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This final guideline has now been published and can be found by visiting the NICE website: https://www.nice.org.uk/guidance/NG17

This update is focused on the long-acting insulin recommendations only. Further updates will be published in due course.

The recommendations from this guideline have been included in the NICE Pathway on Type 1 diabetes in adults, which brings together everything we have said on Type 1 diabetes in adults: diagnosis and management (update) in an interactive flowchart. There is brief information about the guideline for people using services, carers and the public at ‘Information for the public’.

Having diabetes does not automatically mean that you fit into the clinically vulnerable category, this only applies to people who received a letter during lockdown telling them they are in this group or if they have been told by their GP.

Expert doctors have identified specific medical conditions that, based on what is known about the virus so far, place someone at greatest risk of severe illness from COVID-19. The following people are included but disease severity, history or treatment levels will also affect who is in the group.

• People with specific cancers:
• people with cancer who are undergoing active chemotherapy
• people with lung cancer who are undergoing radical radiotherapy
• people with cancers of the blood or bone marrow such as leukaemia, lymphoma or myeloma who are at any stage of treatment
• people having immunotherapy or other continuing antibody treatments for cancer
• people having other targeted cancer treatments which can affect the immune system, such as protein kinase inhibitors or PARP inhibitors
• people who have had bone marrow or stem cell transplants in the last 6 months, or who are still taking immunosuppression drugs.
• People with severe respiratory conditions including all cystic fibrosis, severe asthma and severe chronic obstructive pulmonary (COPD).
• People with rare diseases and inborn errors of metabolism that significantly increase the risk of infections (such as severe combined immunodeficiency (SCID), homozygous sickle cell).
• People on immunosuppression therapies sufficient to significantly increase risk of infection.
• Women who are pregnant with significant heart disease, congenital or acquired.
• you do not have any of the conditions that makes you clinically extremely vulnerable
• you have not been told by your GP or specialist that you’re clinically extremely vulnerable or received a letter

IDDT offices are open with all the necessary safety precautions in place. However, there is a slightly reduced number of staff in the office.

This may mean that there will be a slight delay in responding to requests for leaflets and dealing with incoming post but we are sure that you will understand that this is necessary.

It also means that there will be a delay in drawing the lottery for the time being but each month will be drawn separately and the winners informed as soon as possible.

On a positive note:

• We are able to answer emails and offer help and support this way, just email enquiries@iddtinternational.org
• All our leaflets and booklets are available on our website, just click on https://www.iddt.org/publications
• We are able to answer your calls to offer help and support on the telephone, just call 01604 622837.

Up to date Government information on Covid can be found at: https://www.gov.uk/coronavirus

We hope all our members and visitors stay safe and well.

Jenny Hirst
Co-chair
InDependent Diabetes Trust

We are always very grateful for the donations of unwanted, in-date and unused insulin and other diabetes supplies, such as needles, lancets and test strips. This is a great help to people with diabetes in developing countries. However, due to regulations during the pandemic, we have been unable to send insulin or other items for several months and this does not seem likely to change in the foreseeable future.

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Rapid COVID-19 guidance on vitamin D
In collaboration with Public Health England and the Scientific Advisory Committee on Nutrition, NICE has published rapid guidance on vitamin D in relation to COVID-19. This supports current government advice for everyone to take a 10 microgram (400IU) vitamin D supplement every day throughout the autumn and winter. This dose is safe and effective at maintaining vitamin D levels. Vitamin D is important for bone and muscle health.

Click here to read more

A number of you have been in touch looking for advice relating to the global Coronavirus (also known as COVID-19) outbreak. The information about the coronavirus is based on advice from NHS England, NHS Improvement and Public Health England.

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This is just a reminder for all of us. There are general principles you should follow to help prevent the spread of airway and chest infections caused by respiratory viruses, including:

• wash your hands more often with soap and water for at least 20 seconds or use a hand sanitiser. Do this after you blow your nose, sneeze or cough, and before you eat or handle food,
• avoid touching your eyes, nose, and mouth with unwashed hands,
• avoid close contact with people who have symptoms,
• cover your cough or sneeze with a tissue, then throw the tissue in a bin,
• clean and disinfect frequently touched objects and surfaces in the home.

The World Health Organisation (WHO) has some clear guidance on how we should wash our hands and it can be found at the following link: https://www.who.int/gpsc/clean_hands_protection/en/

Did you know that you can help us raise funds simply by recycling your ink cartridges via our Recycle4Charity programme?

For each inkjet cartridge recycled via the programme we will receive a £1 donation, meaning you can help the environment whilst raising money for IDDT!

Click here to read more

During lockdown many routine appointments, many standard screening appointments are being cancelled. This includes routine podiatry appointments to check the health of your feet, therefore it is more important than ever that you regularly check your feet for any changes.

Foot problems are one of the common complications of diabetes and are caused by nerve damage (neuropathy) or damage to blood vessels in the feet and legs.

Our booklet ‘Looking After Your Feet’ tells you what to look for and is available online by clicking on:
https://www.iddt.org/publications/looking-after-your-feet

If you are concerned about the development of any changes to your feet or lower limbs, you should contact your GP or your usual podiatrist as help is available to prevent the development of serious complications.

One way or another, many of us are using various devices and screens for many hours of the day through working from home or in our leisure time. Spending long periods looking at computer, phone, or tablet screens can strain the eyes. Using the 20-20-20 rule can help to prevent this problem.

The rule says that for every 20 minutes spent looking at a screen, a person should look at something 20 feet away for 20 seconds. Read more:
https://www.medicalnewstoday.com/articles/321536

We are all being advised to take exercise once a day and this is particularly important for people with diabetes as the treatment of both types of diabetes is medication (whether insulin or tablets) diet and exercise.

Click here for advice and some exercises to get you started

Some of our members sponsor children and young people at the Dream Trust in Nagpur, India and they will be concerned about the health and wellbeing of these vulnerable young people as a result of the lockdown in India.

This article emphasises his advice that they should not lower their insulin doses because of fears of lack of availability of insulin. This link provides you with te English translation of Dr Pendsey’s newspaper article offering advice to families.

Our booklet, ‘Diabetes – Everyday Eating’ provides menus for breakfast, lunch and evening meal for 28 days. The menus are for everyday eating, so ideal for this difficult time when sometimes we can only buy essential items.

As we have lots of time on our hands at the moment, now might be the time to try something different to eat! You can access this booklet on our website at: https://www.iddt.org/wp-content/uploads/2011/10/A4_Health_Nutrition_Booklet.pdf

Brexit and insulin supplies

As most people are aware, all human and analogue insulins are made outside the UK and only pork insulin is made in the UK. It is understandable that people have concerns about insulin supplies as a result the UK leaving the European Union (Brexit). The insulin manufacturers have stated that they already have stockpiles in the UK and this is more than the normal 6 weeks’ supply recommended by the Government. They have also set up alternative delivery routes into the UK.

They are urging people not to stockpile insulin or any other diabetes medication, themselves because this disrupts supplies for everyone and could put some people at risk of not being able to get their insulin. However, it is recommended that people reorder their insulin and other medicine supplies early in case there are local delays.

Reassurances from the Royal Pharmaceutical Society have issued a statement to confirm that “protecting patient care, supporting the pharmacy workforce, and ensuring the continuity of medicines supply will continue to be high priorities for 2021…”Having sought and received assurances from the UK Government, devolved governments, the pharmaceutical industry and others on plans to sustain the supply of medicines following the Brexit transition period while we will continue to monitor the situation in the short-term, the organisation’s focus for 2021 will be on the medium to long-term plans for pharmaceutical care.”

Post Brexit changes

Perhaps it is difficult to see at the present time, but there will come a time when we can safely travel abroad again. We are all aware that the UK has left the EU but because of the pandemic, perhaps we are not as aware of the changes as we would otherwise have been…

The changes affect us all, but some are particularly important for people with long-term health conditions, such as diabetes, so below is a brief outline of the key changes.

Health insurance

EHIC and GHIC – for travel within most European countries we have previously had a free European Health Insurance Card (EHIC). This remains valid until it runs out and then you have to apply for a free Global Health Insurance Card (GHIC). Just like an EHIC, it is possible to apply for this new card on behalf of yourself, but also your spouse/ partner, your children (under 16) and other family members. However, you and each person on the application must meet the nationality and residency conditions which basically are focused on making sure that you and they are UK citizens.

You get a GHIC card by applying on the NHS website: https://www.nhs.uk/using-the-nhs/healthcare-abroad/apply-for-a-free-ehic-european-health-insurance-card/ Be aware that there are some websites that try to ‘sell’ these cards, so do not fall for this, the official cards are free.

A still valid EHIC or the new GHIC enables you to benefit from prompt, largely free health services in the 27 countries which are part of the European Union but from 1st January 2021, neither a GHIC nor most EHICs will cover you in Norway, Iceland, Liechtenstein or Switzerland. When visiting these countries, you must make sure your travel insurance covers you for healthcare cover.

NOT a replacement for travel insurance – it is important to remember that the GHIC (or valid EHIC) is NOT an alternative to travel insurance. It helps you to access types of healthcare quickly and usually free at the point of delivery but not all countries offer the same free services that you would receive on the NHS so you could have to pay for some services. In addition, travel insurance is still needed for many reasons including getting you home following an injury, illness or specialist treatment for existing health conditions, such as diabetes.

Just a reminder too, that you need to check that any travel insurance you take out, does cover your pre-existing health conditions and this is not always the case with insurance offered by travel agents.

Passports

• You need at least 6 months on your passport to travel.
• Your passport must be no older that10 years, even if it has 6 months or more left on it.
• You can apply online for a new passport at: https://www.gov.uk/apply-renew-passport and the cost is £75.50.
• A paper application form can be obtained from a Post Office and the cost for this is £85.00.

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One of our Type 1 members phoned today to warn other people of his experience with the DVLA online driving licence application.

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Please click here to read more about this important announcement

FreeStyle Libre – the latest not-so-good news!!!

Diabetes care in nursing homes still remains “fragmented” and urgent steps need to be taken to restore the “health and dignity” of older people, leading experts have said.

A review of multiple studies carried out across 25 years involving residents with diabetes has slammed care home provision saying that care homes “often do not meet national standards” of diabetes care and staff training is “patchy”. 

Lead author Professor Alan Sinclair, from the Foundation for Diabetes Research in Older People and University of Aston, said: “Our findings show the level of diabetes care remains fragmented which is quite worrying because figures suggest over a quarter of care home residents are believed to have the condition. Without proper management, it can lead to frailty, dependency, disability and reduced life expectancy.

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