Contribution
It is an honour to serve under your chairship, Sir Alec. I welcome the Minister to her place; the all-party parliamentary group for diabetes had a positive and constructive relationship with her predecessor, the hon. Member for West Lancashire (Ashley Dalton), and I hope that that will continue.
I am grateful to the petitioners and to the petition’s creator, John, who is in the Gallery. He has been tirelessly campaigning in memory of his daughter, Lyla. His courage in speaking out and pushing for change has brought national attention to the urgent need to improve the way we recognise and diagnose type 1 diabetes. Earlier today, a group of cross-party MPs and of health professionals and families handed in a petition to Downing Street on this matter.
About 400,000 people in the UK live with type 1 diabetes. That includes tens of thousands of children. It is most commonly diagnosed in childhood, but can develop at any age. Crucially, it cannot be prevented at the moment and is not linked to lifestyle. There is nothing a child or their parents could have done differently. Despite our understanding of the condition, too many people are still diagnosed only when they are already dangerously ill. Too often, the warning signs are missed.
As we have heard, the classic symptoms are known as the four Ts: thirst, tiredness, thinning, and needing to go to the toilet more frequently. They are well known and simple to check. A quick finger-prick test can measure blood glucose and confirm whether urgent action is needed, but too many families find themselves making repeated visits to healthcare professionals before a diagnosis is made. In many cases, by the time that type 1 diabetes is identified, the patient is already experiencing diabetic ketoacidosis. DKA is a serious and potentially life-threatening condition caused by dangerously high blood glucose levels and the build-up of ketones in the blood. It frequently requires emergency hospital treatment. More than one in four children in the UK diagnosed with type 1 diabetes are diagnosed when already in DKA. This is an issue of health inequalities, too. We know that among children under five, and among those from deprived backgrounds, the proportion can be even higher.
These are not just statistics. Behind every number is a child, a family and a moment of trauma that could all too easily have been avoided. Lyla Story’s case tragically illustrates that. In the days before her death, Lyla showed the classic symptoms of type 1 diabetes. Her parents sought medical help and she was seen by a GP, but the symptoms were attributed to another illness. Her condition deteriorated rapidly, and sadly she passed away after developing diabetic ketoacidosis.
Since I met John months ago, he has sent endless examples of other families across the country. The same story has rung true time and again. This is not just one example; it is emblematic of our current systemic failure. There is an urgent need to improve awareness among healthcare professionals and ensure rapid testing when symptoms appear. They must be tret as a priority. NICE guidelines already state that children suspected of having type 1 diabetes should be referred immediately to a specialist paediatric diabetes team, but we know that, in practice, signs are sometimes missed or not acted on quickly enough. Ensuring that every GP practice has access to relevant glucometers and that the staff are confident about recognising the four Ts is one of the most simple and effective ways we can reduce those missed opportunities. Education and training can make a real difference. At a roundtable held by the APPG for diabetes earlier this year, we heard how quality improvement work in Cardiff has demonstrated that targeted education for primary care teams can significantly reduce emergency diagnoses.
Alongside improving diagnosis, we are entering a new and exciting phase in our understanding of type 1 diabetes, with the possibility of identifying the condition before symptoms even begin. Research has shown that the immune attack that eventually leads to type 1 diabetes produces autoantibodies in the blood long before symptoms appear. Those markers can be detected through screening, and studies such as ELSA have demonstrated that childhood screening is feasible and can identify children at risk before they become unwell.