New evidence shows impact of social deprivation on access to structured disease education and mortality rates in type 1

  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
sarah.crack@kcl.ac.uk