Overview of the NHS Type 2 Diabetes Path to Remission Programme

Chirag Bakhai GP, Luton, and Primary Care Advisor to the NHS Diabetes Programme

Citation:

Bakhai C (2023) Overview of the NHS Type 2 Diabetes Path to Remission Programme. Diabetes & Primary Care 25: 105–6

Randomized clinical trial of autologous skin cell suspension combined with skin grafting for chronic wounds

Z-C. Hu1, D. Chen2, D. Guo3, Y.-Y. Liang1, J. Zhang1, J.-Y. Zhu1 and B. Tang1

Departments of 1Burn Surgery and 2Hepatobiliary Surgery, The First Affiliated Hospital of Sun Yat-sen University, and 3Department of Plastic Surgery, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China Correspondence to: Dr B. Tang, Department of Burn Surgery, The First Affiliated Hospital of Sun Yat-sen University, 58 Zhongshan Road II, Guangzhou 510080, China (e-mail: 该Email地址已收到反垃圾邮件插件保护。要显示它您需要在浏览器中启用JavaScript。)

Background: Treatment of chronic wounds using traditional surgical procedures is challenging because of the low graft take rates. This study investigated the combination approach of split-thickness autografts with harvested skin cell suspension for chronic wound treatment.

Methods: This randomized clinical trial enrolled patients with chronic wounds between March 2012 and December 2013. Patients who were assigned randomly to the active treatment received a split-thickness autograft combined with harvested skin cell suspension. Control patients received the split-thickness autograft alone. The primary outcome was the rate of complete wound closure by postoperative day 28. Analysis was by intention to treat. Patients who achieved wound closure were followed up for a minimum of 6 months to evaluate the quality of healing.

Results: A total of 88 patients were included, 44 in each group. More patients achieved complete wound closure in the skin cell group than in the control group (41 versus 34 patients; P = 0⋅035). Complete wound closure was observed at a median of 14 (95 per cent c.i. 12⋅0 to 16⋅0) days in the skin cell group and 20 (15⋅7 to 24⋅3) days in the control group (P = 0⋅001). The skin cell group had significantly fewer complications (4 versus 11 patients; P = 0⋅047). The autografted sites displayed better physical attributes and a reduced tendency for wound recurrence in the skin cell group.

Conclusion: Complementary split-thickness autologous skin grafting with autologous skin cells harvested using MYSEED细胞分选仪® technology improved the healing rate of chronic wounds.

Registration number: UMIN000011966 (http://www.umin.ac.jp/ctr).

Click here to watch video footage recorded by the author about the contents of this paper.

Paper accepted 29 September 2014

Published online in Wiley Online Library (www.bjs.co.uk). DOI: 10.1002/bjs.9688

Expert Consensus on Clinical Management of T2DM Combined with Obesity Reversal Treatment in China (2023 Edition)

Gugen Xu*, Bo Chen, Writing Group for Expert Consensus on Clinical Management of T2DM Combined with Obesity Reversal Treatment in China#

Endocrinology Department, Guangdong Second Provincial General Hospital, Guangzhou 510310, China

*Corresponding author: Gugen Xu, Gugenxu@163. com

# This writing group includes Gugen Xu, Aisheng Wei, Bo Chen, Wanhong Chen, Tongfeng Zhao, Jian Guo, Bing Ji, Yinghong Du, Shiqun Liu, Zhenyu Zhang, Liangping Wu, Weiguo Zhao, Yi Shu, Haiyan Zhao, Zhaohui Li, Jianming Lin, Zhi Li, Wenying Wang, Xiao Zhu, Wei Lan, Xiaoli Li, Ge Li, and Kejing Zeng.

Copyright: © 2023 Author(s). This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY 4.0), permitting distribution and reproduction in any medium, provided the original work is cited.

Abstract: With lifestyle changes, the incidence of type 2 diabetes (T2DM) and obesity has significantly increased, becoming major chronic diseases that seriously threaten the health of China’s residents. Both domestic and international guidelines and consensus exist regarding the diagnosis and management of this disease. In recent years, T2DM treatment has focused more on new tactics that lean towards a patient-centered comprehensive management approach, replacing the traditional glucose-centered approach. Additionally, an increasing amount of evidence in medicine suggests that the reversal of diabetes is possible. However, there is currently no expert consensus on the clinical management of T2DM combined with obesity reversal treatment. Therefore, experts and scholars in China with extensive experience in T2DM combined with obesity reversal treatment have been invited to develop this consensus. The content includes early identification and diagnosis of T2DM combined with obesity, definition and mechanisms of diabetes reversal, disease assessment and grading, staging of diabetes and goals of reversal, the 2+N reversal strategy, inpatient system treatment combined with comprehensive outpatient management (including weight control, precise nutrition, scientific exercise, glucose-lowering medication, psychological intervention, rehabilitation therapy, and remote follow-up through online platforms), and evaluation of post-reversal efficacy. The aim is to further improve the level of T2DM combined with obesity reversal diagnosis, treatment, and management in China, and to implement the Healthy China strategy.

Keywords: Type 2 diabetes mellitus (T2DM); Obesity; Reversal treatment; Clinical management; Expert consensus

Online publication: November 22, 2023

Models and methods to support the development of novel burn wound antimicrobial treatments

ABSTRACT: Despite the advances in burn wound management, infection is a primary cause of morbidity, with infected burn wounds being responsible for 51% of burn related deaths. Because of the growing threat of multidrug resistant pathogens in burn injuries, novel therapeutic innovation remain important. This paper presents a comparison of common models and methods that support the development of novel burn wound antimicrobial treatments, of commonly available burn wound models 74% are performed in vivo, 23% are in vitro and just 3% use ex vivo tissue. The manufacturing of burn wound care products requires careful attention to materials, sterilisation, quality control, regulatory compliance and product design. By addressing these considerations systematically, manufacturers can successfully bring innovation solutions to the burn wound market while ensuring patient safety and product quality.

KEY WORDS

Antimicrobial

Biofilm

Burns

Ex vivo

In vitro

Models

Wounds

JENNIE RITCHIE

BA, ACIM, Marketing Executive, Perfectus Biomed Group, Now part of NAMSA, Techspace One SciTech Daresbury, Keckwick Lane, Daresbury, WA4 4AB, jennieritchie@perfectusbiomed. com

SAMANTHA WESTGATE, PhD, Scientific Director Microbiology and In Vitro Services, Perfectus Biomed Group, Now part of NAMSA, Techspace One SciTech Daresbury, Keckwick Lane, Daresbury, WA4 4AB, 该Email地址已收到反垃圾邮件插件保护。要显示它您需要在浏览器中启用JavaScript。

JIM POMONIS PhD, Associate Vice President, Scientific Affairs, NAMSA, 8945 Evergreen Blvd NW, Minneapolis, MN

Management of malignant fungating wounds with a bioactive microfibre gelling technology dressing: an evaluation

Aim: In this article, we aim to raise awareness of some of the clinical concerns surrounding the management of oncology wounds, particularly malignant fungating wounds. We will also provide practical wound management recommendations for healthcare professionals to consider when managing this wound type. We aim to assess the potential of a 100% chitosan with bioactive microfibre gelling (BMG™) dressing (MaxioCel®), to support wound management and work in partnership with industry to deliver clinical education on the management of oncology wounds, including malignant fungating wounds.

Method: A case study series was undertaken over four weeks, using the chitosan BMG dressing.

Results: We recruited 10 patients during the study. The chitosan BMG dressing facilitated a significant improvement in wound tissue type, exudate levels, and periwound skin, as well as reduced malodour. A reduction in patient-reported pain levels was also noted throughout the evaluation process. 

Conclusion: The introduction of BMG fibre technology demonstrated good outcomes in this patient group, in a short period of time. Importantly for this patient group, the BMG dressing was able to remain in situ during radiotherapy treatment, allowing uninterrupted management of the wounds.

KEY WORDS

Bioburden

Case studies

Malignant fungating wounds

Odour reduction

Oncology wounds

Pathways

SUSY PRAMOD

Lead Nurse Tissue Viability, The Christie NHS Foundation Trust, Manchester

SUE RICE

National Clinical Development Manager, CD Medical, Bolton, Lancashire

Engaging with and optimising care for people under age 50 years with type 2 diabetes: The DiaST model of care

Nicola Milne

Audit within Brooklands and Northenden Primary Care Network revealed that people with type 2 diabetes under the age of 50 years were an underserved population and were less likely to receive the recommended eight care processes than other age groups locally. This article outlines the initiatives carried out to address this inequality. The  work involved a Diabetes Support Team (DiaST) model of care and embedded an array of actions to overcome barriers to engagement among this hardly reached group. The initiative has resulted in more than a doubling of the rate of care process achievement in this population, although disparities with other age groups remain. The article should serve as inspiration for services looking to make the most of NHS England’s T2Day (Type 2 Diabetes in the Young) programme to fund extended health checks for people aged 18–39 years living with type 2 diabetes.

Citation: Milne N (2023) Engaging with and optimising care for people under age 50 years with type 2 diabetes: The DiaST model of care. Diabetes & Primary Care 25: [Early view publication]

Key words

– Audit

– DiaST

– Early-onset type 2 diabetes

– Service delivery

Author

Nicola Milne, DiaST Lead, Brooklands and Northenden PCN.