Lilly Diabetes and Disney Publishing Worldwide (DPW) have expanded their US collaboration to bring educational materials to children with type 1 diabetes and their families worldwide.

The educational resources will include a series of books featuring Mickey Mouse and his friend Coco the monkey, who has type 1 diabetes, to be translated and distributed initially in 18 countries.

The UK has recently seen an increase (as yet unexplained) in type 1 diabetes – a genetic auto-immune condition – among children, and lack of effective patient education has been identified by Diabetes UK as a significant problem.

The materials produced by the Lilly-Disney partnership will be available from diabetes healthcare professionals, and will aim to guide families in meeting the challenge of type 1 diabetes control in children.

Effective control of type 1 diabetes requires a blend of medication (injected insulin), carefully managed diet and exercise, and regular monitoring and dose adjustment. For many families, managing the condition in a child is disruptive and traumatic.

Speakers at the recent UK conference Diabetes: A Call to Action emphasised that a strict focus on blood glucose targets can be counter-productive, and that control needs to be integrated with a healthy and positive lifestyle. The Lilly-Disney materials reflect this philosophy, focusing on management of opportunities rather than on negative restrictions.

“We are excited to be part of this effort to bring informational material about type 1 diabetes to kids around the world who are living with the disease,” said Andrew Sugerman, Executive Vice President of DPW. “Lilly Diabetes’ expertise with the disease, combined with Disney’s tradition of great storytelling, gives us an opportunity to inspire and motivate children and families with type 1 diabetes.”

Andrew Hodge, Vice President, International of Lilly Diabetes, commented: “Lilly Diabetes’ objective is to bring safety, health, comfort and a bit of magic to children worldwide. We saw the positive impact our collaboration with Disney Publishing Worldwide had on families living with type 1 diabetes in the US over the last two years, and we are excited to expand our reach globally.”

One in five PCTs will miss the mandatory ‘MOT’ health check target in 2012–13.

GPs are required to give the MOT check, which provides early warning of cardiovascular problems, to all patients aged 40–74.

However, according to data obtained by GP magazine, up to nine million eligible patients will not be given the relevant checks and questions.

A PCT that has not even started giving the MOT checks blamed “other pressures” for the omission.

The health MOT records age, height, weight, blood pressure and blood cholesterol (plus blood glucose in certain cases), as well as responses to enquiries about current medication, smoking and family history.

This can provide early warning of heart and circulatory disease and diabetes.

In the year 2011–12, before the MOT became compulsory, the NHS set a target of 20% of eligible patients receiving the checks. However, only 14% did so.

In that year, four PCTs gave no or very few MOTs, and two-thirds of PCTs did not meet the interim target.

A spokeswoman for NHS Cornwall and Isles of Scilly said the programme could not be delivered “owing to other pressures”.

Dr Richard Vautrey, Deputy Chairman of the BMA’s GP Committee, commented that giving the scheme “greater national standards” and “national rates of payment” would have led to “better cost and clinical effectiveness”.

From April 2013, offering five-yearly MOT checks will be among the public health responsibilities of local government.

NHS diabetes services in England are failing to deliver adequate care and allowing too many patients to develop complications, the National Audit Office (NAO) has said.

The NAO estimates that the NHS spent £3.9bn on diabetes services in 2009–10, but only half of patients received the recommended standards of care.

It recommends only paying GPs for diabetes care if they provide all nine relevant care processes, including a range of tests.

According to the NAO report, the achievement of treatment standards and expected levels of care for diabetes is poor, with no PCT delivering adequate care to all its diabetes patients.

Only half of people with diabetes received the recommended standards of care in 2009–10, though this is an improvement on the 36% achieved in 2006–07.

Fewer than one in five people with diabetes are receiving the recommended tests to measure blood glucose, blood pressure and blood cholesterol.

The NAO states that the variation in the quality of care received by people with diabetes “cannot be explained by need or spending alone and is likely to be influenced by the local organisation and management of health services”.

Amyas Morse, head of the NAO, said: “The expected 23% increase by 2020 in the number of people in England with diabetes will have a major impact on NHS resources unless the efficiency and effectiveness of existing services are substantially improved.”

Among the NAO’s recommendations are:

• GPs should only be paid for diabetes care if they deliver all nine of the recommended care processes, including tests for complications and risk factors.

• The NHS Commissioning Board should “introduce effective systems of governance and accountability” to minimise inequalities in diabetes care.

A combination of a branded drug from Boehringer Ingelheim and Eli Lilly and a drug widely available in generic form has been shown in a phase III trial to be effective in treating type 2 diabetes.

Boehringer and Lilly’s Trajenta (linagliptin) in combination with metformin was shown to be more effective in controlling blood glucose levels than metformin alone.

Metformin, a successful glucophage drug for control of type 2 diabetes, was developed by Bristol-Myers Squibb and is now available in multiple branded and generic formulations.

Both drugs are used as monotherapies for type 2 diabetes in the UK, and some doctors already prescribe them together; but the new findings are likely to make the combination a standard treatment option.

The 24-week trial, part of a wider phase III study of the combination, showed that poorly controlled patients who received both drugs achieved an average reduction of 3.7% in HbA1c.

The drug combination was well tolerated, with only 9% of patients suffering side-effects and only 1.5% suffering hypoglycaemic events.

A previous one-year monotherapy trial had shown Trajenta to be of similar efficacy to glimepiride but with a significantly lower risk of side-effects, hypoglycaemic events and weight gain.

Trajenta is also the only approved diabetes medication with no need for dose adjustment in adult patients.

Professor Klaus Dugi, Corporate Senior VP of Medicine at Boehringer Ingelheim, said: “Many patients with high HbA1c levels require more than metformin alone to reach their blood glucose targets. Linagliptin can support patients with type 2 diabetes to effectively manage their condition.”

The European Commission (EC) has extended its licence for Novartis’ diabetes drug Galvus (vildagliptin) to cover a new indication.

The DPP-4 inhibitor is now approved for use (together with metformin, sulphonylurea or thiazolidinedione) to treat patients with type 2 diabetes who have moderate or severe renal impairment.

Renal failure is a common cause of death in people with diabetes, and the new indication will enable Galvus to be used with some of the most vulnerable diabetes patients.

Galvus was previously approved only for diabetes patients with mild renal impairment or none at all.

The drug joins Onglyza from AstraZeneca and Bristol-Myers Squibb and Trajenta from Boehringer Ingelheim and Lilly in being approved this year for treatment of diabetes patients with advanced kidney disease.

The extended indication for Galvus follows a phase III trial involving 515 patients with type 2 diabetes and moderate or severe renal impairment, in which the drug was shown to significantly improve glycaemic control when added to an existing anti-diabetic therapy while having a similar safety profile to placebo.

Professor Per-Henrik Groop of Helsinki University Central Hospital commented: “The data supporting this approval demonstrate that with vildagliptin good tolerability can be achieved without compromising on efficacy.”

“This approval provides physicians with a much-needed new treatment to control blood sugar in a vulnerable patient population whose management is highly challenging,” commented Timothy Maloney, Global Business Franchise Head of Primary Care at Novartis.

Intensive control of type 1 diabetes to maintain near-normal blood glucose levels halves the long-term risk of kidney disease, according to a US trial funded by the National Institutes of Health (NIH).

The landmark Diabetes Control and Complications Trial (DCCT) followed patients for more than 20 years following a 10-year trial period.

The results provide definitive evidence of the long-term benefits of careful medication adjustment soon after diagnosis to optimise the value of insulin and other diabetes-controlling drugs.

This finding adds significantly to the body of evidence supporting an intensive control strategy, despite the financial and logistical challenges it presents, and endorsing the use of new types of insulin and drug delivery strategies that help to address those challenges.

The DCCT was conducted from 1983 to 1993 in 1,441 people with type 1 diabetes, an average of six years after diagnosis. Half of them used conventional blood glucose control (based on daily testing) in the trial and half used a more intensive approach.

After an average of 22 years follow-up, 24 in the intensive group developed significantly reduced kidney function compared to 46 in the conventional group. Intensive control also reduced eye and nerve damage.

Griffin P. Rodgers, Director of the NIH’s National Institute of Diabetes and Digestive and Kidney Diseases, which oversaw the DCCT, commented that it showed “the value of long-term studies”.

“The full benefit of treatment may not be seen for decades, especially for complications of diabetes, such as kidney disease, which can progress slowly but have devastating consequences,” he said.

Diabetes is a leading cause of kidney failure – in the US, it accounts for 38% of patients on dialysis or living with a kidney transplant.

Eli Lilly’s diabetes injection Bydureon, exenatide prolonged release suspension, has been preliminarily recommended by NICE.

The draft guidance recommends the injection as part of a triple and duel therapy regimens for type II diabetics when their control of blood glucose remains or becomes inadequate in certain circumstances.

Professor Carole Longson, Health Technology Evaluation Centre Director at NICE says the Institute is “pleased” to recommend another treatment option for people with the condition.

The injection improves glycaemic control by lowering the rise in blood sugar from eating and prevents hyperglycaemia.

In triple therapy regimens in combination with metformin and a sulphonylurea, or metformin and thiazolidinedione, Bydureon is recommended if a person has a certain body mass index (BMI) and has specific psychological or medical problems associated with their weight, or if therapy with insulin would have significant occupational implications or weight loss would benefit other significant obesity-related comorbidities.

Bydureon is recommended in dual therapy regimens in combination with metformin or a sulphonylurea if either of the two together or separately is contraindicated or not tolerated or treatment with thiazolidinediones and DPP-4 inhibitors are contraindicated or not tolerated.

NICE says that treatment with the injection for both triple and dual therapy regimen should only be continued if a beneficial metabolic response has been proven.

Final guidance is likely to be published in February 2012.

Eli Lilly expects the drug’s increasing approval to create jobs at its US manufacturing facility in West Chester.

Bydureon was approved by the European Commission to treat type 2 diabetes in June 2011.

UK company Cellnovo, supplier of the first mobile-based system for diabetes management, has formed a global technology alliance with US diabetes monitoring specialist LifeScan.

Under the agreement, Cellnovo will integrate LifeScan’s successful OneTouch blood glucose monitoring technology into its mobile diabetes management system.

The innovative Cellnovo system combines an insulin patch pump with a touch-screen mobile handset (pictured) that wirelessly transmits real-time patient data to a web-based portal, enabling patients to keep track of their blood glucose control without needing to keep a diary.

Dr. David Kerr, Consultant Physician and Diabetologist at the Bournemouth Diabetes and Endocrine Centre, commented at the launch of the system: “It is clear that new technologies for diabetes care, such as Cellnovo’s mobile health solution, are going to forever change the way we practise medicine and more effectively manage diabetes long into the future.”

The integration of LifeSpan’s monitoring technology ensures that a very rapid fingerprick test can be used to generate readings.

“We wanted superb blood glucose monitoring technology inside our mobile handset, and LifeScan is a market leader,” said William McKeon, CEO of Cellnovo. “Through our partnership with LifeScan, our combined technologies will advance care through connectivity.”

Cellnovo is based in London.

AccuNostics, an international company specialising in devices for patient self-monitoring, has secured £4m investment to base its international business in northern Scotland.

The company, with major expertise in the development of blood glucose monitoring systems, has chosen a site in Forres Enterprise Park, Moray.

The funding round for development of the business includes £2.5m of capital and a £1.5m grant from Highlands and Islands Enterprise (HIE).

Scotland’s First Minister, Alex Salmond, commented after meeting the AccuNostics team: “Scotland’s reputation as one of Europe’s leading locations for life sciences continues to be further strengthened by companies such as AccuNostics choosing to locate research businesses and jobs here.

“The fact that the sector is continuing to grow in today’s tough economic climate is down to young, dynamic and innovative companies like AccuNostics, which is focusing on developing technology that will dramatically help improve the quality of life for millions of sufferers of diabetes and other conditions.”

AccuNostics was founded by leading figures in the development of blood glucose monitoring devices. CEO Giles Hamilton was previously CEO of Glysure, a developer of blood glucose sensors for intensive care. CTO and COO Olly Davies was one of the creators of the One Touch Ultra self-monitoring device for people with diabetes.

According to Giles Hamilton, the company’s reasons for selecting the Moray site as its base included the region’s infrastructure, skilled workforce and life science expertise. “These are vital assets when attracting world-class talent and building a business.”

Calum MacPherson, Moray Area Manager for HIE, said: “We are excited to be working with this life science business. Basing their operations in Moray will only strengthen the overall impact that this sector is contributing to the Highland economy.”