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14 November 2018

World Diabetes Day

Diabetes

Approximately 400,000 people in the UK are living with type 1 diabetes, with over 29,000 being children and young people ^[1]. Type 1 diabetes affects 96% of all children with diabetes in England and Wales, with incidences increasing by approximately 4% each year.

Globally, the UK has the fifth highest rate of type 1 diabetes diagnosis in children (aged up to 14) with 85% of these children having no family history of the condition. Whilst the condition isn’t fatal and can be managed, it cannot be cured. Type 1 diabetes increases the risk of developing other health problems such as heart disease, stroke, foot and circulation problems, sight problems including blindness, nerve damage and kidney problems. However, many of these related conditions are preventable and it is recommended to stabilise blood sugar levels, attend diabetes appointments regularly and complete a diabetes course to educate patients and family members and prevent the risk of further help complications^[2].

Diabetes in children

Children under five are at the highest risk of developing diabetic ketoacidosis due to a late diagnosis and it is also thought to be due to of lack of public knowledge of the signs and symptoms attributed to type 1 diabetes. Such symptoms include:

Frequent urination as the kidneys are trying to expel excess sugar in the blood, resulting in dehydration which leads to extreme thirst.
Increased hunger or unexpected weight loss because the body is unable to attain enough energy from food
Slow healing cuts as high blood sugar levels can affect blood flow which can cause nerve damage.
Fatigue as the body is unable to convert sugar into energy
Irritable behaviour combined with other symptoms can be a means of concern

Diabetes and the NHS

Diabetes costs the NHS approximately £9.8 billion per year, an estimate of 10% of total expenditures. Hospital admissions of children and young people with diabetes presents a considerable burden on themselves, their families and the NHS. It is estimated that approximately 80% of these cases are potentially avoidable.

A report produced by the National Paediatric Diabetes Audit found that although the numbers of admissions didn’t significantly differ year to year, it highlighted differences in terms of socio-economic risk factors:

Living in a deprived area increases the risk of hospital admissions which can be attributed to lack of education in the community about diabetic symptoms and the management of diabetes.
Children below 5 years of age have a 35% increased risk of hospitalisation compared to those aged 5-9
Females have a 33% increased risk of developing type 1 diabetes compared to males.
Children with poor diabetes control have a twelve-fold increased risk of hospital admission
Insulin pump users have a 27% increased risk of hospital admission compared to those who use insulin injections.

Figure A. Number of preventable paediatric diabetes admissions ^[3]

Prevention

There are campaigns in place to aid in the early diagnosis of type 1 diabetes which mainly focus on raising awareness of the signs and symptoms of diabetes. On this World Diabetes Day, it is important to know that it is not just simply the responsibility of the diabetic patient to prevent admission but the main responsibility lies with the diabetic teams that inform the families with children who are diagnosed with type 1 diabetes.

Paediatric diabetes teams should ensure that the families and the children receive structured education for self-management when diagnosed and throughout the illness. In doing so, the diabetic teams should implement blood ketone testing from diagnosis and utilise the nationally agreed hypoglycaemia management guidelines. It is also important that diabetic teams are fully aware of the patient characteristics associated with a greater risk of admission and that they use this knowledge to develop anti-admission strategies specifically tailored to the needs of each individual group.

Primary care practitioners should seek access to a specialist diabetic team who they can refer to when deciding if a patient requires admission to hospital. Furthermore, they should access blood glucose and ketone testing to identify patients at risk of diabetic ketoacidosis that require hospital admission.

How Randox can Help

Randox offer a range of assays to diagnosis and monitor diabetes and to monitor associated complications. Some of these tests are unique to Randox, including:

Fructosamine

The Randox fructosamine assay employs the enzymatic method which offers improved specificity and reliability compared to conventional NBT-based methods. The Randox enzymatic method does not suffer from non-specific interferences unlike other commercially available fructosamine assays.

Learn more about the Randox Fructosamine test

D-3-Hydroxybutyrate (Ranbut)

The Randox D-3-Hydroxybutyrate (Ranbut) assay detects the most abundant and sensitive ketone in the body, D-3-Hydroxybutyrate. The Randox Ranbut assay is used for the diagnosis of ketosis, more specifically diabetic ketoacidosis. Other commercially available tests, such as the nitroprusside method, are less sensitive as they only detect acetone and acetoacetate, not D-3-Hydroxybutyrate.

Learn more about the Randox D-3-Hydroxybutyrate test

Adiponectin

The Randox adiponectin assay is a biomarker in diabetes testing as adiponectin is a protein hormone responsible for regulating the metabolism of lipids and glucose and influences the body’s response to insulin. Adiponectin levels inversely correlates with abdominal visceral fat levels.

Learn more about the Randox Adiponectin test

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References
[1] National Paediatric Diabetes Audit and Royal College of Paediatrics and Child Health, National Paediatric Diabetes Audit Report 2012-15: Part 2, 2017
[2] NHS, “Avoiding Complications” – Type 1 Diabetes, Available at: https://www.nhs.uk/conditions/type-1-diabetes/avoiding-complications/ [Accessed on 24^th October 2018].
[3] “Potentially Preventable Pediatric Hospital Inpatient Stays for Asthma and Diabetes, 2003-2012”, www.hcup-us.ahrq.gov, 2015. [Online] Available: https://www.hcup-us.ahrq.gov/reports/statbriefs/sb192-Pediatric-Preventable-Hospitalizations-Asthma-Diabetes.jsp [Accessed 08-Nov-18]

One of the fastest growing health threats of our times is diabetes. Type-2 diabetes is now among the most common long-term health conditions affecting people right across the globe. On World Diabetes Day we want to raise awareness of this particular condition – because it’s possible to spot warning signs and take steps to prevent it.

THE BACKGROUND

Since 1996, the number of people living with diabetes has more than doubled and type-2 diabetes is by far its most prevalent form. Though it is potentially reversible, using more advanced diagnostics, clinicians can diagnose pre-diabetes and enable patients to make lifestyle changes to avoid the condition from developing in the first place.

THE FUTURE

Adiponectin is a biomarker which can powerfully predict the development of pathologies such as Type 2 Diabetes Mellitus (T2DM) and cardiovascular disease (CVD). This biomarker can be tested as an automated biochemistry reagent from Randox.

With the global prevalence of diabetes continually rising in adults over 18 years of age, from 4.7% in 1980 to 8.5% in 2014, adiponectin should be an integral part of every laboratory’s testing panel. Randox Adiponectin will enable physicians and clinicians to accurately evaluate more individuals, with a convenient format for routine clinical use.

When risk is identified via adiponectin measurement, it is essential for individuals to carry out lifestyle modification to lower T2DM risk. This will also help to prevent the development of cardiovascular diseases and metabolic syndrome. This indicates that Randox automated adiponectin should be a routinely run test across the world.

OUR CASE STUDY – SIR AP MCCOY

Earlier this year Sir AP McCoy came to Randox Health. After a career dedicated to becoming the world’s most successful jockey, he was never going to leave the next stage of his life to chance. It was lucky he did: our advanced test for adiponectin was within the panel of tests run and was able to identify that AP was pre-diabetic.

Don’t leave your health to chance. 70% of cases of type-2 diabetes are preventable by adopting a number of lifestyle changes, so take action today.

For further information phone the Randox PR Team on 028 9442 2413, or email randoxpr@randox.com