Integrated Technology Platform to Support Optimal Management of Ageing with Diabetes

支持老年糖尿病优化管理的综合技术平台

• 批准号: ES/V009796/1
• 负责人: M Benaissa
• 金额: $ 6.42万
• 依托单位: University of Sheffield
• 依托单位国家: 英国
• 项目类别: Research Grant
• 财政年份: 2020
• 资助国家: 英国
• 起止时间: 2020 至 无数据
• 项目状态: 已结题
• 来源: https://gtr.ukri.org/projects?ref=ES%2FV009796%2F1
• 关键词: Integrated; Technology; Platform; Support; Optimal

Latest data suggests that in the UK ~10% of the annual NHS £100 billion budget is spent on treating diabetes, equating to £192 million a week. Of this, nearly 80% is spent on treating irreversible, but preventable diabetes-related complications. Currently there are 3.8 million people diagnosed with diabetes, an estimated 900,000 are yet to be diagnosed, and in 2030 it is expected that more than 5 million people in the UK will have diabetes (as 80-85% of cases of type 2 diabetes is caused by obesity).Uncontrolled diabetes in older people leads to a range of problems. Hypoglycaemia (low blood glucose) causes a slowing of cognition and may result in acute confusion, accidents and falls and an increased risk of developing dementia. Conversely, hyperglycaemia (high blood glucose) increases the risk of infections, dehydration, and in the longer-term can lead to a significantly higher loss of muscle quality and strength (sarcopenia) as well as irreversible damage to eyes, kidneys, and nerves supplying the feet. This places significant demands on NHS services including GP callouts, ambulance services, A&E attendances and lengthy hospital admissions.Increasing physical activity levels in people with diabetes would lead to better outcomes in terms of less diabetes-related complications, less depression, slower rates of cognitive decline, lower rates of cardiovascular disease and ultimately less healthcare resource use. However, some people with diabetes find it hard to exercise as the risk of hypoglycaemia is increased. The complex relationship between diabetes, physical and cognitive decline, and ageing is not well understood (understudied) often leading to sub-optimal management of people with diabetes as they get older. This in turn results in higher risk of diabetes related complications and increased incidence of morbidity and disability in this population in later years. The aim of this proposal is to provide a single technology platform that will implement a data-driven approach to the analysis of this complex relationship via automated machine learning (ML)-driven analytics based on the real-time remote monitoring of the key diabetes markers (Blood Glucose, Insulin, Carbohydrates) and incorporating physical activity measures, as well as cognitive assessment scores. This integrated environment will provide decision support for optimal diabetes management and service planning and provision for healthcare, social and community care. This will enable a shift from the current unsustainable, static and reactive management model, to a future-proof dynamic, intelligent proactive model that will impact in the following ways, for: - Patients: a personalisation of support to enable pro-active engagement and empowerment; improved quality of life; healthier ageing.- Clinicians / Carers: remote monitoring; decision support; prioritisation of those most in need; improved cognitive screening.- CCG and commissioners / wider NHS / Social service: optimised use of limited healthcare and social care resources; optimal pathways of care.

最新数据表明，在英国，每年NHS 1000亿GB预算中约10%用于治疗糖尿病，相当于每周1.92亿GB。其中，近80%用于治疗不可逆转但可预防的糖尿病相关并发症。目前有380万人被诊断患有糖尿病，估计有90万人尚未确诊，预计到2030年，英国将有超过500万人患有糖尿病(因为80%-85%的2型糖尿病病例是由肥胖引起的)。老年人的糖尿病得不到控制会导致一系列问题。低血糖(低血糖)导致认知减慢，可能导致急性精神错乱、事故和跌倒，并增加患痴呆症的风险。相反，高血糖(高血糖)会增加感染和脱水的风险，从长远来看，可能会导致肌肉质量和力量的显著丧失(肌肉量减少)，以及对眼睛、肾脏和足部供应神经的不可逆转的损害。这对NHS的服务提出了巨大的需求，包括全科医生服务、救护车服务、急诊室就诊人数和漫长的住院时间。增加糖尿病患者的体力活动水平将带来更好的结果，包括较少的糖尿病相关并发症、较少的抑郁、较慢的认知减退率、较低的心血管疾病发生率以及最终较少的医疗资源使用。然而，一些糖尿病患者发现很难锻炼，因为低血糖的风险增加了。糖尿病、身体和认知能力下降以及衰老之间的复杂关系没有得到很好的理解(研究不足)，这往往导致随着糖尿病患者年龄的增长，对他们的管理处于次优状态。这反过来又会导致糖尿病相关并发症的风险增加，并在以后几年增加这一人群的发病率和残疾。这项提议的目的是提供一个单一的技术平台，通过自动化机器学习(ML)驱动的分析，实施数据驱动的方法来分析这种复杂的关系，该分析基于对关键糖尿病标志物(血糖、胰岛素、碳水化合物)的实时远程监测，并纳入体力活动测量以及认知评估分数。这一综合环境将为最佳糖尿病管理和服务规划提供决策支持，并为医疗保健、社会和社区护理提供服务。这将使目前不可持续、静态和被动的管理模式转变为适应未来的动态、智能主动模式，将在以下方面对患者产生影响：-患者：个性化支持，以实现主动参与和赋权；提高生活质量；更健康地老龄化。-临床医生/照顾者：远程监测；决策支持；对最需要帮助的人进行优先排序；改进认知筛查。-CCG和委员/更广泛的NHS/社会服务：优化使用有限的医疗保健和社会护理资源；最佳护理途径。