Type 1 diabetes: Time to act to raise standards of care

Abstract

Most people with diabetes are now treated and monitored in primary care, where GPs and practice nurses have become confident in initiating and adjusting insulin. Consequently, the distinction between type 2 and type 1 diabetes has become blurred with the risk that the specialist needs of people with type 1 diabetes may be overlooked. The National Diabetes Audit has demonstrated year on year that people with type 1 diabetes do much worse than their type 2 peers when structured education, care processes, treatment targets and mortality are measured. The paediatricians, faced with similar audit results, have set an example by introducing a Best Practice Tariff (BPT) to raise standards of care for children with diabetes. The recent publication of 'Type 1 Diabetes Through the Life Span", a position atatement from the American Diabetes Association (ADA), emphasises the specialist needs of people with type 1 diabetes and sets out in detail the standards of care people of all ages should expect. Diabetes organisations in the UK should follow the lead of the ADA by specifying the service requirements which will ensure all people with type 1 diabetes can access the high quality care they need to help them avoid the debilitating complications of their condition.