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Late diagnosis of diabetes

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Healthcare professionals often failed to identify clinical signs of diabetes in pre-school children, leading to late diagnosis, research has found.

A study by researchers at University Hospital Southampton and Oxford Children's hospital, published in Archives of Disease in Childhood, found that healthcare workers failed to identify two thirds of cases of diabetic ketoacidosis (DKA), a condition, which causes the body to break down fat due to a lack of insulin. It is estimated that nearly a quarter of children with type 1 diabetes will develop DKA, with children under two years most at risk. The study of 261 children with type 1 diabetes found that two thirds of those under two years and a third of children between five and ten years old, had had multiple contacts with professionals before being diagnosed.

Diabetes UK has launched a campaign to raise awareness among primary care health professionals of diabetes and DKA in young children. The initiative focuses on the 'four Ts' [tired, toilet, thinner and thirsty], key symptoms of diabetes in young children. Libby Dowling, clinical advisor at Diabetes UK said: 'It is vital that primary care nurses and GPs are aware of diabetes in children. Thirty five per cent of cases in those under five years old are not diagnosed until they present with DKA, which can make a child extremely unwell. It is essential that if a child presents with any of the 'four Ts', a finger prick blood test should be performed immediately.'

Diabetes costs the NHS approximately £10 billion to treat each year, nearly 10 per cent of its entire budget. A recent report by Diabetes UK predicted that this cost could rise by 70 per cent in the next two decades.

For more information about the campaign, the 'four T's' and resources for healthcare professionals visit, http://www.diabetes.org.uk. NHS Funding

Changes needed to avoid financial crisis

The NHS needs to improve frontline efficiency and alter inefficient clinical practice to avoid a 'financial crisis,' according to a new report from The King's Fund.

The report warns that holding down salaries, cutting management costs and reducing hospital costs have little more to offer, and that a financial crisis is inevitable in 2015/16, unless there are major improvements in efficiency and an increase in funding. It warns that such a crisis would have a significant, detrimental effect on patient care in the NHS. Current projections predict that the NHS budget will fall to six per cent of GDP by 2021, the lowest level since 2003.

Using research carried out in six NHS trusts, the report identifies four areas crucial for the overall improvement of efficiency in the NHS.

For the full report, visit www.kingsfund.org.uk/publications/nhs-productivity-challenge.

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