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Improved Care and Support for Older People with Diabetes

Summary of the impact

The work of IDOP has resulted in:

  • Improved awareness of challenges posed by diabetes in older people among NHS commissioners and service providers
  • Greater recognition at national and international level of the importance of frailty in diabetes
  • Developing the growing national community network for practice and learning (ODN)
  • Publication of UK and European Guidelines for clinicians outlining better standards of diabetes care and best clinical practice
  • Improved service commissioning by creation and dissemination of specific guidance
  • Initiating major new national, European and global projects being initiated, attracting considerable funds, and providing the platform for enhanced diabetes care in older people (see www.instituteofdiabetes.org).

Submitting Institution

University of Bedfordshire

Unit of Assessment

Allied Health Professions, Dentistry, Nursing and Pharmacy

Summary Impact Type

Health

Research Subject Area(s)

Medical and Health Sciences: Clinical Sciences, Public Health and Health Services

Pre-diabetes and Type 2 diabetes: Risk-assessment tools for early detection and prevention

Summary of the impact

Around 2.5 million people in the UK have Type 2 diabetes, with many more in a pre-diabetic state, Both conditions are hard to detect and frequently remain undiagnosed and untreated for years. The cost burden to the NHS of eventual treatment is estimated at £10 billion; 80% of which is spent on complications that are, with good care, avoidable. Targeted diabetes prevention programmes could aid in prevalence reduction and associated costs. Leicester's Diabetes Research Centre has developed two risk scores, both suitable for use with an ethnically diverse UK population, to detect these conditions: a self-assessment questionnaire and a general practice database tool. Recommended by NICE, they have been used successfully in varied settings. Since July 2011, around 260,000 people have completed the self-assessment score online and more than 40,000 through other means.

Submitting Institution

University of Leicester

Unit of Assessment

Public Health, Health Services and Primary Care

Summary Impact Type

Health

Research Subject Area(s)

Medical and Health Sciences: Clinical Sciences, Public Health and Health Services

UOA01-18: Planning for a Future with Diabetes: Tools to Assess Diabetes Risk and Outcomes

Summary of the impact

We are facing a diabetes epidemic: the number of people affected worldwide is estimated to rise from 366 million in 2011 to 552 million by 2030, representing a huge financial burden on society. Using data from the United Kingdom Prospective Diabetes Study (UKPDS), the University of Oxford's Diabetes Trials Unit developed two assessment tools - the UKPDS Risk Engine (a diabetes-specific heart attack and stroke risk calculator) and the UKPDS Outcomes Model (a lifetime simulator for people with diabetes) to better understand and plan for diabetes risk and its outcomes on both individuals and society as a whole. Patients, clinicians and policymakers globally are now using these tools to assist in planning for future health economic needs, and for predicting health risks for people with diabetes.

Submitting Institution

University of Oxford

Unit of Assessment

Clinical Medicine

Summary Impact Type

Political

Research Subject Area(s)

Medical and Health Sciences: Clinical Sciences, Public Health and Health Services

QRISK – a new cardiovascular risk score to identify patients at high risk of cardiovascular disease for prevention

Summary of the impact

QRISK is a new algorithm which predicts an individual's risk of cardiovascular over 10 years. It was developed using the QResearch database and is in routine use across the NHS. It is included in national guidelines from NICE and the Department of Health and in the GP quality and outcomes framework. It is incorporated into > 90% of GP computer systems as well as pharmacy and secondary care systems. The web calculator has been used >500,000 times worldwide. ClinRisk Ltd was incorporated in 2008 to develop software to ensure the reliable widespread implementation of the QRISK algorithm into clinical practice.

Submitting Institution

University of Nottingham

Unit of Assessment

Public Health, Health Services and Primary Care

Summary Impact Type

Health

Research Subject Area(s)

Medical and Health Sciences: Public Health and Health Services

Statin Therapy: Patient Selection, Clinical Guidelines and revision of safety labelling

Summary of the impact

Over the past ten years, the prescription of cholesterol-lowering statins has soared and they are now the most prescribed drugs in the UK and the US. However, this has raised concerns about inappropriate prescribing. University of Glasgow research has been pivotal in addressing this issue and has triggered revision of major international guidelines to stratify patients in the general population for statin therapy and guide statin use in the rheumatoid arthritis patient population. The identification of a statin-associated risk for diabetes prompted the European Medicines Agency and the US Food & Drug Administration to revise safety labelling for all classes of statins. This risk is now communicated to the 27 million patients in the UK and US who are prescribed statins.

Submitting Institution

University of Glasgow

Unit of Assessment

Clinical Medicine

Summary Impact Type

Health

Research Subject Area(s)

Medical and Health Sciences: Cardiorespiratory Medicine and Haematology, Clinical Sciences, Public Health and Health Services

UOA01-17: Defining Type 2 Diabetes in the United Kingdom

Summary of the impact

The University of Oxford's United Kingdom Prospective Diabetes Study (UKPDS) was a landmark 30-year clinical trial, reported in over 80 academic research papers between 1983 and 2008. It showed beyond doubt that diabetic complications, previously thought to be inevitable consequences of the condition, could be delayed or prevented by improved treatment from the time of diagnosis. These findings have had a profound influence on the management of type 2 diabetes, clinical guidelines, and standards of care, and have reduced diabetes-related complications worldwide, lowering the incidence of blindness, kidney failure, amputation, heart attack and stroke.

Submitting Institution

University of Oxford

Unit of Assessment

Clinical Medicine

Summary Impact Type

Health

Research Subject Area(s)

Medical and Health Sciences: Clinical Sciences, Public Health and Health Services

The Safety of Nanotechnology in Fisheries and Aquaculture

Summary of the impact

Research on the environmental safety and toxicity of nanomaterials in fishes has had a global impact across both government and industry contributing to:

(i) Consensus building on biological effects allowing regulatory agencies/governments to make proper decisions on the hazard of nanomaterials to farmed fish and wildlife.

(ii) Critical evaluation of the internationally agreed process of toxicity testing to determine whether the current legislative test methods are fit for purpose and acceptable to the aquaculture industry.

(iii) Identification of national/international research priorities and policies via work with the OECD and the US Government.

(iv) Influencing government policy to support training and information for industry.

Submitting Institution

Plymouth University

Unit of Assessment

Agriculture, Veterinary and Food Science

Summary Impact Type

Environmental

Research Subject Area(s)

Technology: Nanotechnology
Medical and Health Sciences: Pharmacology and Pharmaceutical Sciences, Public Health and Health Services

The introduction of the Life Market, a global capital market for transferring longevity risk

Summary of the impact

The Life Market is a major new global capital market for transferring longevity risk from corporate pension plans and annuity providers to long-term capital market investors, such as sovereign wealth funds and endowments, in exchange for a longevity risk premium (paid to the investors by the institutions laying off their longevity risk). Previously, the only source of longevity risk hedging was the insurance industry which, given that so many people are living much longer than anticipated, now has insufficient capacity to deal with this risk (estimated at $25trillion) on a global basis. The size of their future pension liabilities now present serious threats to the solvency of many companies. The longevity bonds and swaps designed by Professor David Blake at the Pensions Institute at Cass Business School, City University London, were integral to the creation and operation of the Life Market. The adoption of these bonds and swaps by investors has served to establish a global capital market investor base contributing towards the long-term availability of longevity solutions, benefiting the insurance and pensions industries, employers and, in turn, employees through greater security of their pensions in retirement.

Submitting Institution

City University, London

Unit of Assessment

Business and Management Studies

Summary Impact Type

Economic

Research Subject Area(s)

Medical and Health Sciences: Public Health and Health Services
Economics: Applied Economics
Commerce, Management, Tourism and Services: Banking, Finance and Investment

The use of aspirin as a primary prophylaxis against cardiovascular events in patients with Diabetes

Summary of the impact

An eight year MRC-funded clinical trial led by the University of Dundee and run throughout Scotland (16 hospitals, 188 GP Surgeries) exploring aspirin in diabetes for primary cardiovascular event prevention, where clinical practice had evolved without evidence.

  • NHS: Implementation of results in general practices, hospitals, and Health Boards globally, by ceasing to prescribe aspirin as primary prevention in diabetes.
  • Policy: Resulted in major changes to international Guidelines globally e.g. American Diabetes Association Guidelines, Australian, New Zealand and Canadian Guidelines and Scottish Intercollegiate Guideline Network (SIGN).
  • Improved Patient Care and Health Outcomes: Reduction in aspirin prescribing with decrease in adverse events, reduction in concomitant proton pump inhibition prescribing.
  • Internationalisation: Implementation worldwide, by doctors and pharmacists with reports in lay publications, radio programmes, TV interviews and patient targeted websites.

Submitting Institution

University of Dundee

Unit of Assessment

Clinical Medicine

Summary Impact Type

Health

Research Subject Area(s)

Medical and Health Sciences: Cardiorespiratory Medicine and Haematology, Clinical Sciences, Public Health and Health Services

Exercise and quality of life improvements in different populations

Summary of the impact

This case study illustrates the development of novel research materials designed to improve quality of life and performance in different populations. Impact has been achieved through the use of research findings in professional practice, formulation of health-related policies and in the development of new indicators of health and well-being. RCSEP research has been used by international and national health-service organisations (e.g., European League Against Rheumatism, Evidence NHS), industrial establishments (e.g., ArtEZ Conservatoire, Netherlands; Royal Ballet), national governing bodies (British Heart Foundation), and professional bodies (e.g., Dance UK, International Association of Dance Medicine & Science).

Submitting Institution

University of Wolverhampton

Unit of Assessment

Sport and Exercise Sciences, Leisure and Tourism

Summary Impact Type

Health

Research Subject Area(s)

Medical and Health Sciences: Clinical Sciences, Public Health and Health Services
Studies In Creative Arts and Writing: Performing Arts and Creative Writing

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