Understanding Diabetes
“In England alone, diabetes leads to 812 strokes, 568 heart attacks and 2,909 cases of heart failure each week.”
Colette Marshall, Chief Executive, Diabetes UK Page 02
“Governments must step up. We need policies that make healthy food more affordable than junk food.”
Professor Peter Schwarz, President, International Diabetes Federation Page 06
Sharing our stories through music has been more than we could have hoped for.
~1Type girl band
Image provided by Sanofi
Study
aims to find out how
type 1 diabetes develops in adults
More than 400,000 people in the UK live with type 1 diabetes. Many consider it a condition of children and are surprised to learn that more than half of type 1 diabetes cases are diagnosed in adults (Rogers et al, 2017).
Until now, research has largely focused on type 1 diabetes diagnosed in children. The Type 1 Diabetes Risk in Adults study (T1DRA; pronounced Tedra), is aiming to change this.
Early markers predict type 1 diabetes
Unlike many other conditions, type 1 diabetes can be very accurately predicted. Studies in children have shown that there are proteins in the blood that can be measured years before diagnosis occurs. These proteins (or antibodies) are often detectable in the first two years of life. Children who have two or more of these proteins in their blood early in life are more than 80% likely to develop type 1 diabetes by the age of 20 years (Ziegler et al, 2013). This largely explains type 1 diabetes in children — but how does type 1 diabetes develop in adults?
To date, over 11,000 have joined, and the team can already see differences between antibody patterns in children and adults.
Participate through accurate home testing
Over the last decade, the diabetes research team at the University of Bristol have optimised very accurate tests to measure the key antibodies in tiny blood samples (1/1000 of a teaspoon). Adult participants are asked to collect a small finger-prick blood sample at home and post it to the T1DRA study team. Once tested, they let study participants know if they are likely to develop type 1 diabetes in the future.
They will not be diagnosed in an emergency. Anyone with the antibodies will be supported and monitored for any changes yearly. To date, over 11,000 have joined, and the team can already see differences between antibody patterns in children and adults. This will help diagnose type 1 diabetes in adults more accurately in the future.
Anyone between the ages of 18 and 70 years can sign up. We would particularly like to encourage men and people from ethnically diverse backgrounds to take part in research so that our study results can reflect the population as a whole.
Eight simple diabetes checks you need to know
Executive,
For the millions of people living with diabetes in the UK, a small number of regular medical checkups are vital to their wellbeing.
People with diabetes should receive eight vital checks as part of their annual review. These checks can spot early signs of diabetes-related complications, which can occur when blood sugar levels become too high.
Essential checks for diabetes
The checks are carried out in a variety of ways. A simple blood test can measure average blood sugar levels (HbA1c), cholesterol levels, as well as analyse kidney function. A urine sample can spot early signs of kidney disease, and a foot check can identify any nerve damage, infections or ulcers. People with diabetes should also have their body mass index (BMI) measured, as well as blood pressure.
People will also be asked whether they smoke and will be offered support on how to stop if they need it. In addition to these eight checks, people with diabetes should also be invited to an eye check every one to two years. Diabetic eye screenings are vital in helping prevent and spot any early signs of eye damage, which, if left untreated, could lead to sight loss.
Why are the checks important?
Diabetes can cause other health problems that can become serious if not picked up and monitored or treated in the early stages. In England alone, diabetes leads to 812 strokes, 568 heart attacks and 2,909 cases of
heart failure each week.1
Why aren’t people getting all their checks?
A worrying 40% of people with diabetes in England and Wales alone are missing out on at least one of these vital health checks.2 There are lots of reasons people aren’t getting all their checks, from not being invited to a lack of appointments or long waiting times.
For some people, feelings of shame and fear of judgment can hold them back from attending appointments. In addition, people living in the most deprived areas — particularly those of working age — are disproportionately less likely to receive all eight annual checks.
Support prevents diabetes complications Diabetes is serious, affecting millions of people in the UK. It’s vital that everyone gets the care they need to manage their diabetes because, with the right support, it’s possible to avoid potentially life-altering complications. That’s why this Diabetes Week, we’re determined to raise awareness and help ensure no one misses out on this crucial part of diabetes care.
References:
1. NHS England Digital. 2024. National Diabetes Audit: Complications and Mortality Outcomes Dashboard, 2009-2023.
2. NHS England Digital. 2024. National Diabetes Audit, 2023-24.
Why catching type 1 diabetes early could save lives
One quarter of children in the UK are still being diagnosed with type 1 diabetes only once they develop diabetic ketoacidosis,1 a serious and preventable medical emergency.
WRITTEN BY
The latest figures from the NHS show that the number of children experiencing diabetic ketoacidosis at diagnosis has risen by 3% in the past year.1 Early detection is transforming healthcare across many conditions, enabling treatment before emergencies occur and improving long-term outcomes.
Early type 1 detection changes futures
Thanks to decades of research, we now understand how to identify type 1 diabetes before symptoms develop. By identifying type 1 diabetes before symptoms become severe, children can avoid frightening hospital admissions and overwhelming life changes.
At Breakthrough T1D, we believe that with the right actions and support, we can change the future for children who develop type 1 diabetes. We are calling for a national early detection pathway that combines free, targeted screening with access to emerging treatments, alongside ongoing monitoring and personalised support.
Delaying type 1 transforms care
We now have the world’s first immunotherapy drug, which can delay the progression of type 1 diabetes by preserving the body’s ability to produce insulin for longer. New treatments like this offer hope by allowing us to delay the onset of clinical diabetes, giving families crucial time to
prepare. Combined with regular monitoring, these advances could transform how T1D is experienced and managed. When families know what to expect and receive timely care, diagnosis does not have to be a medical emergency. Early detection opens the door to better health outcomes and management.
Awareness saves young lives
While promising early detection studies are underway in the UK, there is still no national screening programme. Without this, many children continue to miss the chance for early intervention. Until a national programme is established, awareness of the four Ts remains our most powerful tool for spotting early signs:
• Toilet: going more often
• Thirsty: constant drinking
• Tired: feeling unusually tired
• Thinner: losing weight without explanation
Recognising these symptoms could save a child’s life. Increasing awareness and improving early detection are key steps toward changing the story of type 1 diabetes.
Reference:
1.
Diabetes has become one of the greatest global health challenges. We must respond to this silent pandemic with the urgency and collaboration it demands.
~Professor Peter Schwarz , President, International Diabetes Federation
National Paediatric Diabetes Audit (NPDA). 2025. Report on Care and Outcomes 2023/24.
Odette Myall Head of Content, Breakthrough T1D
INTERVIEW WITH Ahmed Moussa General Manager, General Medicine, Sanofi UK & IE
WRITTEN BY Tony Greenway
This project, the band and all assets associated with this band were initiated, organised, sponsored and funded by Sanofi. The song ‘Rise Up’ was co-written by the band members, Studio Salamanca and Duke Al Durham. Sanofi is licensing the song and will not make any profits from the song. By listening to ‘Rise Up,’ you’re directly supporting charities that support people living with T1D, as Sanofi will match the profits from the song with a donation to such charities.
Scan this code to listen to 1Type’s song:
WRITTEN BY Tony Greenway
Reference: Stats from Sanofi UK’s 2025 Study: Perceptions of living with Type 1 Diabetes for Adults in the UK.
Image provided by Sanofi
Evaluating continuous glucose monitors for insulin safety
Continuous glucose monitors (CGMs) offer real-time data to aid diabetes management. In the UK, most insulin users are recommended CGMs, but only non-adjunctive types are approved for insulin dosing without finger pricks.
What is a CGM?
CGMs are small wearable devices that display real-time glucose levels. They help people with all types of diabetes better understand their patterns; make safer decisions on their treatments; avoid dangerous highs and lows; and make informed insulin decisions. As technology advances, CGM has become a key tool in personalising diabetes care.
What does safety look like?
In the UK, CGMs are now recommended for most people who use insulin, including those with type 1 diabetes and some with type 2, type 3c and gestational diabetes. However, not all CGMs are suitable for insulin dosing. Some are ‘adjunctive’ and require a capillary glucose measurement as a confirmation, while ‘non-adjunctive’ CGMs are approved for direct insulin decisions.
accuracy, like MARD (mean absolute relative difference), can be misleading. MARD is an average value and may mask significant inaccuracies at the extremes of low or high glucose levels. The 20/20 and 40/40 accuracy metrics are more meaningful, showing how closely CGM readings match lab-tested blood glucose levels. Devices scoring highly on these metrics offer greater safety for people adjusting insulin based on CGM data.
Everyday practicality
CGMs are now recommended for most people who use insulin, including those with type 1 diabetes.
Our understanding of a CGM’s safety and accuracy depends on how and where it has been tested. A device may perform well, but without data from real-world conditions — such as during meals, insulin use or rapid glucose changes — its effectiveness in those situations remains unknown. International guidelines recommend that CGMs be evaluated under these challenging conditions to ensure their reliability in everyday use.
Accuracy is critical. Common figures, once used to assess
There are 250 million undiagnosed: why early diabetes detection must be a priority
Diabetes has become one of the greatest global health challenges. We must respond to this silent pandemic with the urgency and collaboration it demands.
DPractical features help people find the right fit. Some sensors last seven days, others 14 or more. Some link with smartphones or insulin pumps, or allow family members to share data. Many offer alerts for glucose highs, lows or rapid changes. These can support daily routines, safety and peace of mind.
Diabetes specialist nurses are key to helping people choose a CGM that fits their clinical needs and lifestyle. They consider not just cost, but also safety, regulatory approval, device usability and compatibility with hybrid closed-loop systems.
Reference: Pleus, S., Eichenlaub, M., Eriksson Boija, E., Fokkert, M., Hinzmann, R., Jendle, J., Klonoff, D.C., Makris, K., Nichols, J.H. & Pemberton, J., 2024. The Need for Standardization of Continuous Glucose Monitoring Performance Evaluation: An Opinion by the International Federation of Clinical Chemistry and Laboratory Medicine Working Group on Continuous Glucose Monitoring. Journal of Diabetes Science and Technology, p.19322968241296096.
iabetes is no longer a looming threat — it’s a full-blown global health crisis.
Global diabetes crisis escalates
According to the latest Diabetes Atlas from the International Diabetes Federation (IDF), over 250 million adults worldwide are living with undiagnosed diabetes, most of them with type 2 diabetes. These are people who may only discover their condition because they already have serious complications like kidney failure, cardiovascular disease, nerve damage or vision loss. These
could have been prevented with early detection and treatment. The burden is heaviest in low and middle-income countries, where three out of four people with diabetes live. These countries often lack the infrastructure for routine screening or long-term care. IDF projections predict that more than 850 million people will be living with diabetes by 2050. That’s nearly 1 in 10 people on the planet.
Diabetes prevention policies
This is not just a health issue; it’s an economic one. In 2024
alone, diabetes-related healthcare spending topped $1 trillion globally, according to the IDF Diabetes Atlas. We need to shift the conversation from treatment to prevention. That means investing in accessible screening programmes, especially in underserved communities. It means educating the public about risk factors like poor diet, lack of exercise and family history. It means using digital tools to help people monitor and manage their health. Most importantly, it means political will. Governments must step up. We need policies that make healthy food more affordable than junk food. We need urban planning that encourages walking and cycling.
Lifestyle programmes and digital interventions
Landmark studies and real-world evidence confirm that type 2 diabetes can be prevented or delayed through culturally adapted lifestyle programmes and digital interventions. We now have scalable, cost-effective models that can be implemented, even in lowresource settings. We have the tools, and we have the knowledge. What we need now is the courage and the political will to act before another 250 million people slip through the cracks.
WRITTEN BY
Bethany Kelly Clinical Lead, Diabetes Specialist Nurse and Director, Diabetes Specialist Nurse Forum UK
WRITTEN BY
Amanda Williams Lead Nurse for Diabetes and Endocrinology, East Kent Hospitals and Director, Diabetes Specialist Nurse Forum UK
WRITTEN BY Professor Peter Schwarz President, International Diabetes Federation
Could it be type 1 diabetes? Know the 4 Ts:
Toilet - going to the toilet a lot?
Thirsty - always asking for drinks?
Thinner - sudden weight loss?
Tired - more exhausted than usual?
breakthrought1d.org.uk
These are the early warning signs of type 1 diabetes (T1D) - an autoimmune condition where the body can’t produce insulin. Recognising these signs early could save a life. Scan to learn more.