King’s Health Partners Diabetes, Endocrinology & Obesity (KHP DEO) Clinical Academic Partnership brings together clinical, operational and academic teams from across Guy’s and St Thomas’ NHS Foundation Trust (NHS FT), King’s College Hospital NHS Foundation Trust (NHS FT), South London and Maudsley NHS Foundation Trust (NHS FT) and King’s College London with colleagues from across the south east London (SEL) system. We work together to improve the health, wellbeing and outcomes of people living with diabetes, obesity & endocrine disorders for our local population and beyond.
In this newsletter edition, we wish to raise awareness for National Diabetes Week. Read more here and find out how to get involved.
For this edition, we caught up with Millie and Elliot, Health and Welbeing Practitioners who work with young people with diabetes across King's Health Partners.
Millie Chatfield, Senior Health and Wellbeing Practitioner
Guy’s and St Thomas’ Hospital NHS FT, King's College Hospital NHS FT,
The Well Centre
Millie
What is your role? I am a Senior Health and Wellbeing Practitioner, specialising in diabetes. I work within the Paediatric, Transition, and Young Adult Diabetes services across Guy's and St Thomas’, (including the Evelina London Children’s Hospital) and King's College Hospital NHS Foundation Trusts. Working in collaboration with The Well Centre, a confidential health hub supporting 11-20-year olds with their physical, sexual and mental health.
What do you enjoy most about your role? I enjoy the variety that each day brings! Whether this is in outpatient clinics, delivering workshops or group sessions and supporting children and young people 1:1 in the community. Working through a meaningful intervention with a young person and seeing them exceed their expectations, by observing a change in their self-esteem, mood, and motivation to improve their health-related outcomes, is incredibly rewarding. As well as being a part of their journey that empowers them to live a life not controlled by their diabetes.
I have also enjoyed shaping the role of a Health and Wellbeing Practitioner within a hospital-based setting and working on the development and expansion of the Youth Empowerment Skills (YES) programme for young people aged 14-19 living with type 1 diabetes.
What inspired you to get into this work? I have always been interested in physical and mental health and working with, and advocating for, children and young people. Through volunteering, university studies and various courses, I stumbled into a newly developed hybrid role that combined these, a Health and Wellbeing Practitioner!
There are many challenges growing up as young person in the current society, particularly those with a long-term health condition, such a diabetes, those struggling with their mental health, and those who perhaps aren’t surrounded with as much support as others. We are all aware of the widespread impact of COVID-19, but I feel the cohort who received a diagnosis or experienced a significant life event during this time show remarkable resilience.
What are the benefits of working in partnership? Working between multiple hospital teams has allowed me to better understand and help to bridge the gap between paediatric and adult diabetes care. Each clinic is run by a multidisciplinary team, including a Health and Wellbeing Practitioner, who often offers an alternative perspective, centred around a holistic approach to patient care.
Last year, the above teams, as King’s Health Partners, worked together and ran a successful pilot bid with NHS England to improve the Transition and Young Adult Diabetes services for young people aged 19-25 with both type 1 and type 2 diabetes. This collaboration across Guy’s and St Thomas’ and King’s College Hospital NHS FTs, aims to provide streamlined services across Lambeth and Southwark, in both hospital and community settings. We are also working in partnership with patients to help us shape this pilot, not only to provide better care for them, but for future young people.
What would be your one career top tip to staff and students? Put yourself out there and network with people, be curious and ask questions, you never know where this may lead! I am grateful to be surrounded by so many inspiring clinicians, who have influenced my next career chapter. Finally, to be kind to yourself and others.
Elliot Omari, Health and Wellbeing Practitioner,
Guy’s and St Thomas’ Hospital NHS FT, King's College Hospital NHS FT,
The Well Centre
Elliot What is your role? I work as a Health and Wellbeing Practitioner with the young adult diabetes team. My job is fairly broad; it involves aiding with engagement, one-to-one work, and facilitating groups, working with both type 1 and type 2 patients. I like to think of myself as the point of contact or the “friendly face/ bridge” between patient and health team.
What do you enjoy most about your role? The thing I enjoy most about my role is the satisfaction I get from helping young adults reach a point of confidence with their diabetes, that they felt that they would never reach. Nothing is more rewarding than when you introduce yourself to a newly diagnosed patient and you can clearly see that they are really struggling with management, expectations, and feel like their life has been put on hold. Through one-to-one sessions and being the friendly face of clinic, you can see how their hope slowly increases. Empowering them to take control of their life and continue to live a happy and fulfilling life.
What inspired you to get into this work? As a type 1 diabetic myself, I have personal experience in dealing and managing diabetes. I know how difficult and tasking it is. When I was first diagnosed, I did not have the best experience. I remember feeling like my whole world was crashing in on me and I felt a lot of resentment and anger towards myself, my body and life in general. This cumulated in me not being the best controlled diabetic and really struggling with my emotions, I felt like I had been left alone to deal with a long-term health condition I that did nothing to deserve. In my lowest moment I began absconding my appointments and not taking my insulin. My local dietitian insisted I come in to be seen after missing many appointments, I did everything to avoid this; making excuses and doing anything in my power not to face my situation.
This dietitian was kind enough to visit me at home and spoke with me candidly but also in a way that no health professional had ever spoken to me. I slowly re-engaged with my health, thanks to them and now years later have never been healthier. This made me aware of how there are many people that feel the way I felt, and I decided I wanted to put myself in a situation where I could help those who need the help most. Like I once needed. This experienced has both shaped how I work with patients and how I approach my work; and I am forever grateful for it.
What are the benefits of working in partnership? Hospitals and Trusts are all split via boroughs, but community transcends all of that. Working across sites has shown me how there is so much overlap between them all. This gives me the ability to take a lot of the burden and stress off patients. It also gives me an insight into how different teams across London work. Taking a little from each organisation and bringing it back to each team to make services stronger, faster, and more effective. All of this helps those who need our support the most, giving them the mindfulness and confidence needed to tackle something as life-altering as diabetes.
What would be your one career top tip to staff and students? One career top tip I’d give is to never give up on any patient and to always try give our patients time. We are all fighting our battles, and some of us are able to stand our ground better than others. It can be very daunting and scary to speak to a health care professional; and this is something we take for granted.
In March 2023, the King's Health Partners (KHP) Diabetes, Endocrinology and Obesity Clinical Academic Partnership secured funding to offer four grants of up to £15,000 to fund research projects over the next 12 months. This opportunity was open to colleagues from across the partnership to pump-prime innovative research projects in the field of diabetes, obesity, and endocrinology.
14 applications were received from early career researchers whose work involves clinical and basic science. These were reviewed by our panel: Gavin Bewick (Reader in Endocrinology and Metabolism, King’s College London), Angus Forbes (Professor and Chair of Clinical Diabetes Nursing – Care in Long Term Conditions, King’s College London), Luigi Gnudi (Professor of Diabetes & Metabolic Medicine, King’s College London), Kevin Murphy (Professor of Endocrinology and Metabolism, Imperial College London) and Marietta Stadler (NIHR Clinician Scientist, King’s College London).
The following research projects were awarded the grants by the panel:
Effects of eNAMPT on inflammation in NAFLD (Jithu Varghese, King’s College London). Non-alcoholic Fatty Liver Disease (NAFLD)/Non-alcohol related steatohepatitis (NASH) affects 32.4% of the population, with a high prevalence in obese individuals. Current treatments are limited to lifestyle factors or bariatric surgery. Most drugs in development were found to have sub-optimal efficacy or cause unpleasant/dangerous side-effects. Hence, this is an urgent unmet clinical need for the identification and development of novel targets for treatment in this disease with the aim of preventing NAFLD progression into NASH.
Novel placental signals driving islet adaptation to pregnancy (Lorna Smith, King’s College London). This project will support better understanding of the signals driving the islet adaptation to pregnancy, and why that adaptation is insufficient in women with gestational diabetes mellitus (GDM).
Safe management of people with Type 1 diabetes and Eating Disorders Study (STEADY) – (Natalie Zaremba, King’s College London). This project will use mix method evaluation to assess the fidelity of delivery and feasibility of STEADY during its completed Randomised Controlled Trial feasibility study.
Multi-omics analysis of PPGLs to investigate tumour behaviour and highlight transcriptomic markers of aggressive disease (Mark Quinn, Guy’s and St Thomas’ NHS FT). This project will analyse multi-omics from pheochromocytomas and paragangliomas (PPGL) tumours focusing solely on one specific group and will implement a comparative multi-omics analysis between tumours that spread and tumours that do not using the data to identify a potential marker that we can use to predict tumours that are likely to behave in an aggressive way. If we are able to highlight patients, early in their care, who are at risk of developing aggressive disease, we will be able to focus our resources more appropriately; helping avoid over investigating patients who will never develop aggressive disease.
Researchers will submit a mid-point and a final report at the end of the 12-month project to share the overview of the key findings and their implications, including their impact on patient care across King's Health Partners.
King’s College Hospital has been selected as a site to conduct a promising new research study using stem-cell therapy to treat type 1 diabetes.
The novel treatment called VX-880 by Vertex Pharmaceuticals hopes to help those with type 1 diabetes produce their insulin again. The treatment involves transplanting lab-grown insulin-producing beta cells into people with type 1 diabetes. By replacing the destroyed beta cells, the VX-880 treatment allows the body to produce its insulin again, potentially reducing the need to inject insulin.
At King’s College Hospital, the study will be led by Dr Sufyan Hussain, Clinician Scientist in translational aspects of cell therapy in type 1 diabetes, Guy’s and St Thomas’ NHS Foundation Trust and King’s College London, and Dr Yee Cheah, Diabetes Clinical Lead for Islet Transplantation and Director of the Islet Isolation Facility, King’s College Hospital NHS Foundation Trust.
More information about this study is available here.
Youth Empowerment Skills (YES) is a psycho-educational programme for young people with type 1 diabetes. This intervention aims to facilitate a positive adaptation to life with diabetes and engagement with diabetes care through peer-based learning, immersive simulations, and support from an outreach youth worker.
On 13 June, the YES Programme team came together to celebrate and reflect on the Diabetes-UK funded study of the YES programme, which has recently come to an end. The event was attended by a range of key stakeholders, including representatives from referring organisations, YES facilitators, charity and industry partners, and the team from Guy’s and St Thomas’ NHS Foundation Trust, which highlights the huge collaborative effort to develop and run YES over the years.
As part of the event, we heard from previous participants about their experience, as well as from our excellent peer facilitators and health and wellbeing practitioners. The group also heard the findings from the recently completed feasibility and acceptability study by Prof Angus Forbes’s team at King’s College London. This informed discussion on how we can develop and expand YES beyond south east London in the future.
Diabetes UK’s Diabetes Research Steering Groups (DRSGs) bring together scientists, healthcare professionals, and people living with, or at risk of diabetes to determine the most important areas of diabetes research, focusing specifically on areas of unmet need. They then then work together to make research happen in those areas so that we can make the greatest possible difference to the lives of people with diabetes. As everyone with diabetes is different, the DRSGs understand the importance of listening to as many voices as possible and bringing unheard voices into diabetes research.
Though groups often work together, each group focuses on a different area of diabetes research:
DRSG1 - Causes of diabetes
DRSG2 - Type 1 treatments and prevention
DRSG3 - Type 2 treatments and prevention
DRSG4 - Acute care
DRSG5 - Living with diabetes long term
DRSG6 - Complications
DRSG7 - Children and young people with diabetes
If you are interested in getting involved or would like more information about the DRSGs, please email drsgs@diabetes.org.uk.
Pam Chen, Nalini Campillo Vilorio, Ketan Dhatariya, William Jeffcoate, Ralf Lobmann, Caroline McIntosh, Alberto Piaggesi, John Steinberg, Prash Vas, Vijay Viswanathan, Stephanie Wu, Fran Game. Guidelines on interventions to enhance healing of foot ulcers in people with diabetes (IWGDF 2023 update). Diabetes Metab ResRev.2023;e3644. https://doi.org/10.1002/dmrr.3644
Dane K. Wukich, Nicolaas C. Schaper, Catherine Gooday, Arun Bal, Robert Bem, Avneesh Chhabra, Mary Hastings, Crystal Holmes, Nina L. Petrova, Maria Gala Santini Araujo, Eric Senneville, Katherine M. Raspovic. Guidelines on the diagnosis and treatment of active Charcot neuro-osteoarthropathy in persons with diabetes mellitus (IWGDF 2023) Diabetes Metab ResRev.2023;e3646. https://doi.org/10.1002/dmrr.3646
Barbara M. McGowan, Azadeh Houshmand-Oeregaard, Peter Nørkjær Laursen, Niels Zeuthen, James Baker-Knight. Impact of BMI and comorbidities on efficacy of once-weekly semaglutide: Post hoc analyses of the STEP 1 randomized trial. Obesity (Silver Spring). 2023 Apr;31(4):990-999. https://doi.org/10.1002/oby.23732
Ornella Verrastro, Simona Panunzi, Lidia Castagneto-Gissey, Andrea De Gaetano, Erminia Lembo, Esmeralda Capristo, Caterina Guidone, Giulia Angelini, Francesco Pennestrì, Luca Sessa, Fabio Maria Vecchio, Laura Riccardi, Maria Assunta Zocco, Ivo Boskoski, James R Casella-Mariolo, Pierluigi Marini, Maurizio Pompili, Giovanni Casella, Enrico Fiori, Francesco Rubino, Stefan R Bornstein, Marco Raffaelli, Geltrude Mingrone. Bariatric-metabolic surgery versus lifestyle intervention plus best medical care in non-alcoholic steatohepatitis (BRAVES): a multicentre, open-label, randomised trial. Lancet. 2023 May 27;401(10390):1786-1797. https://doi.org/10.1016/S0140-6736(23)00634-7
Madeleine Benton, Megan Davies, Khalida Ismail, Jacopo Lenzi. Gestational diabetes mellitus and its impact on the mother-infant relationship: A cohort study in the postnatal period. Preventive Medicine Reports, Volume 34, 2023, 102270, 2211-3355, https://doi.org/10.1016/j.pmedr.2023.102270
Madeliene Benton, Jeni Baykoca, Khalida Ismail, Hermione Price. Healthcare professionals' experiences in identifying and supporting mental health problems in adults living with type 1 diabetes mellitus: A qualitative study. Diabet Med. 2023 Apr 2:e15103. https://doi.org/10.1111/dme.15103
NIHR Programme Grants for Applied Research For research proposals to develop individual programmes of applied health research
Maximum value: project dependent
Deadline: 02/08/2023
Society for Endocrinology Travel Grant For attending endocrine meetings or conferences in which members have an active involvement by acceptance of an abstract
Maximum value: £850
Deadline: 09/08/2023
ABCD Conference 2023 – taking place from 5 – 6 September 2023, this event hosted by the Royal College of Physicians Edinburgh offers professional education, update, development and networking for clinicians working in diabetes and endocrinology.
The Multi-Disciplinary Care and Surgical Construction of the Diabetic Foot – taking place from 14 – 15 September, this symposium organised by the King’s Diabetic Foot Unit will cover a range of topics related to diabetic foot care, with a particular focus on multi-disciplinary and surgical reconstruction of aspects of Charcot Foot.
MSc Diabetes: Clinical Care and Management at King’s College London – this course is open for applications to start in October 2023. The aim of this three-year programme is to equip health professionals with advanced skills in formulating diabetes care to improve patient outcomes.
Become a Diabetes UK Expert by Experience – if you have lived experience of diabetes and are interested in the research funded by Diabetes UK, then joining the Diabetes Research Steering Groups might be the perfect opportunity for you. You don’t need to have previous experience of research, just be prepared to discuss your experience of diabetes and where you feel there are gaps in diabetes care and treatment..
Cognitive Behavioural Therapy for Diabetes Short Course – this new online, six-week course, running from 25 September – 5 November 2023, is now open for expressions of interest. It will focus on providing the knowledge and skills in a diabetes-specific cognitive behavioural therapy model and its application in the diabetes setting.
Stay in Touch
We hope these quarterly newsletters help keep you informed about news, updates, and opportunities across our partnership. If you would be interested in contributing to future editions or have a publication you would like to share with our readers, please get in touch with us via email at DEO@kcl.ac.uk.
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