Update of the Consensus Report on the Management of Type 1 Diabetes in Adults

00:00:00: Diabetes Insights, Breakthroughs and Innovators.

00:00:04: The EASD TV podcast from the annual meeting of the European Association for the Study of Diabetes.

00:00:13: This year's EAS-D Congress has seen a new consensus report on type one diabetes And with me to discuss it are Richard Holt and Kerstin Nogurd.

00:00:25: I hope i've got that nearly right from Copenhagen.

00:00:28: And first of all, Richard it's always slightly confusing consensus guidelines.

00:00:34: Where does this fall in the hierarchy?

00:00:38: So when we're thinking about the guidance documents that come from EASD there is as you say a hierarchy.

00:00:44: so right at the very top Is the guideline and We know That At This Meeting Launched The First Ever EASd Guideline but rung down, if you like is the consensus reports.

00:00:55: And really the difference between them Is a methodology that's used to develop The different types of documents and the reason why You need to have both?

00:01:06: That the guideline is the most robust.

00:01:08: But it also takes a long time To actually developing lots of resources to develop.

00:01:14: in many ways the ESD needs to be more nimble for some topics.

00:01:18: so hence the creation Of the consensus report which has been produced in at least the update, it's being produced just nine months whereas the guideline took two years.

00:01:29: So this is a joint production isn't it?

00:01:31: It's The American Diabetes Association and its EASD And both of you are on the ESD side.

00:01:40: That that's correct.

00:01:41: so This was a joint venture with our colleagues over in the ADA from ADA and we've been meeting regularly online over the last nine months or so to create the update of The Consensus Report.

00:02:00: Okay, So the Last Consensus report was in the time of Covid.

00:02:05: how is this report different Kerstin?

00:02:08: From one that went before?

00:02:12: One thing to say it's that members were exactly same as on the first reports.

00:02:17: It's nice.

00:02:18: they all agreed too participate to update it.

00:02:21: And then we look carefully through the report, see what did we miss from last one and based on that included new topics first of all and also merged a couple.

00:02:34: not get too lengthy but also content had developed because treatment possibilities for type I diabetes changed over four years.

00:02:45: So for a person who's coming to this new, what would be the big thing that you'd immediately point out as being different?

00:02:55: I think we are stronger in our opinion about treatment which is one of my favourite chapters.

00:03:03: We're now strong saying that CDM is golden standard for treating type-one diabetes although not all people can afford it.

00:03:13: But it is golden standard because of the evidence that's so strong.

00:03:17: And next on the technology side, we have also emphasised that automated insulin delivery system are simply for most people with type one diabetes if they can afford it.

00:03:30: Okay Richard what else?

00:03:32: So we've added some new sections within the reports and this based on feedback which has been received.

00:03:39: So one of those sections is the management of obesity for people with type I diabetes.

00:03:44: We know that the rates of obesity among people with Type I diabetes are at least as high in their general population, and there were additional challenges from managing obesity on people who have Type I Diabetes because things like hypoglycemia or hyperinsulinemia.

00:04:02: so it was important to include a specific section about that.

00:04:06: We've also included two new sections on diabetes-related complications.

00:04:11: So first, we have a section on the identification and assessments of microvascular complications—the INERV kidney complications.

00:04:20: And in the First Consensus Report, we specifically avoided that not because we didn't think it was important but because so much specific to type one diabetes rather than generically diabetes, but we had very strong feedback from our readership that they would like guidance within the consensus report.

00:04:44: So we included that in the update and similarly We also have guidance around the management of cardiovascular risk factors.

00:04:54: And give me the full pitch now, both of you each view as to why it's important that your members should be reading this... Reading marking learning and immediately digesting at this document.

00:05:07: So I think she'll do ladies first?

00:05:09: Yes

00:05:09: okay.

00:05:10: So first of all, it's really a good paper.

00:05:12: If you are less familiar with treating type one diabetes we have simply everything included in that paper and its all up-to-date reference wise.

00:05:26: so the bases are really really good I think is something people should be familiar with.

00:05:32: So State Of The Art very understandable written incomprehensive language fully referenced.

00:05:38: So I think, and obviously the reports have tremendous implications for individual clinicians.

00:05:45: But also it has a broader perspective as well.

00:05:48: so if we look at the original report that was published in twenty-twenty one We know its been cited academically over a thousand times In just four years which is an amazing number of citations Over short period time.

00:06:04: but of course academic citation exactly where we want to go.

00:06:08: We want to see implementation and changing clinical practice, so we know that the consensus reports in provision of guidance improves the variation in care but it also has impact for payers and for policymakers.

00:06:25: And just to give you one example about how the first Consensus report had an impact I Know from colleagues at NHS England when they were producing the UK guidance about use of continuous glucose monitoring.

00:06:41: They actually reference the EASD ADA consensus report, so we very much hope that with the update this time not only will it improve individual care but also continue to drive service improvements for the management of people with type one diabetes.

00:06:58: Fantastic,

00:06:59: very good adverts there for this consensus!

00:07:03: There'll be more from ESDTV in a moment.

00:07:06: Thank you for joining us on the podcast of The European Association For The Study Of Diabetes.

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