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DIABE T E S


more likely to require amputation than a member of the general public. Regulating glucose levels as close as possible to normal levels, in the long term can reduce the chances of vision or nerve damage. Some comorbidities can require visits to the hospital and can even be life-threatening. Hyper- and hypoglycaemia can both require visits to A&E, as can ketoacidosis resulting from prolonged hyperglycaemia. High blood sugar levels also increase the risk of heart disease, stroke and kidney disease, all of which can result in acute health emergencies. As with all other comorbidities, adequate insulin treatment can reduce the likelihood that a person with diabetes will develop life-threatening complications. Healthcare systems are faced with a


disproportionately large number of people with diabetes seeking urgent care, often because they have made the simple mistake of misjudging the amount of insulin they need. One in six people in hospital is diabetic, while they make up just one in every sixteen


members of the general public. This imposes significant costs on the NHS, which spends approximately £10 billion a year – 10% of its entire budget – on treatment for patients with diabetes. This immense cost does not represent the cost of successfully managing diabetes through insulin, which is relatively affordable. At the moment, 80% of the money that the NHS spends on patients with diabetes is used to treat complications, which suggests better diabetes management could save money and improve patients’ lives.


Despite treatment for diabetes costing less than treating the complications, there is still poor access to treatment in the first place. People are still having to fight to get access to the latest treatment, or to even see an endocrinologist.


The future of diabetes management


Improving the way that we manage diabetes – a diverse collection of related conditions


– in the future requires a commitment to a personalised approach. Diabetes is an umbrella term, not a specific disease. In the future, we can expect there to be at least as many solutions as there are variations of the condition and individual lifestyles. We will look back at our current one-size-fits-all solution as ineffective. One day, we will identify, name, research, treat, and possibly even cure all of the diseases that we currently call ‘diabetes’. Soon, diabetes management apps promise to collate the lived experiences of people with diabetes to produce practical, applicable insights. Quin is embarking on an equity crowdfunding campaign to make its AI-driven medical application a reality. Knowing when to take insulin and how much to take are critical to the everyday life of people with diabetes and leaving them to struggle with trial and error is unacceptable. It is time to use modern solutions to start to take a human-first approach to diabetes.


Charity calls for protection of people with diabetes


Diabetes UK warns that people with diabetes have been ‘forgotten’ amid the easing of the lockdown. The charity has delivered more than 12,000 signatures from the UK public calling for more robust protections for clinically vulnerable workers.


Steps to ease lockdown and reopen the UK risk leaving millions of people with diabetes in the dark about how best to keep themselves safe, the charity Diabetes UK has warned. It states that not enough is being done to keep people with diabetes – and those with other long-term conditions – safe, and that the guidance for clinically vulnerable people, and employers, remains unclear. Supported by an open letter signed by more than 12,000 people living with and affected by diabetes, the charity is calling on the UK Government to urgently respond to its concerns and be explicit in its commitment to protecting clinically vulnerable people. This is backed up by new analysis from Diabetes UK, which shows that two thirds (64%) of the public agree that all UK Governments need to be doing more to ensure people with underlying health conditions are kept safe at work during the COVID-19 (Coronavirus) pandemic – this rises to three quarters (75%) among 55+ year olds. Diabetes UK is calling for:


l The development of the national COVID-19 risk prediction tool to be fast-tracked, making it possible to assess a person’s individual risk based


on different factors (such as age, sex, ethnicity, health condition and so on) as soon as possible. It is also calling for a robust process to be put in place to ensure that the advice a person is offered from the use of this tool will inform decisions about their own safety in their workplace.


l Until then, people who are vulnerable to serious harm, including those with diabetes, should have a right to stay working at home at this time.


l If an employer cannot facilitate this and the employee still has concerns, they should have access to fair remuneration such as the option to be furloughed through an extension of the UK Governments’ job retention scheme for those who are vulnerable from serious harm from Coronavirus. People who are at risk of serious harm should not have to decide between their health or financial security.


l There must be robust enforcement of guidance on employment protections for clinically vulnerable people and workplace COVID-19 risk assessments which specifically address their safety.


l There must be effective and proactive communication of these measures so that people with diabetes know their rights.


It is important that people with diabetes who want to get back to work, are able to do it safely. But currently, without robust guidance, employers can continue to decide their own ‘acceptable risk’ with no safeguards for individual staff, or


64 l WWW.CLINICALSERVICESJOURNAL.COM


consequences for non-compliance. The evidence shows that social distancing is key to keeping people safe, but the new rules changing this to 1m+ is pushing people to their breaking point. The 3.9 million people diagnosed with diabetes in the UK are identified in the Government’s list of clinically vulnerable groups, and the advice, as of the 4th of July, is that people with diabetes should take particular care to minimise contact with others outside their household and to be especially careful and be diligent about social distancing and hand hygiene. Chris Askew, chief executive at Diabetes UK, commented: “The message from people with diabetes is clear; we want to go about our lives, but we’re deeply worried about our health as lockdown eases, and we want to know we’re going to be protected.


“But what is also clear is that – with the next stage of the re-opening of the UK imminent – the needs of people with diabetes are not being properly considered. People with long-term conditions cannot and should never have been the Government’s blind spot. Lives are at stake. We reiterate our calls to ensure that people with diabetes are not forgotten, and that additional measures and safeguards are in place – and enforced – to keep them safe.” More information on coronavirus and diabetes can be found at: www.diabetes. org.uk/coronavirus


SEPTEMBER 2020


CSJ


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