to the best treatments and equipment to manage their condition. You can read about the campaigning work we do in more detail here.

Last Friday, Scottish government announced that a quarter of young people with type 1 diabetes in the country will have access to insulin pumps by 2013. It was also confirmed that over the next three years, the number of insulin pumps available to people of all ages with type 1 diabetes will almost triple to more than 2,000.

JDRF is delighted that the government in Scotland have recognised the need for greater uptake of insulin pumps. We feel its vital that people with type 1 diabetes have access to the medicines and equipment that help them to stay healthy and manage their condition effectively whilst we search for the cure.

Health Secretary Nicola Sturgeon said, “The pumps can mean freedom from having multiple injections a day, and, for the youngest diabetics, can go some way to giving them back a normal childhood. I want to see insulin pumps made available to 25 per cent of children and teens with type 1 diabetes by 2013. We will also increase the number of pumps available to all Scots to over 2,000 - almost tripling the current amount over the next three years. 

"Diabetes is a growing problem for NHS Scotland. It’s now thought that around 10 per cent per cent of overall hospital expenditure relates to the treatment of diabetes and its complications."

“The consequences of not dealing effectively with diabetes can cause long term health problems and we need to make sure that the youngest people with type 1 diabetes get the treatment that’s right for them as early as possible.”

These plans were announced as part of the Diabetes Action Plan which was published in August of this year. You can read the full report here

JDRF works hard to raise awareness of the issues people with type 1 diabetes face and to ensure they have access to the best treatments and equipment to manage their condition. You can read about the campaigning work we do in more detail here

A new clinical guideline spells out that continuous glucose monitoring (CGM) can be a beneficial tool to help maintain target blood glucose levels, and limit the risk of hypoglycaemia.

The guideline was developed by the Endocrine Society, an international organisation for researchers and clinicians who work on hormone disorders like type 1 diabetes. The complete guideline is published in the current issue of Journal of Clinical Endocrinology and Metabolism. 

A team of experts from the society reviewed all of the evidence around CGM use published to date in order to come up with the new guidelines. They found that there was high-quality evidence to recommend the use of real-time CGM in children and adolescents with type 1 diabetes who are at least eight years old, and in adults with type 1 diabetes as well. But the guideline does stress that CGMs are only useful if the person with type 1 is prepared to use it on a daily basis.

The chair of the task force that drew up the guideline, Dr David Klonoff of Mills-Peninsula Health Services in San Mateo, California, said “There are some caveats to consider before accepting continuous monitoring of glucose as a routine measure to improve glycaemic control in diabetes. There are still concerns about the high costs of CGM and the accuracy of the various systems available. However, the new CPG shows that CGM can be a beneficial tool to help maintain target levels of glycaemia and limit the risk of hypoglycaemia.”

Rachel Connor Head of Research Communication at JDRF UK said “This new clinical guideline may help to convince some clinicians, who may still feel uncertain about the accuracy and usefulness of CGM, that this technology has a place in the management of type 1 diabetes.”

The Endocrine Society’s patient education affiliate, The Hormone Society has produced a really helpfulpatient guide to CGM, which includes information about the new recommendations.

A study carried out on behalf of JDRF in the US has revealed the potential savings that could be made to the Medicare programme (which provides health insurance to those over 65 years old or who have disabilities) because of the artificial pancreas. These savings are estimated to total $1.9 billion over 25 years.
 
The JDRF Artificial Pancreas project aims to link an insulin pump with a continuous glucose monitor (CGM) to provide automatic, real-time monitoring of blood glucose and delivery of insulin. Early studies of a prototype artificial pancreas have already shown clinical improvements in blood glucose control.

The research team, led by Dr Michael J. O’Grady, modelled 25 years of medical costs for people between 30 and 60 years old. Their analysis revealed the accumulated cost savings resulting from avoiding complications in this group.

Poorly controlled blood glucose levels in type 1 diabetes can cause complications later in life, such as diabetic eye disease and cardiovascular disease. A new technology that can significantly slow or stop the progression of these has the potential to deliver substantial health and financial benefits. 

Debbie Young is a JDRF supporter and mother to Laura, an eight year old girl with type 1 diabetes. They both attended the JDRF Type 1 Discovery Day at Puxton Park on Saturday 7 May 2011 and Debbie has written an account of the day... 

Not being much of a scientist, when I went along to this year’s JDRF Discovery Day at Puxton Park I was prepared for the scientific presentations to go over my head. So I was mightily impressed when I realised that thanks to Dr Garry Dolton I suddenly understood the concept of T-cells and their role in the development of type 1 diabetes.

Dr Dolton is part of the T-cell Modulation Group (www.tcells.org) at Cardiff University School of Medicine’s Department of Infection, Immunity and Biochemistry. His team is carrying out valuable research into why certain T-cells attack insulin-producing cells. Their findings could be critical on the path to preventing and reversing type 1 diabetes. Dr Dolton’s description of T-cells ‘touring the body on surveillance seeking infections and bacteria to kill,’ (mistakenly striking pancreatic beta cells en route) brought James Bond to mind. Never has the search for the cure sounded so exciting! The futuristic laser technology used to identify and track them would certainly seem at home in a 007 film. JDRF is the sole source of funding for this ground-breaking project, and Dr Dolton’s eloquent and accessible explanation was a persuasive argument to support JDRF.

But the Discovery Day was not just about the search for the cure. It also advised how best to manage diabetes until the cure is found. Sabrina Dawe, a volunteer from www.input.me.uk, gave a crystal clear explanation of the value of insulin pumps as an alternative to injection therapy. Her own son has used a pump since diagnosis at 11 months, but her explanation was measured and rational, rather than evangelical – this was no sales pitch. Instead it simply equipped the audience to make their own decisions about whether a pump would be right for them.

The Discovery Day balanced the science of type 1 diabetes and its management with coping strategies for the emotional burden that diabetes places on the individual and their family. Annabel Astle, whose daughter Mimi was diagnosed with type 1 when a baby, gave a moving but ultimately positive account of how diabetes has affected her whole family. Annabel’s husband Jeff then reported on his means of coping by taking a practical approach to fundraising. Along with Sabrina Dawe and 11 other members of ‘Team Pingu’, he ran this year’s London Marathon.

By the end of the morning the audience was left in no doubt as to the value of supporting JDRF, whatever their preferred method of fundraising. We then spent the afternoon enjoying the wonderful family facilities of Puxton Park (free admission was kindly granted to families attending the Discovery Day). The highlight was the amazing owl encounter – catch it next time if you missed it and you will remember it for the rest of your life! I was left buoyed up by the whole day and more resolved than ever to complete my mission the following weekend of running the Bristol 10k for Team Pingu. (Not sure whether I’ll ever make marathon status!)

But that night I was brought back to earth when my daughter had a severe hypo at 3am. Frightening in its intensity, it was a sobering reminder that seeking the cure for type 1 diabetes is a serious, urgent business.

I am thankful to JDRF for all that they do. Their search for the cure continues behind closed doors as we go about our daily lives managing our children’s condition. JDRF then open the doors to us on these occasions and gives us hope for their future. 

For further information on JDRF's Type 1 Discovery Days and other similar events, please visit http://www.jdrf.org.uk/research

Many of you will know that our Chief Executive Karen Addington has type 1 diabetes. However you may not be aware that this year she took the bold step to start using an insulin pump for the first time.

After injecting insulin for over 30 years, the transition to a pump has been a big change for Karen, so she very kindly agreed to record her experiences along the way. You can read Karen’s Insulin Pump Diary  on our website. Her experiences with a new type of pump called the Omnipod make fascinating reading.

Through our 1 Campaign, JDRF has been working to improve access to insulin pumps. Currently only 4% of people with type 1 diabetes in the UK use a pump, yet nearly 35% of people in the USA use them.

It is great news that Karen has started using a pump and we hope that she continues to have a positive experience using the equipment and that her story offers inspiration to anyone who is considering getting a pump. For more information about insulin pump therapy, especially if you have difficulty accessing pumps, visit INPUT.