Remote Type 2 Education Platform Selected For NHS Innovation

Remote type 2 education platform selected for NHS Innovation

A low-cost, online self-management platform for people with diabetes and a fully remote programme of type 2 diabetes structured education are among the latest technologies selected to join the NHS Innovation Accelerator (NIA).
A total of 11 innovations have been selected as part of an event to launch the third year of this NHS England initiative, delivered in partnership with England’s 15 Academic Health Science Networks (AHSNs).
The NIA has supported the uptake and spread of 25 high-impact, evidence-based innovations across 799 NHS organisations since it launched in July 2015.
Each of the new innovations joining the NIA this year offer solutions to key challenges in primary care, urgent and emergency care and mental health. Recruitment onto the NIA follows an international call and robust selection process, including review by a collegiate of over 100 assessors and the National Institute for Health and Care Excellence (NICE).
Simon Stevens, NHS England chief executive said: “Modern medicine is on the cusp of a huge shift in how care is delivered, and practical innovations like these show how NHS patients will now directly benefit. More tests and patient monitoring will be done at home or on the move, without the need to pitch up to a doctor’s appointment or hospital outpatients.”
My Diabetes My Way is an interactive website for people with condition, providing comprehensive information about medication, self-management and lifestyle. online self-management platform for people with diabetes. Recent figures suggested that 88 per cent of users, felt it had helped them Continue reading

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Animal Models of Type 2 Diabetes: The GK Rat

Animal Models of Type 2 Diabetes: The GK Rat
Animal Models of Type 2 Diabetes: The GK Rat
Studying the long-term complications of diabetic pathology is more relevant than ever, driving increased interest in animal models of type 2 diabetes. According to the World Health Organization (WHO) the number of people with diabetes (includes both type 1 and type 2) has risen from 108 million in 1980 to 422 million in 2014.
"[Diabetes] is a major cause of blindness, kidney failure, heart attacks, stroke, and lower limb amputation. Over time, diabetes can damage the heart, blood vessels, eyes, kidneys, and nerves. Adults with diabetes have a 2-3-fold increased risk of heart attacks and strokes. Combined with reduced blood flow, neuropathy in the feet increases the chance of foot ulcers, infection and eventual need for limb amputation. Diabetic retinopathy is an important cause of blindness and occurs as a result of long-term accumulated damage to the small blood vessels in the retina. 2.6% of global blindness can be attributed to diabetes. Diabetes is among the leading causes of kidney failure." (WHO Media Center, 2016).
There are a variety of mouse and rat models which can be used to study aspects of type 2 diabetes:
Varying aspects and severity of complications
+ More robust diet induced obesity in C57BL/6NTac (Gareski T, 2009)
Studying Long-term Pathology in Animal Models of Type 2 Diabetes
The ob/ob and db/db mice, as well as the Zucker Diabetic Fatty rat, are all well-characterized and frequently-used diabetic models which exhibit a mutation in the leptin (ob/ob) or lep Continue reading

Top tips: type 2 diabetes

Dr Kevin Fernando provides top tips on diagnosing and managing type 2 diabetes and identifying people at high risk
identifying people at risk of developing type 2 diabetes and gestational diabetes
tailoring the HbA1c target to the individual
structured education programmes and educational resources that can help patients to self-manage their diabetes.
The State of the nation 2016 (England)time to take control of diabetes report from Diabetes UK warns that 5 million people in England are at high risk of developing type 2 diabetes mellitus (T2DM).1 High-quality evidence from several international diabetes prevention studies shows that early lifestyle intervention can reduce both long-term progression to T2DM,2 and long-term incidence of cardiovascular and all-cause mortality.3 Based on the evidence from five large-scale and tightly controlled randomised trials,3 the NHS Diabetes Prevention Programme46 was launched during 2016 to provide individualised lifestyle support for those at high risk of T2DM.
1 Identify people who are at high risk of T2DM on your practice register
NICE Public Health Guideline (PHG) 38 Type 2 diabetes: prevention in people at high risk recommends the use of a risk-assessment tool such as the QDiabetes-2016 risk calculator to identify patients at high risk of T2DM.7,8 The tool calculates an individuals 10-year risk of developing diabetes; in general, 10% or above is considered high risk.7
NICE PHG38 provides a useful flowchart (see Figure 1, below) outlining recommended interventions for patients at various levels of risk of T2DM:8
if low/medi Continue reading

Resistance Training for Diabetes Prevention and Therapy: Experimental Findings and Molecular Mechanisms

Resistance Training for Diabetes Prevention and Therapy: Experimental Findings and Molecular Mechanisms
1Institute for Nutritional Sciences and Physiology, University for Health Sciences, Medical Informatics and Technology, A-6060 Hall in Tirol, Eduard Wallnoefer-Zentrum 1, Austria
2Department of Internal Medicine, Yale University School of Medicine, 333 Cedar Street, New Haven, CT 06510, USA
1Institute for Nutritional Sciences and Physiology, University for Health Sciences, Medical Informatics and Technology, A-6060 Hall in Tirol, Eduard Wallnoefer-Zentrum 1, Austria
2Department of Internal Medicine, Yale University School of Medicine, 333 Cedar Street, New Haven, CT 06510, USA
Received 2013 Oct 31; Accepted 2013 Dec 9.
Copyright 2013 B. Strasser and D. Pesta.
This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
This article has been cited by other articles in PMC.
Type 2 diabetes mellitus (T2D) is characterized by insulin resistance, impaired glycogen synthesis, lipid accumulation, and impaired mitochondrial function. Exercise training has received increasing recognition as a cornerstone in the prevention and treatment of T2D. Emerging research suggests that resistance training (RT) has the power to combat metabolic dysfunction in patients with T2D and seems to be an effective measure to improve overall metabolic health and reduce metabolic risk factors in diabetic patients. However, there is limited Continue reading

Surgical cure for type 2 diabetes by foregut or hindgut operations: a myth or reality? A systematic review

, Volume 31, Issue1 , pp 2537 | Cite as
Surgical cure for type 2 diabetes by foregut or hindgut operations: a myth or reality? A systematic review
Bariatric surgery results in remission of type 2 diabetes mellitus in a significant proportion of patients. Animal research has proposed the foregut and hindgut hypotheses as possible mechanisms of remission of T2DM independent of weight loss. These hypotheses have formed the basis of investigational procedures designed to treat T2DM in non-obese (in addition to obese) patients. The aim of this study was to review the procedures that utilise the foregut and hindgut hypotheses to treat T2DM in humans.
A systematic review was conducted to identify the investigational procedures performed in humans that are based on the foregut and hindgut hypotheses and then to assess their outcomes.
Twenty-four studies reported novel procedures to treat T2DM in humans; only ten utilised glycated haemoglobin A1c (HbA1c) in their definition of remission. Reported remission rates were 2040% for duodenaljejunal bypass (DJB), 7393% for duodenaljejunal bypass with sleeve gastrectomy (DJB-SG), 62.5100% for duodenaljejunal bypass sleeve (DJBS) and 4795.7% for ileal interposition with sleeve gastrectomy (II-SG). When using a predetermined level of HbA1c to define remission, the remission rates were lower (27, 63, 0 and 65%) for DJB, DJB-SG, DJBS and II-SG.
The outcomes of the foregut- and hindgut-based procedures are not better than the outcomes of just one of their components, namely sleeve gastrectomy. The complexity of these procedures in additio Continue reading