New evidence shows impact of social deprivation on access to structured disease education and mortality rates in type 1 diabetes 10 year analysis from unique public-private partnership reports at American Diabetes Association meeting 2013 Business Wire CHICAGO -- June 24, 2013 New data from the UK presented this week at the 73^rd Scientific Sessions of the American Diabetes Association (ADA) meeting shows that social deprivation is an independent risk factor for mortality in type 1 diabetes. In addition, patients from poorer socio-economic backgrounds were underrepresented in structured education schemes which were shown to improve glycaemia and reduce the need for emergency diabetes care.^1,2 The data, from a retrospective analysis of combined biochemical, demographic and health resource utilisation collected from 2002 to 2012 for a cohort of type 1 diabetes patients across two inner city specialist diabetes outpatients clinics, was conducted as part of a collaboration between King’s Health Partners (an Academic Health Science Centre bringing together King’s College London, Guys’ and St Thomas’s Hospital, King’s College Hospital and South London and Maudsley NHS Foundation Trusts) with Novo Nordisk, a global healthcare company with 90 years of innovation and leadership in diabetes care. Professor Stephanie Amiel, Professor of Diabetic Medicine at King's College London and Leader of the Diabetes Clinical Academic Group, King’s Health Partners commented“These data confirm a higher mortality risk for people with type 1 diabetes from poorer socio-economic backgrounds and the value of an effective intervention which significant numbers of socially deprived patients are not currently accessing. It’s an example of the practical challenges faced by practitioners in improving positive outcomes in diabetes, and has clear implications for improved models of care”. In a cohort of 1038 patients, with a mean age of 41.6 years and duration of diabetes 16.1 years, 37 deaths occurred in a 10 year period (3.6% total cumulative mortality). Patients who died were more likely to be socially deprived, with 61% of deceased patients having scores in the upper quintile of the population range.^1 Age and mean HBA1c were also identified as independent predictors of mortality.^1 A separate analysis of 1365 patients was conducted, with 405 patients (29.7%) attending the DAFNE (dose adjustment for normal eating) structured education programme between 2001 and 2012. ^ 2 Individuals residing in more socially deprived districts were under-represented among those attending (mean index of multiple deprivation score 27.2 DAFNE vs 30.3 others), as were ethnic minorities (21.2% vs 30.5%).^2 However, those who attended DAFNE achieved significantly better long-term glycaemic control (mean HbA1C at study end 8.1 vs 8.4, mean follow-up post-DAFNE 4.8 years) and a lower prevalence of severe hypoglycaemia requiring hospitalisation (1.7% vs 4.8%).^2 The association between DAFNE and improved glycaemic control persisted after controlling for social deprivation alone.” The data reported at ADA this week is part of an initial analysis phase of Changing Diabetes @ King’s Health Partners, a three year collaboration between King’s Health Partners and Novo Nordisk, which aims to create and validate a sustainable model of care for people with diabetes. Professor Stephanie Amiel continued: “There is a clear need to develop cost-effective integrated solutions for long-term conditions such as diabetes, and these datasets demonstrate the potential economic and clinical outcomes from better uptake of programmes such as DAFNE. We now have a solid platform of end to end patient level cost and outcome analysis of diabetes care, upon which we can begin to explore new models for specialist care delivery. We are excited about the potential that this project could have, at the local level and beyond”. Peter Meeus, UK/IRE Managing Director, Novo Nordisk, commented “Changing Diabetes at King’s Health Partners is a unique public-private partnership in the UK, which aims to co-create a world-recognised centre for diabetes research and care. Our participation represents Novo Nordisk’s commitment to addressing the full spectrum of challenges faced by patients and clinicians in managing diabetes. We look forward to seeing the project deliver improvements, both for those already living with diabetes and those who are at risk of developing the condition in future.” - ENDS - Notes to Editors About King’s Health Partners (KHP) King’s Health Partners Academic Health Sciences Centre (AHSC) is a pioneering collaboration between King’s College London, and Guy’s and St Thomas’, King’s College Hospital and South London and Maudsley NHS Foundation Trusts. King’s Health Partners is one of only five AHSCs in the UK and brings together an unrivalled range and depth ofclinical and research expertise, spanningboth physical and mental health. Our combined strengths will drive improvements in care for patients, allowing them to benefit from breakthroughs in medical science and receive leading edge treatment at the earliest possible opportunity. The partnership brings together… *three of the UK’s leading NHS Foundation Trusts; *one of the top 30 universities in the world; *services provided over 225 locations, including seven hospitals and *community and mental health centres; *2.7 million patient contacts each year; *29,000 staff; *24,000 students; *a combined annual turnover of £2.6bn. ... to advance health and wellbeing by integrating world-class research, care and teaching. For more information, visit www.kingshealthpartners.org About Novo Nordisk Headquartered in Denmark, Novo Nordisk is a global healthcare company with 90 years of innovation and leadership in diabetes care. The company also has leading positions within haemophilia care, growth hormone therapy and hormone replacement therapy. For more information, visit novonordisk.co.uk. About Changing Diabetes @ King’s Health Partners See here for an executive summary of the joint working project http://www.novonordisk.co.uk/Downloads/executive-summary-khp-cd-final.pdf About diabetes Diabetes (or diabetes mellitus) is a serious and challenging health condition that develops when there is too much sugar in the blood due to the body being unable to produce or respond to the hormone, insulin, in the normal way.^3 Every three minutes, one person in the UK is diagnosed with diabetes^4, and approximately 2.9 million people have already been diagnosed with diabetes in the UK. This figure is projected to rise to 5 million by 2025.^4 References 1. Thomas S, Yassa L, Simpson D et al. Age, glycemic control and social deprivation independently predict 10-year mortality in a UK type 1 diabetes cohort. Presented at the 73rd Scientific Sessions of the American Diabetes Association (ADA) meeting 2013 2. Hopkins D, Foxcroft R, Simpson D et al. Factors influencing uptake of structured education for type 1 diabetes and long-term outcomes in an urban clinic population; impact of ethnicity and social deprivation. Presented at the 73rd Scientific Sessions of the American Diabetes Association (ADA) meeting 2013 3. NHS Choices. Diabetes introduction. Available at URL: http://www.nhs.uk/Conditions/Diabetes/Pages/Introduction.aspx Last accessed: June 2013. 4. Diabetes UK. State of the Nation 2012. Available at URL: http://www.diabetes.org.uk/Documents/Reports/State-of-the-Nation-2012.pdf Last accessed: June 2013. Contact: For media enquiries in the UK please contact: Novo Nordisk Freeha Rafiq Tel: + 44 (0) 1293 762013 Mob:+44 (0) 7894 784121 FRRF@novonordisk.com or Rachel Cummings Tel: +44 (0) 1293 762086 Mob: +44 (0) 7725 289520 RACU@novonordisk.com or King’s Health Partners Sarah Crack Tel: + 44 (0) 20 7188 4058 firstname.lastname@example.org
New evidence shows impact of social deprivation on access to structured disease education and mortality rates in type 1
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