GUILDFORD, England, February 3, 2016 /PRNewswire/ --
- Almost a million serious medical complications could be avoided, potentially avoiding billions in future NHS costs(1) -
Sanofi, Diabetes UK and JDRF today announce the publication of IMPACT 2 in the journal Diabetic Medicine. This new study shows that, if sustained, even modest improvement in blood glucose(*) levels can provide significantly improved outcomes for the 3.5 million(2) people diagnosed with diabetes in the UK. As a result, if applied to the whole diabetes population, almost a million serious medical complications, such as blindness, amputation and kidney failure could be avoided over 25 years, improving the lives of people with diabetes.(1) Better management of blood glucose levels over the same period could equate to a cost avoidance of £5.5 billion for the NHS.(1)
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IMPACT 2 is a study based on data and population modelling. It is the outcome of a collaboration between Diabetes UK, JDRF and Sanofi, and the analysis was completed by IMS and the York Health Economics Consortium. It quantifies the patient and financial benefit over 25 years of earlier intervention for better controlling blood glucose. The findings highlight results that could have a significant impact for people with diabetes and NHS budgets:(1)
Chris Askew, Diabetes UK Chief Executive commented, "IMPACT 2 demonstrates that even small improvements in blood glucose levels can result in huge benefits for people with diabetes with the potential to stop 23,000 people suffering severe kidney failure, almost 160,000 leg ulcers and amputations and over 50,000 people suffering severe loss of vision. This should be a priority for all those involved in providing care for people with diabetes." He continued, "Preventing Type 2 diabetes through public health initiatives is of course the best way of reducing spend long-term, however much greater efforts are needed to ensure all people with diabetes get the support and care they need for a good quality of life and better health outcomes."
Karen Addington, Chief Executive of JDRF in the UK, agreed, adding, "People with Type 1 diabetes are routinely still receiving poorer care and are less likely to be meeting NICE recommended blood glucose targets, when compared to people with Type 2 diabetes. The IMPACT 2 results show the benefit to people living with Type 1 diabetes and the NHS in providing appropriate care, support and education to help people manage their condition."
The report is published against a backdrop of blood glucose management in the UK being amongst the worst in Europe and around two thirds of all people with diabetes in England not achieving the treatment targets recommended by National Institute for Health and Care Excellence (NICE).(3,4) In addition, despite well-documented benefits of reducing complications through timely control of blood glucose, levels are too high before additional interventions are provided. On average, people in the UK with Type 2 diabetes have the highest blood glucose levels (HbA1c 9.8%) when compared to nine other developed countries, at the point of insulin initiation.(4)
"The scale of the findings have important implications for clinical practice in the NHS. In a cost- constrained healthcare system, interventions, medical or otherwise, will always be required to justify any improvement in patient outcome against cost. For the first time clinicians have clear evidence of the reduction in spending that could be conferred by reducing serious diabetes related complications through better blood glucose control," says Professor Steve Bain, Professor in Medicine (Diabetes), University of Swansea.
NHS spend on diabetes is already considerable and on the increase. IMPACT 1 showed that diabetes costs the NHS £10 billion each year - around £1 million an hour - which is about 10% of the entire NHS budget.(5) Nearly 80% of these costs are attributable to treating avoidable complications, which could potentially be reduced through better management of diabetes, including improved blood glucose control.(3) Diabetes is now the leading preventable cause of sight loss in people of working age in the UK and 135 amputations are carried out every week as a result of poor management of the condition.(2,6)
"Diabetes is a major healthcare problem with a large and increasing number of people in the UK suffering from avoidable microvascular complications such as kidney disease and foot amputations because their blood glucose levels are too high. IMPACT 2 quantifies the reduction in the number of complications, and the potential cost avoidance if modest improvements to patients' blood glucose levels were made. There is the potential to generate real improvements in outcomes for patients with diabetes by making even small but sustained improvements in their blood glucose levels," explains Dr Mike Baxter, Consultant Advisor to Sanofi Diabetes and lead author of the study.
Diabetes in the UK
There are 3.5 million people in the UK currently diagnosed with diabetes and if current trends continue, approximately five million people will have diabetes by 2025.(2) It is predicted that 11.9 million people in the UK are at risk of Type 2 diabetes.(2) Additionally, it is believed that there are approximately 549,000 people in the UK who have Type 2 diabetes but do not know it as they have not yet been diagnosed.(2) The estimated split between people with Type 2 and Type 1 diabetes is 90:10.(2)
Diabetes is a condition where there is too much glucose in the blood because the body cannot use it properly. If not managed well, both Type 1 and Type 2 diabetes can lead to devastating complications. Diabetes is the leading cause of preventable sight loss in people of working age in the UK and is a major cause of lower limb amputation, kidney failure and stroke.(2)
People with Type 1 diabetes cannot produce insulin.(2) Type 1 diabetes is treated by daily insulin doses - taken either by injections or via an insulin pump - a healthy diet and regular physical activity.
People with Type 2 diabetes do not produce enough insulin or the insulin they produce isn't being used properly (known as insulin resistance). Type 2 diabetes occurs because family history, age, ethnic background and lifestyle factors put someone at increased risk. The most potent risk factor for Type 2 diabetes is obesity.(2) Type 2 diabetes is initially treated with a healthy diet and increased physical activity. Over time, tablets and/or insulin may be required.
About IMPACT 2
IMPACT 2 is a collaboration between Diabetes UK, JDRF and Sanofi, and the analysis was completed by IMS and the York Health Economics Consortium. The data from IMPACT 2 builds upon the IMPACT 1 report (published in 2012) and is published in Diabetic Medicine as Estimating the impact of better management of glycaemic control in adults with Type 1 and Type 2 diabetes on the number of clinical complications and the associated financial benefit.(1)
The IMPACT 2 study used the IMS Core Diabetes Model - a simulation model that predicts long- term health outcomes and costs associated with the management of diabetes - to estimate the complications reduced and potential for financial saving, over a 25-year period when improving blood glucose control by set values for people with diabetes. The model used real world patient data to ensure that the estimates were as representative of the UK clinical practice as possible.(1)
The IMPACT 2 model estimates the impact of improvements in blood glucose control on complications and direct healthcare costs in patients with Type 1 and Type 2 diabetes and does not make allowances for the cost of delivering the necessary interventions in order to achieve that tighter blood glucose control. Therefore the potential savings in real terms would be dependent on the costs of implementing programmes or interventions to achieve tighter blood glucose control and would depend on the nature and level of those interventions.
IMPACT 2 only evaluates the benefits of improved blood glucose management. Better cholesterol and blood pressure management would also result in substantial additional benefits for people with diabetes and the NHS.(7)
About Diabetes UK
Diabetes UK is the leading UK charity that cares for, connects with and campaigns on behalf of all people affected by and at risk of diabetes. For more information on all aspects of diabetes and access to Diabetes UK activities and services, visit http://www.diabetes.org.uk. For more information on reporting on diabetes, download our journalists' guide: http://www.diabetes.org.uk/journalists-guide
About JDRF
JDRF exists to find the cure for Type 1 diabetes and its complications, and is the world's leading charitable funder of Type 1 diabetes research. At a global level JDRF volunteers and staff have been responsible for raising over £1 billion to support Type 1 diabetes research since the charity's inception. http://www.jdrf.org.uk
About Sanofi Diabetes
Sanofi Diabetes strives to help people manage the complex challenge of diabetes by delivering innovative, integrated and personalised solutions. Driven by valuable insights that come from listening to and engaging with people living with diabetes, the Company is forming partnerships to offer diagnostics, therapies, services and devices, including blood glucose monitoring systems.
Sanofi markets both injectable and oral medications for people with Type 1 or Type 2 diabetes.
About Sanofi
Sanofi, a global healthcare leader, discovers, develops and distributes therapeutic solutions focused on patients' needs. Sanofi has core strengths in diabetes solutions, human vaccines, innovative drugs, consumer healthcare, emerging markets, animal health and Genzyme. Sanofi is listed in Paris (EURONEXT: SAN) and in New York (NYSE: SNY).
References
* The term blood glucose refers to the glucose that is transported through the bloodstream supplying energy to all the cells in the body. Blood glucose is not derived entirely from sugars but also from the carbohydrates in food. This is why it is advised that the term blood glucose is used instead of blood sugar.
* Modelling for the Impact II study was based on statistics available at the time of analysis (2014)
The Impact Diabetes programme has been developed in partnership with Diabetes UK, JDRF, and Sanofi Diabetes and is funded by Sanofi.
1. Baxter et al, Estimating the impact of better management of glycaemic control in adults with Type 1 and Type 2 diabetes on the number of clinical complications and the associated financial benefit. Diabetic Medicine. (Accepted for publication)
2. Diabetes UK Facts and Stats. 2015. Available at: https://http://www.diabetes.org.uk/Documents/Position%20statements/Diabetes%20UK%20Facts%20and%20Stats_Dec%202015.pdf [Accessed January 2016]
3. Diabetes UK. State of the Nation: Challenges for 2015 and beyond. Available at: http://www.diabetes.org.uk/Documents/About%20Us/What%20we%20say/State%20of%20the%20nation%202014.pdf [Accessed January 2016]
4. Khunti K et al. Study of Once Daily Levemir (SOLVETM) insights into the timing of insulin initiation in people with poorly controlled Type 2 diabetes in routine clinical practice. Diabetes, Obesity and Metabolism (2012)
5. Hex et al. Estimating the current and future costs of Type 1 and Type 2 diabetes in the UK, including direct health costs and indirect societal and productivity costs. Diabetic Medicine (2012).
6. Public Health England Diabetes Foot Activity Profiles. Available at: http://www.yhpho.org.uk/diabetesprofilesfoot/default.aspx [Accessed January 2016]
7. Committee of Public Accounts. Department of Health: The management of adult diabetes services in the NHS. 2012. Available at: http://www.publications.parliament.uk/pa/cm201213/cmselect/cmpubacc/289/289.pdf [Accessed January 2016]
Date: January 2016
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