Diabetes

The NHS is currently facing supply issues with glucagon-like peptide receptor agonists (GLP-1 RAs), a range of drugs used for managing blood glucose levels in people with type 2 diabetes. This includes Dulaglutide, Exenatide, Semaglutide, Liraglutide, Lixisenatide.

Unfortunately, there are widespread national stock shortages which may affect supply of these medications at your pharmacy. This may not be the case for everyone during this time.

If you are a patient taking GLP-1 RA for type 2 diabetes, please read this information leaflet. 

NHS Kent and Medway have been chosen to trial the NHS Type 2 Diabetes Path to Remission programme, aimed at people with type 2 diabetes. The 12-month weight loss programme begins with a 3-month period where the patient is placed on a soup and shake diet.

Along with supplementary lifestyle advice and education, the trial shows significant weight loss in this period which provides an opportunity for remission. The trial officially begun in April 2022 and will last for two years. 

Further information, including the eligibility criteria, can be found here or by contacting your GP.

If you are at risk of developing type 2 diabetes, and are over 18 and not pregnant, then you are eligible for the NHS Diabetes Prevention Programme. Eligibility can be confirmed via a blood test or using the diabetes 'know your risk' tool.

This programme provides education about exercise, diet and mental health, along with providing other advice which can help reduce the chances of developing diabetes. The sessions are primarily held local venues, offering the patient an interactive education course and the opportunity to help keep diabetes at bay.

myDiabetes is an online platform which provides access to educational support for those with diabetes. The service, is provided by my mhealth.

Following a referral from a GP or clinician, patients are asked to fill in details, such as their blood glucose levels or BMI, to tailor the delivery of the service to their needs.

Upon being referred by a clinician, you can access the myDiabetes platform by visiting https://mymhealth.com/mydiabetes or download the application on an iPhone or Android device.

Alternatively, you can scan the QR code to complete a self referral form: 

An albumin to creatinine ratio (ACR) test helps to detect kidney damage and is an important part of the annual diabetes review.

People with diabetes in Kent and Medway now have the option to complete their annual ACR urine test via a home test kit that works with a smartphone app.

The Healthy.io ‘Minuteful kidney test’ can be completed in approximately three minutes, with the results sent straight to the GP.  

Eligible patients will be contacted by their GP. They will be sent a text message with a link to download the smartphone app.

Soon after a ‘Minuteful kidney test’ will arrive in the post, along with instructions explaining how to complete the test.

If patients need any further help or information, the Healthy.io patient support team can be contacted seven days a week on 0207 183 7939. 

Further information can be found below. If you have diabetes and would like to find out more, please speak to your GP.

What is the test? 

It is an albumin to creatinine ratio (ACR) test. An ACR test is part of your annual diabetes review.

The test looks for particles of protein in your urine called albumin, which may suggest the first sign of chronic kidney disease (CKD). 

What is CKD?

CKD affects one in 10 adults, and the most common causes of CKD are diabetes and high
blood pressure.

CKD is an ongoing condition where your kidneys do not work as well as they should.

Untreated CKD significantly increases your risk of developing cardiovasculardisease, which may lead to heart attacks and strokes. If untreated, CKD can progress to kidney failure.

Why should I complete this test?

One of the earliest markers of CKD can be detected by an ACR test.

Early identification and treatment of CKD can slow down or stop kidney damage before it's too late, so it is
important to monitor albumin levels for patients who have CKD or are at risk of CKD.

When should I complete this test?

Once you have downloaded the app, please complete this test the next morning (or as
soon as possible) using your first urine of the day. The testing process will take between
three to five minutes to complete.

Is the test safe and/or accurate?

The test is completely safe and clinically accurate. It is completed from home, and the results are only shared with your GP practice.

The service complies with all relevant legislation and the ‘Minuteful kidney test’ app has been approved by NHS England.

Is it easy to complete?

Yes. 92 per cent of people who have done the ‘Minuteful kidney test’ have found it ‘easy’ or ‘very easy’ to complete, giving it a rating of 4.8 stars on Google Play, and 4.7 stars on the App Store.

 
People over 100 years old have completed the test from home, with one patient recently describing their experience said: “…so much better than having to take a urine sample into my doctors or the hospital. The app guides you through a simple process. Love this new innovation.” 

I don’t have a smartphone, what do I do?

If you have access to a smartphone via a friend, relative, neighbour or carer, you can complete the test this way. If this isn’t possible, your GP practice will be in touch to organise your urine test at the practice.

What do I do with my results? 

Once you have completed the test at home using the smartphone app, your results are automatically sent to your GP practice, so you don’t need to do anything.

There is no need to call your GP practice, or visit them, your GP will follow-up if needed. 

I have an abnormal result, what does this mean? 

This means that the test has detected protein in your urine. You don’t need to worry, your GP practice will be in touch to follow-up on your result. 

Continuous glucose monitoring (CGM) and flash devices allow patients to check their sugar (glucose) levels at any time to see if it is too high or low. It can help patients control their blood glucose levels, as they'll have more information and can act quickly.

The technology reduces the need for finger-prick testing by giving patients a continuous stream of real-time information on a smartphone about current blood glucose levels.

Those eligible for CGM in Kent and Medway include:

• Children with type 1 diabetes
• Children who are already receiving treatment and have moved into adult services
• Adults with type 1 diabetes who are currently using an isCGM device may be able to switch to a rtCGM device. This includes Dexcom One, Glucomen Day or GlucoRx Aidex. Please discuss this with the specialist at your next routine appointment

Please note, patients are unable to claim back payments for self-funded CGM.

The FreeStyle Libre 3 system is not available on prescription. Please contact your hospital team for further information.

The National Institute for Health and Care Excellence (NICE) has recommended the use of real-time continuous glucose monitoring (rtCGM) for adults and children living with type 1 diabetes. 

Intermittently scanned glucose monitoring (isCGM) devices – also known as flash monitoring – has been recommended for patients with type 1 diabetes and adults with type 2 diabetes on insulin therapy.

Funding for adults with type 1 diabetes and eligible type 2 patients on insulin therapy is being considered for 2023/24. We are looking at pathways around this now – in anticipation of future roll out. Further information will be published when it becomes available. 

The Diabetes Education Referral Hub is for people who have received a diabetes diagnosis (Type 1 or Type 2) and would benefit from structured education and those with non-diabetic hyperglycaemia, who are eligible for the National Diabetes Prevention Programme.

The hub is not just for people that are newly diagnosed, anyone in Kent and Medway who has been diagnosed with diabetes can use the hub to access to structured education courses to help them with their illness.

Patients being referred to the service must be 18 or over.  If a patient is under 18, they fall under paediatric diabetic care, which the hub does not support.

You can ‘self-refer’ yourself to the Diabetes Education Referral Hub by visiting the hub’s website and creating an account.

If a referral is made by a clinician, Spirit Healthcare, who have created and manage the hub, will contact the patient’s GP to obtain the required diagnosis and medical information.

Upon receiving the information, they will then contact the patient and provide them access to book education diabetes courses.

The Diabetes Education Referral Hub can be found at www.diabetes-education-km.co.uk/

Please note that Type 1 diabetes courses, which are held face to face, are not available due to lockdown restrictions. Once restrictions are lifted the website will be updated. 

Face-to-face help for people living with or at risk of diabetes is returning as Covid-19 restrictions begin to ease.

Tailored remote services offer video conferences that provide people with the same information as in-person sessions but are delivered on a smaller scale and via a smartphone or computer. This allows people to get information and advice about their diet, exercise and lifestyle where there are individual issues with attending a face-to-face session.

The online National Diabetes Prevention Programme (NDPP) sessions complement the digital support that is already available as part of the programme.

Find information about the apps and online support available below.

The DigiBete app and website offers education, training and support resources for children and young people with type 1 diabetes.

Adults living with type 1 diabetes can access videos and online courses to help manage their condition through the MyType1Diabetes platform. 

Healthy Living is a free online programme clinically proven to help people with type 2 diabetes live well. It provides information and support to help participants adopt healthy lifestyle choices.

The Lower My Drinking website and smart phone application enables users to check their alcohol consumption and find out how it is affecting their health. It supports users to make lifestyle changes to boost physical and emotional wellbeing.

My Quit Route is an application which provides expert advice and scientifically proven tools to help quit smoking.