Research and Audit

ABCD’s Research and Audit Activities

Our activities in research and audit since the year 2000 are summarized below.  For the history of the ABCD nationwide audit programme click here

2016  
The second ABCD endobarrier study - the End-OSA study The endobarrier in obstructive sleep apnoea study of patients with diabetes and obstructive sleep apnoea treated CPAP aims to see if the weight loss associated with endobarrier treatment allows some patients with OSA to improve so much that they no longer require CPAP. This would not only be of considerable benefit to the patient, but also would represent an NHS cost saving. The first patient in the study received their endobarrier on 3 June 2016 and this triggered a BBC news item. Click the link on the left for more information.
The ABCD multi-centre endobarrier study - REVISE Diabesity This study, entitled “REVISE-Diabesity” is a multi-centre randomised controlled trial evaluating the effectiveness of a new device called endobarrier on patients who remain poorly controlled and overweight despite GLP-1 receptor agonist therapy. It is funded by ABCD and is supported by the NHS, as a National Institute for Health Research (NIHR) approved study. As of April 2016 the study achieved it's 1 year results which were presented at ENDO 2016 and the ABCD Spring meeting in Manchester and the slides from this can be viewed by ABCD members. The results triggered a BBC news item. there is a webcast of the 1-year results including assessment of impact on 10-year cardiovascular risk from the presentation at ADA 2016. Click the link on the left for more information.
Nationwide canagliflozin audit The nationwide Invocana® audit launched in January 2016 as a second SGLT2 audit hosted on N3 - the the national broadband network for the NHS. All users of canagliflozin are invited to join the audit. Click the link on the left for more information. Click here to join the canagliflozin, dapagliflozin and exenatide qw audits with a single application.
2015  
National audit of DKA management The results of this audit, which started in 2014, and which we believe is the largest ever national survey on the management of DKA ever conducted, were published in Diabetic Medicine in February 2016 in a paper and a letter. They showed that most hospitals (71%) who returned data used the JBDS guidelines (2a and 2b). The most common precipitant for DKA was infection and a third of patients had at least 1 previous episode of DKA in the previous year. Of some concern was that 7.8% of all of the reported cases occurred in existing inpatients. The guidelines are used well during the first hour after admission; however, later during the hospital admission, observations were not carried out as often as recommended. In addition, a significant minority developed hypoglycaemia and 55% developed hypokalaemia at some stage. It was difficult to know if this was because the guidelines for fluid, glucose and electrolyte replacement was not being followed as recommended, or if it was the guideline that was at fault. Click the link on the left for more information.
2014  
Nationwide insulin degludec audit The nationwide Tresiba® audit launched at the ABCD autumn meeting in November 2014. All users of insulin degludec are invited to join the audit. Click the link on the left for more information.
Nationwide dapagliflozin audit The nationwide Forxiga® audit launched in October 2014 as a second audit hosted on N3 - the the national broadband network for the NHS. All users of dapagliflozin are invited to join the audit. Click the link on the left for more information. Click here to join the dapagliflozin and exenatide qw audits with a single application.
IDOP and ABCD care homes audit The Institute of Diabetes for Older People (IDOP) in association with ABCD has led a national stakeholder audit of diabetes care in care homes. Responses from more than 2000 care homes in England revealed important gaps in screening for diabetes, hypoglycaemia care, and the training and education of care staff in the area of diabetes. The results of this audit have been passed to the Care Quality Commission to assist them in developing inspection processes for care homes. The report was published in June 2014 - click the link on the left.
Nationwide exenatide qw audit The nationwide Bydureon® audit launched in April 2014. The great step forward for this audit is that it is the first ABCD audit to be hosted on N3 - the the national broadband network for the NHS. All users of exenatide QW are invited to join the audit. Click the link on the left for more information.
Nationwide liraglutide audit - ongoing since 2009 The audit is ongoing and now has over 6000 patients. There have been several presentations at national and international meetings and there are papers published and being written. The audit tool was upgraded in 2012 to become secure online/web-based. All users of liraglutide are invited to join the audit.
ABCD Scottish audit of inpatient diabetes care - ongoing since 2009 An audit of Inpatient Diabetes Care across NHS Lothian: The effectiveness of the use of information technology, the Scottish Patient Safety Programme and ‘Think Glucose’. The results to date were presented at ABCD autumn meeting in 2013 and the slides from that presentation are available to ABCD members
2013  
ABCD multi-centre study of urinary C-peptide in liraglutide treated patients ABCD multi-centre urinary C-peptide study aimed to relate initial beta-cell function to response to liragutide. It was led by previous ABCD research fellow, Dr Ken Thong. The study showed that postprandial urinary C-peptide creatinine ratio (UCPCR ) was associated with the subsequent glycaemic response to liraglutide treatment, but a clear cut-off UCPCR level that would help predict a favourable glycaemic response was not identified. The results were presented on a poster at the ABCD Autumn meeting, 2013 and the full results werepublished in Diabetic Medicine in December 2013.
ABCD/JDRF/Diabetes UK Insulin Pump Audit - 2011-2013 The joint ABCD/JDRF/Diabetes UK Insulin Pump Audit for the UK surveyed diabetes centres in the UK, to establish basic data on numbers and type of insulin pump starts and follow up, and availability and use of CGMS. The audit was published on May 14, 2013, and revealed that the proportion of people in the UK who live with type 1 diabetes and use a pump. Publication was accompanied by a press release from JDRF and Diabetes UK, giving their reaction to the audit’s findings and headlined “UK lagging behind Europe for use of insulin pumps”.
2012  
ABCD audits in 2012 All the audits started or continuing during 2012 continued beyond that year
2011  
Nationwide exenatide audit 6717 patients (2007-2009), 315 contributors, 126 centres.  Several papers now published with more still being written and there have been many presentations at national and international.
2010  
TITAN-ACS study THE TITAN-ACS STUDY is a joint venture between ABCD, NHS Diabetes, British Cardiovascular Society, Myocardial Ischaemia National Audit project (MINAP). It is a Trial of Intravenous Insulin Infusion in the Management of Hyperglycaemia in Acute Coronary Syndrome.
2009  
Pre-conception care and diabetes the impact of QoF This audit for which ABCD provided sponsorship in 2007-2008 was presented at the ABCD Spring meeting in 2009. It looked at the care of women with diabetes following the introduction of QoF. It found that there are a significant number of women with diabetes aged under 50. They have significant co-morbidity. Their treatment is aimed at reducing long term cardiovascular disease rather targeting more appropriate age specific risk.
2008  
Nationwide audit of confidence among junior doctors in the UK in management of diabetes A national audit on confidence levels, current practice and perceived training needs of junior doctors in the UK. The audit concluded that trainee doctors in the UK lack confidence in the management of diabetes, are unlikely to take the initiative to optimize glycaemic control and report a need for further training. The project led to two abstracts for posters, 2 presentations at national meetings and 3 papers, the main publication being in QJM in 2010.
2007  
ABCD multi-centre audit of hyperglycaemia management in ACS A multi-centre pilot audit of hyperglycaemic management in acute coronary syndrome stimulated by the contrasting findings between DIGAMI 1 and 2. Glycaemic care was found to be variable within and between centres.
Nationwide exubera audit This audit launched in 2007 was never completed because Exubera was taken off the market
2006  
Nationwide audit of glitazone use with insulin A nationwide audits undertaken in 2005 and presented as a poster at the ABCD meeting in Glasgow in 2006. The audit found that in extreme insulin resistance some, but not all, patients responded to the combination
Nationwide audit of triple OHA use in insulin avoidance A nationwide audits undertaken in 2005 and presented as a poster at the ABCD meeting in Glasgow in 2006. The audit demonstrated that the addition of glitazones to metformin and sulphonylureas was often very effective and allowed insulin to be avoided or postponed.
Second national survey of UK specialist diabetes services As a follow up to the survey carried out in 2000 this survey aimed to assess the extent of changes following the introduction of national service frameworks and changes in commissioning. The results can be viewed through several presentations and publications
ABCD sponsored audit of hypoglycaemia in the community This audit found that between 25 and 40% of ambulance call-outs for hypoglycaemia are taken to A&E and approximately 40% of these were admitted. There was poor communication between ambulance / A&E and the diabetes team. An update from the audit was presented at the ABCD Autumn Meeting, 2012.
2005  
ABCD survey of inpatient diabetes services in the UK Of 262 Acute hospitals surveyed 239 (91.2%) provided data. The survey identified substantial gaps in in-patient diabetes care in the UK. However a rapid increase in DISN indicated increasing attention to in-patient diabetes care. The results were published in Diabetic Medicine in 2007.
Nationwide audit of gestational diabetes screening A national audit of gestational diabetes screening and glycaemic management. The findings were published in QJM in 2008 and showed that standards for GDM screening and management vary significantly across the UK.
2004  
Nationwide audit of glargine in pregnancy This audit was published in Diabetic Medicine in 2008 and suggested that the use of glargine in Type 1 diabetes during pregnancy was not associated with any unexpected adverse maternal or fetal outcome.
2000  
First national survey of UK specialist diabetes services An ambitious but successful attempt to assess the state of diabetes specialist services at the turn of the century. The survey was carried out in 1999 and extensive results are given covering all aspects of diabetes