Facing the Future: Ageing with type 1 diabetes and the need for change
The report cover pictured above shows my diabuddy Pete Davis. Inside the report, it reveals that older people living with type 1 diabetes are being failed by health and social care services. Breakthrough T1D UK are calling for urgent reform. A copy of this report can be downloaded by clicking the button below
Note: Photos used in this blog are copyright owned by Breakthrough T1D UK & used with permission. Except for my #dedoc° image which was issued for my personal use.
I have been working with Breakthrough T1D (Formerly JDRF) on this work for older people with type 1 diabetes for a while now. Last year 'behind the scenes' I was kept abreast of the market research planning - being involved with commenting on the questions that were to be asked etc. The research was carried out by Mel Research Ltd. Of course I had added my two penn'orth, to the research when it was launched.
Earlier this year for the second year in a row I attended the 'Diabetes Professional Care Conference' this time in Glasgow with complimentary registration as part of the #dedoc° voices programme, who also paid for my hotel & travel costs. Part of being one of the #dedoc° voices is to #PayItForward which means to share what I learn with my diabetes community. www.dedoc.org
At the conference I spent my time networking with healthcare professionals and charities. It was there that I met with Breakthrough T1D's Policy and Communications Director, Hilary Nathan who told me that the research had been completed and the report would be launched in the summer at an event where I would be one of the speakers.
The conference was such an exciting time, Hilary and I continued networking around the venue. So many helpful and encouraging people. Many of whom I would like to work with in future with this.
I arranged for Hilary and I to sit down for a chat with Professor Partha Kar - Type 1 Diabetes and Technology Lead, NHSE, who said that he would support us in taking this project forward.
I went home with high hopes for the future confident that in the summer of 2025 this could change the world of older people with diabetes.
A few weeks ago I received a copy of the embargoed report before it was made public. So, I knew how powerful it was and what lay ahead.
The launch day Tuesday 17 June 2025 arrived and I travelled into London to the prestigious Royal College of Physicians of London.
Networking began immediately, the meeting of like-minded people all with the same purpose.
I was an honor to be invited to speak at Breakthrough T1D's launch event of their report 'Facing the Future: Ageing with type 1 diabetes and the need for change.'
Alongside myself the speakers were Karen Addington MBE; the CEO of Breakthrough T1D UK, Partha Kar, Dr Jonathan Golding (pictured below). I think that the speeches went down well with the invited audience. We went home with a sense of achievement and hope for the future. Having #paiditforward.
To give you an idea of the event I am publishing the full transcript of my speech below. I do hope that you enjoy it. The references that I used are included at the end.
Martin Scivier – Breakthrough T1D Speech - 17 June 2025
Good afternoon, picture this, an "avalanche" of older adults living longer with type 1 diabetes, threatening to overwhelm our healthcare systems. Their increasing numbers an unstoppable force, much like a real avalanche.
Globally the number of people with type 1 is predicted to double in the next 15 years, that's possibly an extra 17.4 million type 1s.(1) Here in the UK of the 5.8 million people having diabetes (2) – 8% have type 1 – of these 48% are older adults over the age of 50.(3) That "avalanche" has started.
We are on the cusp of a significant event facing an unprecedented surge in older adults living with type 1, an ever-present and growing challenge that demands the immediate and strategic attention from every healthcare professional, key stakeholder, and parliamentarian, in this room and beyond.
Think about your loved ones, friends, or future self. We cherish the thought of more time, more memories with loved ones. What if those precious latter years were severely impacted by the demands that diabetes brings, in a world that hasn't fully prepared for this growing reality?
Medical advancements & technology, has extended lives, allowing people like me to live into our third age. However, all governments, for decades have neglected to address the increasing challenges within our social care system.
As a society we must prepare for the growing care needs of these older people with type 1 diabetes. To reduce the immense pressure on all aspects of our social and healthcare systems, of which our care homes are at the very heart.
It is within these facilities that we find the 'unsung heroes' – those dedicated care home staff – looking after the complex needs of their type 1 residents, who often may be frail or have other coexisting conditions.
Despite this commitment, they frequently aren't adequately trained for essential tasks such as safely administering insulin and effectively monitoring blood glucose and ketones, as well as crucially recognising and treating hypoglycaemia and ketoacidosis (DKA) in a timely and safe manner.
This training gap jeopardises the safety and well-being of a vulnerable and growing population of type 1s as this "avalanche" continues to build momentum.
Many type 1s are experts in managing their own diabetes, and the thought of us losing control of our diabetes management or having vital diabetes technology taken away, as sometimes happens is deeply concerning.
Staff training in diabetes care can help transform care homes into safer, more supportive environments where older adults with type 1 diabetes can thrive and maintain their independence, giving better health outcomes, as well as the peace of mind for their families.(8,9)
In the spring of 2014, the first and only England-wide Care Home Diabetes Audit (3,4) highlighted serious flaws in diabetes care for residents in care homes, revealing a lack of proper assessment, monitoring, and training amongst staff. A decade later, Dr. Giuseppe Maltese led a local diabetes care home survey, in 'Surrey Downs Care Homes', which highlighted that progress has been minimal. (5).
In 2020, the 'National Advisory Panel on Care Home Diabetes' (NAPCHD) headed by Professor Alan Sinclair, was established to improve this neglected area. In 2022, they published the "Strategic Document on Diabetes Care in Care Homes" (6).
To date voluntary implementation of this document into our care homes system has been poor. More recently their "Position Statement on Type 1 Diabetes Mellitus in Care Homes"(7) highlighted the lack of type 1 diabetes management policies but it also outlines the way forward.
The groundwork has already been done. Let's use it, instead of them gathering dust on bookshelves.
It's crucial to nationally implement these two definitive frameworks documents. The Care Quality Commission (CQC) must amend its regulations to enforce these minimum care standards, including mandatory ongoing 'diabetes care education' for all care home staff. If necessary, supported by the UK government amending the Health and Social Care Act 2008.
This is not just a suggestion, but a key fundamental necessity for safe, quality care for older individuals with type 1s.
My sincere thanks to Breakthrough T1D for their partnership. I'm eager to continue this important work, with us collaborating with all charities, key stakeholders, parliamentarians, and advocates. Together, we can bring about the essential changes needed as outlined in the Breakthrough T1D report, making a real difference for older people living with type 1 diabetes.
We need to act now not in a decade, because time is running out; that "avalanche" is unstoppable.
Join me now, my contact details can be found via the QR code.
-END-
Note: It is type 1 centric as the Breakthrough T1D is obviously a type 1 charity. Most of my speech can relate to any 'type' of older person with diabetes.
REFERENCES USED IN MY SPEECH
- 1. BMJ: Type 1 diabetes: Global prevalence is set to double by 2040, study estimates
https://doi.org/10.1136/bmj.o2289
- 2. Breakthrough T1D UK Facing the future: Ageing with type 1 diabetes and the need for change Report June 2025.
- 3. Diabetes UK. How many people in the UK have diabetes? 2024. https://www.diabetes.org.uk/about-us/about-the-charity/our-strategy/statistics
- 4. Institute of Diabetes for Older People. England-wide Care Home Diabetes Audit. Spring 2014. https://www.diabetesfrail.org/wp-content/uploads/2014/10/England-wide-Care-Home-Diabetes-Audit.pdf
- 5. First diabetes survey in Surrey Downs Care Homes, 10 years after the UK National Diabetes Audit: What has changed? Maltese G, Fountoulakis N, Jupp S, etal. Diabet Med 2024;41:e15221.doi: 10.1111/dme.15221 pmid: 37690128
- 6. National Advisory Panel for Care Home Diabetes. A strategic document of diabete care for care homes. 2022. https://fdrop.net/wp-content/uploads/2022/05/FINAL-NAPCHD-Main-documentfor-FDROP-website-08-05-22.pdf
7. Position Statement: Type 1 Diabetes in care homes: A practical guide on management.
https://doi.org/10.1111/dme.15457
- 8. Improving Diabetes Management in Care Homes within Swale CCG https://www.diabetes.org.uk/sites/default/files/diabetes-storage/migration/pdf/Improving%2520diabetes%2520management%2520in%2520care%2520homes%2520in%2520Swale%2520%28June%25202016%29.pdf
- 9. DUET Diabetes: https://caring-times.co.uk/magazines/caring-times-july-2024/