New comprehensive Consensus Report to manage type 1 diabetes, led by Southampton Professor
A new comprehensive Consensus Report to manage type 1 diabetes (T1D) is today being launched by two leading diabetes societies – the European Association for the Study of Diabetes (EASD) and the American Diabetes Association (ADA).
The wide-ranging document captures best practice for T1D including diagnosis, goals of therapy and blood sugar targets and schedule of care.
Diabetes self-management education and additional behavioural considerations, glucose monitoring, insulin therapy, managing hypoglycaemia and psychosocial care are also included.
Front and centre of the report is the need to address all these factors from the patient’s perspective.
Professor Richard Holt, of the University of Southampton was one of the leaders of the writing team for the guideline, which included 14 experts in the USA and Europe, from a range of healthcare disciplines.
Highlights from the report include an algorithm to accurately diagnose T1D, since no single factor in isolation can accurately confirm the condition. Furthermore, some 40% of individuals diagnosed with T1D as adults are initially misdiagnosed as having T2D, partly because T2D is becoming more common in younger adults due to the rising rates of obesity and physical inactivity.
Psychosocial health and living with T1D is also specifically addressed, since between 20% and 40% of people with type 1 diabetes experience diabetes-related emotional distress (including 15% with depression). These psychosocial health issues emerge particularly at the time of diagnosis and when complications develop. Thus the report recommends that self-management difficulties, psychological, and social problems be screened periodically and monitored using validated screening tools, and the healthcare team should be consistently assessing the mental health needs of those living with T1D.
Psychosocial health and living with T1D is also specifically addressed, since between 20% and 40% of people with type 1 diabetes experience diabetes-related emotional distress (including 15% with depression). These psychosocial health issues emerge particularly at the time of diagnosis and when complications develop. Thus the report recommends that self-management difficulties, psychological, and social problems be screened periodically and monitored using validated screening tools, and the healthcare team should be consistently assessing the mental health needs of those living with T1D.
People with T1D represent 5-10% of all people with diabetes, which amounts to over 25 million people worldwide.
Professor Holt said: “While various other guidance has been published in the past relating to people living with T1D, a clear consensus document has been lacking, and recommendations for people with T1D are often confused with or ‘bundled in’ with those for people who have T2D.
“There are still huge gaps in our knowledge about how to prevent, diagnose and treat type 1 diabetes. We are also aware that many people with type 1 diabetes experience inequalities in treatment. We hope that this report will promote better higher quality research to determine optimal care, while helping to share best clinical practice so that all individuals with type 1 diabetes have access to the care they need.”
The final report, launched at the online annual meeting of EASD this week, is also published in Diabetologia (the official journal of EASD) and Diabetes Care (the official journal of ADA).