Publication, Part of National Diabetes Audit, Type 1 Diabetes
National Diabetes Audit, 2020-21, Type 1 Diabetes
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16 June 2022 09:30 AM
Glucose control, structured education, continuous glucose monitoring and insulin regimen
Structured Education
NICE* recommends that people with type 1 diabetes should be offered structured education 6 to 12 months after diagnosis. If this has not been undertaken within 12 months, it should be offered at any time that is clinically appropriate and suitable for the person, regardless of duration of type 1 diabetes.
- Higher proportions of adults who had a record of attending structured education can be seen in the low and medium HbA1c groups (up to 53 mmol/mol and 54-69 mmol/mol respectively)
- Across duration groups the profile is similar for “attendance recorded” and “attendance not recorded” groups, although a significantly higher percentage of those with a record of attending structured education had been diagnosed for less than 10 years
HbA1c groups by Use of Continuous Glucose Monitoring (CGM), insulin regimen and structured education
* A technical data extraction issue has meant that flash glucose data was not available for Wales for 2020-21, so Wales was not included in CGM breakdowns
Comparing the group of adults with the lowest levels of HbA1c (up to 53 mmol/mol) with the group who had the highest HbA1c (>69 mmol/mol):
- a significantly higher proportion were on CGMs
-
a significantly higher proportion were using an insulin pump
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a significantly higher proportion had a record of attending structured education
- A total of 58,810 adults with type 1 diabetes were on basal bolus and had an HbA1c result of higher than 69 mmol/mol, making them eligible for an insulin pump, according to NICE criteria
Use of Continuous Glucose Monitoring (CGM), insulin pump and recorded structured education by demographics
* A technical data extraction issue has meant that flash glucose data was not available for Wales for 2020-21, so Wales not included in CGM breakdowns
Use of CGM or insulin pumps and recorded attendance at structured education are not distributed evenly across age bands, deprivation quintiles or ethnicity groups within the overall profile of the adult type 1 population
Table 4: Ethnicity profile of adults who have accessed CGM, insulin pump, structured education compared to overall type 1 breakdown, England and Wales*, 2020-21.
| Ethnicity group | All type 1 diabetes | Pump use | CGM use | Structured education attended |
| Asian | 3.6 | 2.2 | 2.9 | 3.4 |
| Black | 2.4 | 1.0 | 1.5 | 2.1 |
| Mixed/Other | 2.2 | 2.1 | 2.0 | 1.9 |
| White | 83.9 | 88.0 | 89.2 | 88.9 |
| Unknown | 7.9 | 6.8 | 4.4 | 3.6 |
* A technical data extraction issue has meant that flash glucose data was not available for Wales for 2020-21
Distribution of insulin pump use and flash glucose monitoring by CCG/LHB
These maps illustrate that there is considerable geographical variation in the percentages of type 1 adults who are using insulin pump technology, and flash glucose monitoring.
Map 2: Percentage of adults with type 1 diabetes in each CCG/LHB who are on insulin pump, England and Wales, 2020-21
Map 3: Percentage of adults with type 1 diabetes in each CCG who are on flash glucose monitoring, England, 2020-21*
* A technical data extraction issue has meant that flash glucose data was not available for Wales for 2020-21, so Wales was not included in CGM breakdowns
- The percentage using insulin pump technology ranged from 4% in Mid Essex CCG to 30% in Cwm Taf Morgannwg ULHB
- The percentage using flash glucose monitoring ranged from 13% in Bolton CCG to 55% in Morecambe Bay CCG
Last edited: 3 October 2024 8:13 am