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Type 1 Diabetes
A JLA Priority Setting Partnership

Type 1 diabetes occurs when the amount of glucose in the blood is too high. It is a leading cause of kidney failure, adult blindness, stroke, heart attacks and nerve damage leading to amputation. There are many unanswered questions about the treatment of type 1 diabetes.

Since the JLA’s inception, people working in diabetes have been interested in how JLA methods could be used to determine research priorities in diabetes. Staff at NHS Evidence Diabetes have added treatment uncertainties to UK DUETs. These have included research recommendations from a variety of sources, and from members of the Insulin Dependent Diabetes Trust (IDDT). More recently IDDT, the Juvenile Diabetes Research Foundation, the Diabetes Research Network, and the JLA facilitated an exploratory workshop in June 2009, with other interested organisations, to explore treatment uncertainties in type 1 diabetes. To see the summary of the workshop click here. For a copy of the Full workshop report click here

With the aim of influencing the research agenda, the James Lind Alliance Type 1 Diabetes Priority Setting Partnership worked with patients and clinicians to identify and then prioritise gaps in the evidence base that affect decisions on treating and managing type 1 diabetes. This work was being taken forward in a transparent and inclusive way with financial support from the Insulin Dependent Diabetes Trust, and practical support from the JLA, the Diabetes Research Network, Diabetes UK, Juvenile Diabetes Research Foundation, NHS Evidence - diabetes and the Scottish Diabetes Research Network.

The Type 1 Diabetes Priority Setting Partnership held their final priority setting workshop in May 2011. To see a the workshop report click here. The workshop culminated in agreement between patients, carers and clinicians on the top 10 priorities for research into treatment for type 1 diabetes, and one overarching research aspiration:

Overarching research aspiration: Is stem cell therapy an effective treatment/cure?

1. Is it possible to constantly and accurately monitor blood sugar levels, in people with type 1 diabetes, with a discrete device (non-invasive or invasive)

2. Is insulin pump therapy effective? (immediate v deferred pump, and comparing outcomes with multiple injections)

3. Is an artificial pancreas for type 1 diabetes (closed loop system) effective?

4. What are the characteristics of the best type 1 diabetes patient education programmes (from diagnosis to long term care) and do they improve outcomes?

5. What are the cognitive and psychological effects of living with type 1 diabetes?

6. How can awareness of and prevention of hypoglycaemia in type 1 diabetes be improved?

7. How tightly controlled do fluctuations in blood glucose levels need to be to reduce the risk of developing complications in people with type 1 diabetes?

8. Does treatment of type 1 diabetics by specialists (e.g. doctors, nurses, dieticians, podiatrists, ophthalmologists and psychologists) trained in person-centred skills provide better blood glucose control, patient satisfaction and self-confidence in management of type 1 diabetes, compared to treatment by non specialists with standard skills?

9. What makes self management successful for some people with type 1 diabetes, and not others?

10. Which insulins are safest and have the fewest long term adverse effects?

Evaluation of the Type 1 Diabetes Priority Setting Partnership