Evidence map›Paper›PMID 39587392›Full record

ArticleDiabetic medicine : a journal of the British Diabetic Association2025

Designing a regional clinical service for people with early-onset type 2 diabetes in England.

Jonathan Goldney, Victoria Alabraba, Priscilla Sarkar, Harriet Morgan, Malak Hamza, Michael Skarlatos, Tommy Slater, Jack A Sargeant, Rhys O'Callaghan, Michelle Hadjiconstantinou and 5 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Diabetic medicine : a journal of the British Diabetic Association, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Review
  3. Review
  4. Designing a regional clinical service for people with early-onset type 2 diabetes in England.Diabetic medicine : a journal of the British Diabetic Association · 2025
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors.

Jonathan GoldneyDiabetes Research Centre, University of Leicester, Leicester, UK.ORCID https://orcid.org/0000-0001-8553-8296
Victoria AlabrabaLeicester Diabetes Centre, University Hospitals of Leicester NHS Trust, Leicester, UK.
Priscilla SarkarDiabetes Research Centre, University of Leicester, Leicester, UK.
Harriet MorganDiabetes Research Centre, University of Leicester, Leicester, UK.
Malak HamzaDiabetes Research Centre, University of Leicester, Leicester, UK.
Michael SkarlatosLeicester Diabetes Centre, University Hospitals of Leicester NHS Trust, Leicester, UK.
Tommy SlaterDiabetes Research Centre, University of Leicester, Leicester, UK.
Jack A SargeantDiabetes Research Centre, University of Leicester, Leicester, UK.
Rhys O'CallaghanLeicester Diabetes Centre, University Hospitals of Leicester NHS Trust, Leicester, UK.
Michelle HadjiconstantinouDiabetes Research Centre, University of Leicester, Leicester, UK.
Julia BurdonDiabetes Research Centre, University of Leicester, Leicester, UK.
Azhar FarooqiClinical Research Network (CRN) East Midlands, NIHR, University Hospitals of Leicester NHS Trust, Leicester, UK.
Samuel SeiduDiabetes Research Centre, University of Leicester, Leicester, UK.
Claire MeekDiabetes Research Centre, University of Leicester, Leicester, UK.ORCID https://orcid.org/0000-0002-4176-8329
Melanie J DaviesDiabetes Research Centre, University of Leicester, Leicester, UK.ORCID https://orcid.org/0000-0002-9987-9371

Funding

National Institute of Health Research (NIHR) Leicester Biomedical Research CentreWellcome Trust Leicestershire Healthcare Inequalities Improvement Doctoral Training Programme 223512/Z/21/Z
6 · The paper itself

Abstract

aimsTo design a regional clinical service for people with early-onset type 2 diabetes (EOT2D) in Leicester, Leicestershire and Rutland (England).

methodsA literature search was undertaken to identify important considerations. A working group of key stakeholders was formed to design a triage system and service pathway. Electronic medical records (EMRs) were searched (15th November 2023) to assess feasibility of the pathway and adapt accordingly.

resultsA literature search identified important considerations: High risk of complications; large proportion from minority ethnic and socioeconomically deprived backgrounds; significant psychological burden; stigma and other social challenges; and misclassification and miscoding. Novel clinical risk criteria were developed, implementable in EMRs, to match intervention-intensity to clinical need. Specialist clinics were planned, one for people at the highest-clinical risk, another for women with adverse perinatal risk factors. A healthcare professional training package was developed to increase awareness of the unmet clinical needs of people with EOT2D and to upskill in provision of holistic care. Subsequent EMR searches supported the need for our service. Due to the large numbers with HbA1c ≥86mmol/mol (10.0%; n=299; 10.8% of total), these people were prioritised for clinic access. We opted for specialist nurse/educator support to practices with clustering of patients and to financially incentivise referrals from primary care into services.

conclusionsWe showcase a service specifically for people with EOT2D based on the literature, a broad range of stakeholder involvement and utilising a locally-sourced data-driven approach. We further discuss areas for development and recommendations based on the challenges we encountered.

Indexed as

Diabetes Mellitus, Type 2Age of OnsetElectronic Health RecordsEnglandFemaleHumansMaleTriagechallengesclinical serviceearly onsetprimary caresecondary careservice designtype 2 diabetes mellitus

Identifiers

PMID39587392
PMCPMC11929562

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.