Chris Askew opens Diabetes UK Professional Conference 2017

In the year since many of us were last in a conference hall together in Glasgow, we have much to acknowledge and celebrate in diabetes care, treatment, prevention and research.

In England, we’re on the threshold of £42 million of new investment being committed to improve diabetes care and treatment, targeting access to education, inpatient care, improvements in foot care and reductions in amputations. Backing this up, we have a national framework for monitoring commissioning outcomes, with diabetes as one of seven clinical priorities.

We have just seen the data that shows that the number of children in England and Wales with good diabetes control has improved again in the last year, by about 10% and the sixth consecutive year of improvement.

Timely offers of structured education continue to increase for adults in England and Wales, though still falling short of where they should be and with questions raised over the quality of what is offered in some areas.

Notwithstanding political change, we now have a diabetes strategy proposed in Northern Ireland with up to £1.7 million earmarked for the Diabetes Network, and delivery of key priorities set in foot care, audit data, pregnancy, access to structured diabetes education and insulin pump therapy.

In Scotland, news last year of £10 million pledged by Scottish Government for insulin pumps technology.

Future investment in research

In England, we have a National Diabetes Prevention Programme gearing up to scale and a Sugar Drinks Industry Levy emerging to reality which, whilst in itself not the panacea to progressive weight gain in the population, flags the growing awareness in society of the challenges of unhealthy foods and drinks, the lure of excess consumption, the role of industry and the choices we all have as consumers.

At the research bench, we have increased our understanding of the complexity of diabetes and of the move towards better personalization in diagnosis, treatment and care.

The pace of technological innovation continues to accelerate, with closed loop systems and digital health moving closer to routine care. And in tackling the growing number of cases of Type 2 diabetes, early intervention strategies are offering signs of hope in reducing and delaying new diagnoses.

Most recently, recruitment has closed to seven Clinical Studies Groups spanning all aspects of enquiry into diabetes and represented by expert researchers, clinicians, health care professionals and people with diabetes. These groups are tasked with considering where future investment in research needs to be targeted and will surely play a fundamental role in advocating for where funders should direct resources in translational diabetes research in the future.

Diabetes prevalence continues to rise

But for all these achievements, new summits of challenge rise before us. Continued and significant variation across Clinical Commissioning Groups in annual care processes delivered and in achievement of treatment targets in England and Wales; geographical variations which also map across gradients of inequality in age, socio-economic status and ethnicity.

We face in diabetes the same systemic workforce shortages emerging in all health services, with – for example – numbers of Diabetes Specialist Nurses (DSNs) failing to keep pace with diabetes case load and nearly 4 out of 5 DSNs voicing concern that their workload is having an impact on patient care and safety.

Diabetes prevalence continues to rise, with 9% of the population in England over 16 now living with diabetes. And whilst the number of children with Type 2 is small in real terms, there’s a clear trend of rising numbers being diagnosed, with greater prevalence among girls than boys (by a factor of 2), greater rates of diagnosis in non-white communities and in more deprived areas; a young person from a deprived background is nearly seven times more likely to be diagnosed with Type 2 than their counterpart in the most affluent areas.

So, there is much more to be achieved to improve the lives and outlook for those affected by or at risk of diabetes. Much more to be achieved if at Diabetes UK we are to achieve our vision of ‘a world where diabetes can do no harm’. This last year, Diabetes UK has called for a recognition of a ‘crisis’ in diabetes; not a word we use lightly, but one we believe is warranted.

Sharing knowledge, changing lives

How, then, does this conference play its part in our collective work? What can this week offer as we consider what it will take to climb these summits of challenge in diabetes?

This year, we’ve coined the strapline ‘Sharing Knowledge, Changing Lives’, as the best expression of the opportunity we have this week to share knowledge and experience to change the outlook for all those who depend upon us as diabetes healthcare professionals.

Tomorrow evening – and I hope you will join us (there are still tickets…) – we sit down to a Conference Dinner themed the ‘Roaring Twenties’, in the Imperial War Museum, itself 100 years old this week. And that brought to mind the words of Diabetes UK’s co-founder, HG Wells, speaking in 1920, on the threshold of those ‘roaring twenties’, as the world sought to repair itself and learn from the horrors of the previous six years.

‘Human history’, he said, ‘becomes more and more a race between education and catastrophe’. What a prescient thought that was and how relevant today, as it was then, in these times when education, and its currency – knowledge, seem under such challenge; when expertise is seen by some as an inconvenient breakwater to the growing waves of populism and facts are traded irrespective of data and evidence.

Driven to know more

I am sure HG Wells was not thinking of his own diabetes when he spoke those words, but he certainly recognised the power of knowledge and understanding and education in diabetes, and talked some years later of ‘the vigour and advancement of research’ when he proposed the founding of a Diabetic Association – Diabetes UK as we are today – in his words: ‘to promote the study, the diffusion of knowledge and the proper treatment of diabetes in this country.’

And is that not why we are here today? To promote the study, the diffusion of knowledge and the proper treatment of diabetes in this country? Sharing knowledge, changing lives.

We are here because we all gain from that exchange. In our work, we are all educators, and pupils. We all have experience to offer and all stand to gain from the experiences of others. At Diabetes UK, one of our four values is that we are ‘driven to know more’; that underpins our staging of this Professional Conference and is the spirit in which we share the week ahead with you all.

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