9.00am to 9.15am: Opening remarks

Colette Marshall

9.15am to 10.00am: From prevention to possibility: what comes next for diabetes prevention

Speaker to be confirmed

The conference opens with the big question in diabetes prevention: how do we turn ambition into action? 

Prevention has never been more important in addressing the growing impact of diabetes. A senior healthcare leader will explore the opportunities and challenges across the UK, and what they mean for people, communities and health systems affected by diabetes.

Personal reflections on the development of GIP and incretin therapeutics for diabetes

This lecture will chart landmarks in the discovery of the incretin hormones, gastric inhibitory polypeptide (GIP) and glucagon-like peptide-1 (GLP-1), their actions and exploitation for obesity-diabetes therapy. The journey will highlight the pioneering contributions from Ulster to demonstrating the surprising therapeutic potential of GIP. It will consider the development of stable GIP analogues together with the early controversy generated by discovering beneficial effects of both GIP agonism and GIP antagonism. Subsequent demonstration of additive effects by the group of combining acylated long-acting analogues of GIP and GLP-1 in animal models of diabetes led to the early design and testing of proof-of-concept unimolecular dual (GIP/GLP-1) and triple (GIP/GLP-1/glucagon) agonists. These turned out to be forerunners of the industry-produced drugs, and such agents are currently enjoying much attention for obesity-diabetes. Incretin therapeutics also hold potential to address many of the associated complications such as cardiovascular disease, dementia, bone disorders and infertility.

The National Diabetes Audit (NDA) has formed the infrastructure for evaluating and guiding the implementation of the NHS England Diabetes Programme.  

In 2016, the NHS in England established the Healthier You: NHS Diabetes Prevention Programme (NHS DPP) to prevent or delay the onset of type 2 diabetes in adults diagnosed with prediabetes, and by 2018, the programme achieved nationwide coverage.  Independent evaluations which used NDA data have demonstrated reduced type 2 diabetes incidence in participants as well as at English population level associated with programme implementation. 

This session will focus on new, as yet unpublished, evaluations of type 2 diabetes risk for both the general population and population diagnosed with prediabetes, and assessments of the effectiveness of the NHS DPP using the NDA.  It will also give a broader international perspective on prediabetes, and updates on the NDA and the evolving NHS DPP

Specialisms: Community care, Specialist care, Primary care

Themes: Commissioning, Education, Service provision, Public health, Prevention

10:10 - 10:15: Chairs introduction - update on the NDA

Garry Tan, Consultant and Clinical lead, National Diabetes Audit

10:15 - 10:20: The evolving NHS DPP

Jonathan Valabhji, Clinical Chair in Medicine, Imperial College London

10:20 - 10:30: Prediabetes - an international perspective 

Kamlesh Khunti, Professor of Primary Care Diabetes and Vascular Medicine, University of Leicester

10:30 - 10:45: Variations in the incidence of type 2 diabetes in England and in the response to the National Health Service Diabetes Prevention Programme

Emma Barron, Imperial College London, NHS Chelsea and Westminster Trust 

10:45 - 10:50: Panel discussion and questions

Jonathan Valabhji, Clinical Chair in Medicine, Imperial College London

Kamlesh Khunti, Professor of Primary Care Diabetes and Vascular Medicine, University of Leicester

Emma Barron, Imperial College London, NHS Chelsea and Westminster Trust 

Garry Tan, Consultant and Clinical lead, National Diabetes Audit

Chair: Garry Tan, Consultant and Clinical lead, National Diabetes Audit

Specialisms: Specialist care, Paediatrics

Themes: Children & young adults, Diabetes lived experience, Psychology & wellbeing, Health inequalities & equity

Deep dive into the successes and challenges of Diabetes UK’s Together Type 1 programme, with insights into engaging young people living with type 1 and practical suggestions on how to build inclusive opportunities for young people to access peer support and wellbeing initiatives.

40 min

Specialisms: Clinical science, Specialist care, Paediatrics

Themes: Technology & innovation, Obesity in diabetes, Dietetics & nutrition 

11:50 AM - RESET: achieving remission of early onset type 2 diabetes

Tom Yates, Professor in Physical Activity and Health, University of Leicester

12:10 PM - Fully closed loops: who can benefit?

Charlotte Boughton, Assistant Research Professor, Institute of Metabolic Science, University of Cambridge

12:30 PM - When type 1 is not type 1 (and type 2 is not type 2)

Nick Thomas, Clinical lecturer, University of Exeter

Chairs:

John Petrie, Professor of Diabetes and Director of Clinical Trials, University of Glasgow

Helen Colhoun, AXA Professor of Medical Informatics and Life Course Epidemiology, University of Edinburgh

This session will discuss the importance of physical activity, with a focus on the results from Refocus-ise. It will also discuss the MiFoot project (seated exercise for those with foot ulceration) and focus on pathway and guidance on exercise for those living with diabetes. The session closes with a 20-minute interactive panel discussion featuring Sam Whittle, Vicki Johnson, Julia Burdon, Nusrat Kausar (dietitian) and Joelle Baynham (podiatrist).

11:50 - 12:10 Refocusise....Welcome to Diabetes Rehabilitation

Samantha Whittle, Diabetes Clinical Nurse Specialist, University Hospitals Dorset NHS Foundation Trust

12:10 - 12:30 - Exercise in type 2 diabetes-related foot ulcer disease: Expert considerations & the MiFoot study

Vicki Johnson, Lead Research Associate for Complex Interventions, University Hospitals of Leicester NHS Trust

12:30 - 12:50 Interactive Panel discussion

Samantha Whittle, Diabetes Clinical Nurse Specialist, University Hospitals Dorset NHS Foundation Trust

Vicki Johnson, Lead Research Associate for Complex Interventions, University Hospitals of Leicester NHS Trust

Nusrat Kausar, Clinical Director and Dietitian (Primary Care Dietitians / BHR PCN)

Joelle Baynham, Consultant Podiatrist - Diabetes Inpatients, University Hospitals Dorset NHS Foundation Trust

Julia Burdon, Education and Research Associate, Chartered Physiotherapist, Leicester Diabetes Centre, University Hospitals of Leicester NHS Trust

Chair: Julia Burdon, Education and Research Associate, Chartered Physiotherapist, Leicester Diabetes Centre, University Hospitals of Leicester NHS Trust

This session will explore the “next big thing” in diabetes through three complementary lenses: disease-modifying therapies in type 1 diabetes (T1D), next-generation incretin-based pharmacotherapy in type 2 diabetes (T2D), and fully automated device systems.

Case discussions of people with positive diabetes autoantibodies, staging of diabetes, eligibility for Teplizumab (possibly), dietetic advice, when to start insulin etc

Neurodiversity and Diabetes: Delivering Equitable Care. Discussions on CYP and across all age groups.

An interactive session exploring where to find evidence and how to use it best to inform multi-professional service developments and business planning to improve outcomes for people with foot problems and diabetes

14:10  - Finding and creating the data; the NDFA and beyond

Professor Fran Game 

14:20 - Using the data to develop limb salvage interventions 

Helen Milnes, Consultant Podiatric Surgeon, University Hospitals Birmingham 

14:30 -  ACT NOW to empower people with diabetes

Nadine Price, Diabetes Specialist Podiatrist, Gillian Hanson Diabetes Centre, Whipps Cross Hospital

Chairs:

Jayne Robbie, Specialist Podiatrist, University Hospitals Birmingham NHS Trust

Joelle Baynham, Consultant Podiatrist, Diabetes Inpatients and Deputy NMP Lead, Bournemouth

Neighbourhood health, integration of diabetes services, specialist support and workforce development

Medicines and medical devices go through rigorous approval systems before they are placed on the market for use. However, post-market vigilance identifies safety issues that may only occur in certain patient populations, certain circumstances or that are rare and therefore not observed in clinical trials. To support a product’s positive benefit/risk profile in clinical practice, the MHRA applies a number of methods to monitor the safety of medicines, medical devices and blood components for transfusions on the market. Information on adverse events from users and healthcare professionals, literature and other sources are used in signal identification and trending activities, with quality checks built into escalation pathways leading to potential regulatory actions. With a focus on diabetes medicines and medical devices, the presentation will exemplify the importance of patient and healthcare professional reporting of adverse events, whilst exploring how reporting to manufacturers and reporting MHRA is linked and where it differs. Elements of how potential safety signals are assessed will be discussed, including escalation routes and the relevance of stakeholder input. The presentation will show examples of safety signal outcomes and engage with the audience on what additional resources it might consider helpful to further support the safe use of products.

14:05 - 14:20 Diabetes Management Devices: ensuring a positive benefit/risk balance in advancing technologies

Inga Bellahn PhD, Head of Metabolic Disorders and Renal Systems, Benefit Risk Evaluation team II, Safety and Surveillance, Medicines and Healthcare Products Regulatory agency

14:20 - 14:35 Post-marketing pharmacovigilance of Diabetes medicines: a case study

Jenn Matthissen, Head of Gastrointestinal system, nutrition, endocrine & fertility, Benefit/Risk Evaluation Team II, Safety and Surveillance, Medicines and Healthcare Products Regulatory agency

14:35 - 14:45 Questions and Answers 

Inga Bellahn PhD, Head of Metabolic Disorders and Renal Systems, Benefit Risk Evaluation team II, Safety and Surveillance, Medicines and Healthcare Products Regulatory agency

Jenn Matthissen, Head of Gastrointestinal system, nutrition, endocrine & fertility, Benefit/Risk Evaluation Team II, Safety and Surveillance, Medicines and Healthcare Products Regulatory agency

Chair: Partha Kar, Consultant Physician, Portsmouth Hospitals NHS University trust

Link in with our Diabetes UK North of England team and fellow professionals to explore our work and collaborate on future opportunities. Connect, share, or simply sit back and listen.

Chair: Thomas Lambert, Healthcare Engagement & Systems Change Manager, Diabetes UK

Specialisms: Clinical Science

Themes: Technology & Innovation

Pregnancy-specific HCL rollout and improved maternal/neonatal outcomes

The presentations will educate and include a tailored approach to the management of pancreatic type 3c diabetes, provide an update of autologous islet cell transplantation for patients with pancreatic diabetes including recent outcomes from Leicester. Exploring PEI (pancreatic exocrine insufficiency) across all forms of diabetes; how to screen and when to treat and will delve into the relationship between diabetes and pancreatic cancer including discussion of the UK-EDI trial results. This symposium will bring together national experts in the field of pancreatic diabetes to discuss the best practice for the management of patients with this form of diabetes. It is suitable to a wide range of specialists including primary and secondary care colleagues, including dieticians, diabetic nurses, diabetologists, gastroenterology and hepatobiliary. The symposium will shine a light on this. 

14:55 - 15:10 Beyond standard diabetes care: a tailored approach to Type 3c Diabetes

Dr Philip C Johnston MD FRCP, Consultant Diabetes and Endocrinology, Honorary Lecturer Faculty of Medicine, Health and Life Sciences, Queens University Belfast, Regional Centre for Endocrinology and Diabetes, Royal Victoria Hospital

15:10 - 15:25 TP-IAT the Coming of Age

Ashley Dennison, Professor of HPB Surgery, University Hospitals of Leicester, Leicester HPB Unit

15:25 - 15:40 The Forgotten Pancreas: Exocrine Insufficiency in Diabetes 

Laura McGeeney, Diabetes Specialist Dietitian, Cambridge University Hospitals NHS Foundation Trust

15:40 - 15:55 Using the link between Pancreatic Cancer-related diabetes to inform early cancer detection

Eithne Costello, Professor of Molecular Oncology, University of Liverpool

Chair: Zaed Hamady, Consultant Hepatobiliary, Pancreatic, and Robotic Surgeon, University Hospital Southampton NHS Foundation Trust

Professor John Wilding, Professor of Medicine, Honorary Consultant Physician, Aintree University Hospital, Liverpool

This interactive session will explore how to improve access to self-management education (SME) for people living with early-onset type 2 diabetes. 

This interactive workshop will focus on developing advanced consultation skills for clinicians working with people with diabetes, co-facilitated by diabetes psychologists and young people with lived experience from the Together Type 1 project. 

Running order:

1. A lived experience presentation about what ‘good care’ looks like from the receiving end

2. A practical session to demonstrate advanced communication skills, with tips to take home

3. A presentation from a Diabetes UK clinical champion who has successfully introduced more holistic approaches in clinic

4. Q&A session for problem-solving and sense-testing ideas

Every clinician is asked ""should I exercise?"", and most answers are about avoiding hypoglycaemia. This session reframes activity as something that can improve glucose, tests whether that holds outside the lab, gives clinicians a tool to judge safety before exercise, and ends with the practical barriers, above all for children. It brings together new trial results, new paediatric data and a view from the charity sector in one hour. Learning outcomes.

By the end of the session, delegates will be able to:

1. Distinguish the evidence that activity improves glucose under controlled conditions from the evidence that an activity prescription works in daily life, in type 1 and type 2 diabetes.

2. Use starting glucose, trend arrow and planned duration to discuss hypoglycaemia risk before exercise with an adult or child with type 1 diabetes.

3. Name the main barriers to physical activity for children and young people with type 1 diabetes, and one action they can take locally to reduce them.

16:55 - 16:58 - Welcome and introduction by chairs

Professor Noel Morgan, Editor-in-Chief, Diabetic Medicine

Professor Rob Andrews, University of Exeter

16:58 - 17:08 - Moving to lower glucose: what we know, and what we don't

Breaking up sitting is established practice in type 2 diabetes. In type 1 diabetes, short walks every 30 minutes raised time in range in a laboratory trial without increasing hypoglycaemia, and about 20 minutes of everyday activity lowered a high glucose by a mean 2.2 mmol/L (40 mg/dL) in a matched analysis of 1,546 activity bouts. That is efficacy. Effectiveness in daily life is untested.

John Pemberton, Diabetes Dietitian, Birmingham Women's and Children's NHS Foundation Trust

17:08 - 17:20 - EXTOD-Active: first results

A randomised controlled trial of real-world active breaks, 3 minutes of walking every 30 minutes through the working day, with time in range as the primary outcome in sedentary adults with type 1 diabetes.

Joseph Jenkins, School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham

17:20 - 17:35 - GlucoseGo: predicting hypoglycaemia before exercise, in adults and now in children

A traffic-light tool built from 16,430 exercise sessions in people aged 12 to 80, using three things a person can see before they start: starting glucose, trend arrow and planned duration. Then new data in children under 12 (Exeter, unpublished).

Catherine Russon, Data Scientist, University of Exeter Medical School

17:35 - 17:47 - Hypoglycaemia should not be the barrier: getting children and young people with type 1 diabetes moving

What stops children and families, including stigma, where sport's governing bodies fall short on type 1 diabetes policy, and what clinicians, clubs and schools can do next.

Chris Bright, Breakthrough T1D UK

17:47 - 17:55 - Questions from the floor with all speakers

Chairs:

1. Professor Noel Morgan, Editor-in-Chief, Diabetic Medicine

2. Professor Rob Andrews, University of Exeter Medical School

60 min

This session will provide a critical and up-to-date overview of developments in the field of Type 1 Diabetes and disordered eating (T1DE), focusing on the gap between clinical need and available services and current research and clinical developments.

16: 55 - 17:00: Chair's opening remarks

Hilary Nathan, Director of Policy and Communications, Breakthrough T1D

17:00 - 17:15: What Happened?

Sarah Alicea, Clinical Lead – Type 1 Diabetes & Eating Disorders (T1DE), Barts Health NHS Trust & North East London ICB

17:15 - 17:30: What Now?

Dr Marietta Stadler, Clinical Senior Lecturer & Hon Diabetes Consultant, King’s College London

17:30 - 17:45: What next?

Dr Rose Stewart, Consultant Clinical Psychologist & National Lead for Adult Diabetes Psychology, Betsi Cadwaladr University Healthboard & NHS Wales Performance and Improvement Unit

17:45 - 17:55: Panel Discussion & Chair's Closing Remarks

Sarah Alicea, Clinical Lead – Type 1 Diabetes & Eating Disorders (T1DE), Barts Health NHS Trust & North East London ICB

Dr Marietta Stadler, Clinical Senior Lecturer & Hon Diabetes Consultant, King’s College London

Dr Rose Stewart, Consultant Clinical Psychologist & National Lead for Adult Diabetes Psychology, Betsi Cadwaladr University Healthboard & NHS Wales Performance and Improvement Unit

Chair: Hilary Nathan, Director of Policy and Communications, Breakthrough T1D

The increasing availability of C-peptide, diabetes antibody and genetic testing has meant that an increasing number of people living with diabetes find that their initial diabetes diagnosis was incorrect. How can we as primary and secondary care clinicians explain the new diagnosis in a way that causes least psychological harm? How can we best support those struggling with a new diagnosis and change in treatment? 80% of people diagnosed with MODY initially received an alternative diagnosis and Maggie Shepherd has many years of clinical and research experience supporting people living with a new MODY diagnosis and their families. Claire Howells is an expert by experience who was diagnosed with T1DM after 30 years of being told she had T2DM. DSN Tamsin Fletcher will share her experience of supporting patients in this situation, and specialist diabetes psychologist Vicky McKechnie will give practical advice for non-psychologist clinicians and those with lived experience in supporting others adjusting to a new diabetes diagnosis.

4.58 - Supporting individuals with monogenic diabetes who were previously misdiagnosed and received unnecessary insulin treatment

Maggie Shepherd, Consultant nurse in Monogenic diabetes and honorary clinical professor, University of Exeter 

5.10pm - DSN experience of supporting people with misdiagnosis

Tamsin Fletcher, lead DSN University Hospital of North Midlands, Director DSN Forum 

5.22pm - Interview with Claire Howells regarding her lived experience of finding out she had T1 after many years of living with assumed T2DM

Claire Howells

5.34pm - Overview and practical skills for non-psychologists

Dr Vicky McKechnie, Highly Specialist Clinical Research Psychologist, Imperial College London

Chairs:

Kriss Owen, GP partner and clinical lead for diabetes Derby and Derbyshire ICB

Emma Wilmot, Associate Professor and Honorary Consultant Diabetologist, University of Nottingham and University Hospitals of Derby and Burton

60 min

Lost between two specialties? Reconnecting eye care and diabetes care

Diabetic retinopathy is often managed through separate diabetes and ophthalmology pathways, leaving patients navigating multiple services with limited coordination. This interactive workshop will bring together people living with diabetes, ophthalmologists, diabetologists and diabetes healthcare professionals to explore how care can be better integrated. Using patient experiences and facilitated discussion, delegates will identify practical solutions to improve communication, shared care and patient outcomes across the diabetes-eye care pathway.

16:55 to 17:00 - Welcome and Introduction

Dr Becky Thomas, Senior Lecturer in Population Health and Medical Sciences, Swansea University

17:00 - 17:10 - Lived experience perspective: navigating diabetes and eye care  

Person living with diabetes and diabetic retinopathy - Speaker to be confirmed

17:10 - 17:15 - Ophthalmology perspective: what happens after referral 

Peter Scanlon, Consultant Diabetologist, Gloucestershire Hospitals NHS Foundation Trust

17:15 - 17:20 - The diabetology perspective: why eye disease matters beyond vision 

Dr Garry Tan, Consultant and Clinical Lead, National Diabetes Audit

17:20 - 17:40 - Interactive group exercise: where does care become fragmented

All speakers

17:40 - 17:50 - Feedback and discussion: building a more connected pathway

All speakers

17:50 - 17:55 - Key messages and close

All speakers

Chair: Dr Becky Thomas, Senior Lecturer in Population Health and Medical Sciences, Swansea University

60 min