15
NEWS
Unacceptable inequalities
New data reveals improving outcomes in adults with
Type 1 diabetes, but that those in more deprived
communities are falling behind.
New research shows
disparities in Type 1
diabetes (T1D) outcomes
between adults living in
the most and least deprived areas.
As a result, Diabetes UK has called
for a renewed focus on fair access to
diabetes technology and care.
Researchers from Imperial
College London analysed data from
the National Diabetes Audit (NDA),
a major clinical audit conducted by
NHS England in partnership with
Diabetes UK. The team analysed
trends in HbA1c levels from 2007 to
2023, in adults living in England with
T1D. HbA1c is an important clinical
measure that indicates how diabetes
is being managed.
The new findings highlight that
while the overall percentage of adults
with higher average blood glucose
(HbA1c >58 mmol/mol) has declined
from 72% in 2007 to 68% in 2023,
not everyone is benefiting equally.
The data shows that by 2023, 70% of
adults with T1D in the most deprived
areas had markedly high blood sugar
levels, compared to 56% in the least
deprived areas.
While the prevalence of T1D
is similar across all social groups,
inequalities exist in how the
condition impacts long-term
health. A study of the Scottish
T1D population estimated that
those living in the most deprived
areas would develop diabetes
complications five years sooner and
die eight years earlier than those
living in the least deprived areas.
Deprivation gap
Many factors are likely to contribute
to the deprivation gap in T1D
outcomes, and previous analyses of
NDA data has highlighted inequities
in diabetes care. For example, those
in the least deprived areas were more
likely to receive all eight essential
diabetes care checks than those in
the most deprived communities in
2023. Additionally, adults with type
1 diabetes in the least deprived areas
were more likely to use diabetes
technology than those in the most
deprived areas in 2022.
To help all people with T1D
live longer, healthier lives and
avoid complications, Diabetes UK
is calling for improved access to
comprehensive, regular diabetes
care, including fair access to
technology.
Head of Policy and Campaigns
at Diabetes UK, Helen Kirrane,
says, "This new analysis lays bare
the stark inequalities that persist
for adults with T1D. Last year,
the Darzi Review highlighted the
unacceptable inequalities in access
to essential care for people with T1D
The Government must take action
to address this issue in the NHS's
forthcoming 10-year health plan."
Research Fellow in Epidemiology
and Intervention Effectiveness
at Imperial College London, Dr
Naomi Holman, added, "This work
shows that whilst blood glucose
management has improved for adults
with T1D as a whole, the change has
not been equal for everyone that
needs it. This highlights the need to
look beyond high-level figures and
investigate how care and outcomes
change across different sections
of the population, and to consider
how changes in policy or healthcare
delivery may improve or widen
existing health inequalities."
Dr Garry Tan, Interim Clinical
Lead for the National Diabetes Audit,
pointed out that, "HbA1c levels
have improved for everyone living
with T1D compared to just before
the Covid-19 pandemic. However,
looking further back to 2007, these
improvements are mainly seen in
the most affluent areas. Expanding
access to technology in the coming
years will be crucial in reducing these
inequalities."
www.diabetes.org.uk
Image courtesy of Weronika Burkot of Blue Sugarcube fame.