Are the updated NICE guidelines just an academic exercise?
The InDependent Diabetes Trust express concern that the new NICE guidelines relating to Type 1 diabetes may be ignored.
The InDependent Diabetes Trust welcomes the updated NICE guidelines relating to Type 1 diabetes. We appreciate that they are evidence-based but we are concerned that they may be ignored.
There is already a situation where many people with Type 1 diabetes are not achieving the existing targets for blood glucose levels (HbA1cs), leaving them at risk of serious complications. Suggesting that lowering these targets even further can be achieved with the support of structured education programmes seems unrealistic when the National Diabetes Audit 2012/13 showed that only 4% of newly diagnosed people were offered such a programme. For children and young people with Type 1 diabetes there is not even a nationally agreed education programme.
Again, we fully support the updated guidelines on foot care for people with Type 1 diabetes, however, 27.7% of people with Type 1 diabetes are not being given an annual foot check to prevent amputations, 80% of which could be avoided with appropriate care. The proposal that active foot problems should be referred to a multidisciplinary foot care service is, of course, correct but many people cannot obtain an appointment with their GP at such short notice, which can only mean attendance at AE, something which is being discouraged by the NHS.
To add to this catalogue of lack of care, only 41% of adults with Type 1 diabetes are receiving the 9 key annual health checks recommended by NICE. For children and young people, only 16.1% are receiving the 7 annual health checks they should receive.
With respect to NICE and its remit, we have to wonder if the updated guidelines are an academic exercise which cannot be put into practice unless there are major changes in the strategy for the care and treatment of people with Type 1 diabetes.