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Semaglutide for early onset Type 1 diabetes – but a very small study…

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Semaglutide for early onset Type 1 diabetes – but a very small study…
In a small study involving only 10 people, semaglutide, a Type 2 drug, was given to people with Type 1 diabetes soon after the diagnosis. This led to no need for mealtime insulin in all patients and no need for basal insulin in most, along with improved glycaemic control. (The New England Journal of Medicine. September 2023)

Before building up our hopes, we have to recognise that this is a very small study and a much larger study is needed. In addition, we have to question whether there could be adverse effects.

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Free life-changing technology for people with Type 1 diabetes

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NHS patients in England with Type 1 diabetes are now eligible for a free continuous glucose monitor (CGM) after the health service secured a new ‘cost-effective’ deal.

Earlier this year, the NHS announced it would rollout CGM technology to everyone living with Type 1 diabetes as part of its ‘Long Term Plan’ to deliver world-class healthcare. Now a deal between the NHS and manufacturer DEXCOM means a CGM called the Dexcom ONE Real Time-Continuous Glucose Monitoring will soon be available on prescription to people with Type 1 diabetes.

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NICE update recommendations for continuous glucose monitoring (CGM) and flash monitoring (Freestyle Libre) – now available for all people with Type 1 diabetes and people with Type 2 diabetes using insulin

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More than 250,000 people living with type 1 diabetes are set to be offered new technology to help them manage their condition and at the same time reduce the need for finger prick testing by up to 50%, following new advice from NICE. New guidance from NICE has recommended the use of real-time continuous glucose monitoring (rtCGM) for adults and children living with type 1 diabetes for the first time. It will give them a continuous stream of real-time information on a smartphone about their current blood glucose level.

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“Scotland to rollout diabetes test for Type 1 patients”

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This was a headline in November 2021 along with the statement that “Misdiagnosed Type 1 diabetes patients could be freed from the need to take insulin after a new test is rolled out.”

Scotland will become the first country to offer the C-peptide blood test to all patients who have had a Type 1 diagnosis for at least three years. The test became available from 1st November 2021 in Scotland.

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First ever injection pen recycling pilot launched in UK pharmacies

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Novo Nordisk has launched the PenCycle scheme to enable people to recycle their pre-filled FlexPen and FlexTouch devices by returning them to participating pharmacies or through pre-paid Royal Mail boxes which hold up to 12 used pens (with the needles removed).

This system, called PenCycle, started on 1st November 2021 and is being run in partnership with Alliance Healthcare, Lloyds Pharmacy, the National Pharmacy Association (NPA) and Royal Mail. It will be piloted in 13 clinical commissioning groups in Greater Manchester and Leicestershire and Rutland and in the Greater Glasgow and Clyde health board, ahead of a planned national rollout in 2022. The scheme is thought to be the first of its kind in the UK.

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Diabetes and Tattoos

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By Martin Hirst
CEO, InDependent Diabetes Trust

Why should we talk about diabetes and tattoos?

Tattoos are a cultural phenomenon that exist in most parts of the world. They can be used to signify things like social status or family history as in Polynesian culture or as a form of art often seen, for example, in European culture. Tattoos tend to divide people into three groups, people who can’t bare them, people who love them and those who are “tattoo-curious”. Whichever group you belong to, tattoos by their very nature are here to stay. There are now over 12 million people in the UK who have been tattooed and not surprisingly some of them have diabetes as well and in this article we look at various aspects of getting tattooed if you have diabetes.

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NICE guideline on Type 1 diabetes in adults: diagnosis and management (update)

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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’.

Who is classed as ‘clinically vulnerable’?

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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

Pandemic Update for IDDT

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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 [email protected]
  • 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

NICE News

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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.

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Handwashing and respiratory hygiene

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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/

 

Looking after your feet

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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.

 

Eye strain from long periods on a screen

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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

 

InDependent Diabetes Trust
IDDT