NCL Diabetes and Weight Management Network

The NCL Diabetes and Weight Management Network meets on the third Thursday of each month to discuss projects, services and wider aspects of diabetes and weight management care for NCL residents. It has core representation from primary and secondary care, community teams (such as diabetes specialist nurses and dietetics), diabetes education teams, foot services and public health.

The chairing of the network is shared between primary and secondary care. The network has a clinical advisory role and feeds into the NCL Long Term Conditions Steering Group. 

All clinicians working on diabetes are welcome to join the network meetings. If you have any queries or would like to attend the meetings, contact Dr Karl Roberts, GP and network co-chair (see Clinical Leads tab).

Shortage of GLP-1 receptor agonists used to manage type 2 diabetes

NCL resources to support primary care with the impact of the shortage have been developed. These include a webinar, EMIS patient searches and template letters. They are available on a dedicated GLP-1 receptor agonists shortage page.

NCL anti-hyperglycaemic agents for type 2 diabetes guidance

The NCL anti-hyperglycaemic agents for type 2 diabetes guidance was first published in August 2021, following a joint review of the evidence for patients across primary and secondary care. The document includes guidance on setting HbA1C targets for individual patients. It was updated in September 2022, following the publication of the updated NICE guideline (NG28), and includes updated recommendations on the place in therapy for SGLT2 inhibitors and GLP-1 mimetics.

The NCL anti-hyperglycaemic agents for type 2 diabetes guidance is intended to be a guide for all clinicians working for patients with type 2 diabetes. See the Prescribing Guidelines and Fact Sheets sections below for additional management of diabetes guidance, including insulin, blood glucose and ketone monitoring, flash glucose monitoring, and gliptins.

Diabetes structured education 

Free national digital services for patients include DigitBete (type 1), My Type 1 Diabetes, and Healthy Living (type 2).

Promotional material can be found on the FutureNHS page.

To find local structured education services, type 'education' into the Services search bar below.

NCL services include:

• Diabetes Prevention Programme
• Digital Weight Management Programme
• Type 2 Diabetes Path to Remission Programme
• DESMOND (Barnet, Camden, Enfield, Haringey and Islington)
• DAFNE.

Haringey and Islington services include:

• Diabetes Self-Management Programme
• Expert Patient Programme.

Coding attendance at structured education

The National Diabetes Audit measures patient attendance for structured education. Despite the offer for type 1 and type 2 diabetes patients in NCL, the percentage of patients recorded as having attended structured education is very low. This is likely due to the variability of coding and recording of this information within patients' EMIS records. It is therefore important that practices have processes in place to ensure coding of patient structured education attendance. The correct codes are listed on each service page. 

Ambulatory Acute Foot Service at Royal Free Hospital

Healthcare professionals can refer directly to the Acute Foot Service at Royal Free Hospital for any acute diabetic foot condition. The service includes clinical guidance via the service hotline, which is open seven days a week. The team are able to offer urgent face-to-face, telephone or video reviews for patients following their referral.

HbA1c conversions

• HbA1c conversion chart
• HbA1c conversion calculator

London Diabetes Clinical Network

The London Diabetes Clinical Network provides clinical leadership and subject matter expertise, supporting local healthcare systems to improve diabetes care and health outcomes by connecting commissioners, healthcare providers, professionals, those living with diabetes and the public to share best practice and ideas. The network also plays a strategic role in reducing care variations and driving improvement across London, whilst measuring quality and outcomes related to diabetes.