Diabetes - Type 1 Diabetes Mellitus in Adults Refresh
About this Priority Setting Partnership
The treatment of type 1 diabetes centres around insulin administration and the management of complications or co-morbidities that can also arise.
In 2011 a PSP in the area of type 1 diabetes published its list of research priorities. By 2023, the number of people being diagnosed with type 1 diabetes had increased and advances in the technologies available for monitoring blood glucose and delivering insulin meant that the treatment landscape had changed significantly since 2011. The Type 1 Diabetes Mellitus in Adults refresh PSP re-evaluated the priorities of the diabetes community and those involved in their care, to ensure that priorities are current and a representation of the needs of patients, carers and clinicians.
The Type 1 Diabetes Mellitus in Adults refreshed Top 10 was published in August 2024.
Top 10 priorities
The most important questions
- Can the use of artificial intelligence or fasting acting insulins help achieve fully closed loop insulin delivery?
- Is time in range a better predicter of diabetes management and complications compared to HbA1c (an average reading of blood sugar over a 3-month period)?
- What impact do hormonal phases such as the perimenstrual period and menopause play in glycaemic management and what treatments are most effective for managing glucose levels around these times?
- What interventions are the most effective for reducing diabetes related distress and burnout?
- What are the long-term implications of frequent hypoglycaemia on physical and mental health?
- What impact does type 1 diabetes (including frequent low blood sugar) have on memory and cognition in older adults?
- How can health care professionals better take into account the physical, psychological and social aspects of type 1 diabetes in clinics?
- How can access to potential therapies like stem cell therapy, transplants and medications that modify the immune systems be improved so that everyone with type 1 diabetes can be guaranteed access?
- Why do some people with type 1 diabetes become insulin resistant and does resistance increase with the number of years a person has diabetes and if so why?
- Can technology assist to accurately count carbohydrates without having to weigh or measure all foods and drink?
The following questions were also discussed and put in order of priority at the workshop:
- What practical, emotional (including peer support) and financial supports do adults with type 1 diabetes need most (including support in school/workplace)?
- How much does glucose variability contribute to complications?
- Aside from managing blood glucose levels, what other measures can be taken to predict/prevent complications?
- What impact do protein and fat have on blood glucose and should insulin dosing include protein and fats or carbohydrate alone?
- Does later onset type 1 diabetes have different triggers than younger onset?
- Do adults with type 1 diabetes and good glycaemic management have similar or worse long term outcomes than those without diabetes?
- Does stress or stressful situations impact glucose levels in the day-to-day and long-term?
- As people with type 1 diabetes do not produce amylin, C-peptide, ghrelin, glucagon and somatastin could supplements of these proteins/hormones improve time in range?
- What is the most effective form of carbohydrate counting for people with type 1 diabetes?
Key documents
These documents set out the aims, objectives and commitments of the PSP.
Type 1 Diabetes Mellitus in Adults refresh PSP protocol
Type 1 Diabetes Mellitus in Adults refresh PSP Steering Group terms of reference