Diabetes is a long-term condition and can lead to complications including kidney failure, coronary heart disease, stroke, blindness and amputation. Diabetes is caused by too much glucose, a type of sugar in the blood. This is because the body cannot process the glucose properly. Read this introduction to diabetes to find out more about how diabetes occurs.
There are two main types of diabetes: type 1 and type 2.
Type 1 diabetes is most common in children and young adults and accounts for between 5% and 15% of all people with diabetes. Type 1 diabetes occurs when the body produces no insulin. The Health A-Z section has more information about type 1 diabetes.
Type 2 diabetes accounts for the vast majority of people with diabetes and is strongly linked to obesity. This form of diabetes can often be managed by just keeping up a healthy diet and lifestyle. More information about type 2 diabetes, including the causes and symptoms, can be found in the Health A-Z section of this website.
The diabetes national service framework (NSF)
The diabetes national service framework (NSF) was published in December 2001. It was the first-ever set of national standards aimed to develop a patient-centred service, improve health outcomes for people with diabetes in England, raise the quality of services and reduce unacceptable variations between them.
The National Institute of Health and Clinical Excellence (NICE) quality standard for diabetes
NICE has now published a Quality standard for diabetes (2011), which supports the existing NSF and provides an authoritative definition of good quality care. NICE quality standards enable the following to happen:
- Health and social care professionals can make decisions about care based on the latest evidence and best practice.
- Patients can understand what service they can expect from their health and social care providers.
- NHS trusts can quickly and easily examine the clinical performance of their organisation and assess the standards of care they provide.
- Commissioners to be confident that the services they are providing are high quality and cost-effective.
Identifying and preventing type 2 diabetes
Early intervention and treatment, especially in high-risk groups, can reduce or delay the onset of long-term complications of diabetes.
NHS Health Check
Collectively, vascular disease (heart disease, stroke, diabetes and kidney disease) affects the lives of more than four million people and kills 170,000 in the UK every year. These conditions also account for more than half the mortality gap between rich and poor. Modelling work undertaken by the Department of Health has found that offering the NHS Health Check to all people between the ages of 40 and 74 in England, and recalling them every five or 10 years would be a cost-effective and clinically beneficial programme.
The NHS Health Check assesses people’s risk of heart disease, stroke, kidney disease and diabetes by looking at their age, gender, family history, height and weight, as well as their blood pressure and cholesterol levels.
Everyone will receive a personal assessment, setting out personal levels of risk and strategies to reduce it. For those at low risk, this might be no more than general advice on how to stay healthy, weight management programmes or stop smoking services. Those at the highest risk might also require preventive medication with statins or blood pressure treatment.
NHS Health Checks have the potential to prevent 1,600 heart attacks and strokes and save up to 650 lives each year. They could prevent over 4,000 people a year from developing diabetes and detect at least 20,000 cases of diabetes or kidney disease earlier.
Change4Life
The Change4Life campaign was launched in 2009 as part of a strategy to help reduce obesity, which can result in type 2 diabetes, and to help people maintain a healthy weight. Aimed at families, it promotes messages such as healthy eating and being more active.
Managing diabetes
Supporting people with diabetes to understand their condition is an important part of the disease management. Structured education programmes, access to specialist diabetes advice, care planning discussions and annual checks are opportunities to identify necessary changes to treatment regimes and refer to specialist services.
There are currently two national patient education programmes designed to give people the skills and confidence to manage their condition. The Dose Adjustment for Normal Eating (DAFNE) is an educational programme which helps people with type 1 diabetes adjust their insulin injections to fit their lifestyles, rather than fitting their lives round rigid insulin regimes. The Diabetes Education & Self Management for Ongoing & Newly Diagnosed (DESMOND) provides a structured education programme for those with type 2 diabetes.
Care planning is an inclusive process that supports the ongoing partnership between healthcare professionals and people with diabetes. The process of agreeing a care plan offers people active involvement in deciding, agreeing and "owning" how their diabetes will be managed.
