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  4. I want to achieve remission of my type 2 diabetes
  5. How can I reduce my risk factors for type 2 diabetes?
Important: please update your RDS app to version 4.7.3 Details with newsletter below.

Please update your RDS app to v4.7.3

We asked you in January to update to v4.7.2.  After the deployment planned for 27th February, this new update will be needed to ensure that you are able to download RDS toolkits even when the RDS website is not available. We will wait until as many users as possible have downloaded the new version before switching off the old system for app downloads and moving entirely to the new approach.

To check your current RDS version, click on the three dots bottom right of the RDS app screen. This takes you to a “More” page where you will see the version number. 

To update to the latest release:

 On iPhones – go to the Apple store, click on your profile icon top right, scroll down to see the apps waiting to be updated and update the RDS app.

On Android phones – these can vary, but try going to the Google Play store, click on your profile icon top right, click on “Manage apps and device”, select and update the RDS app.

Right Decision Service newsletter: February 2025

Welcome to the February 2025 update from the RDS team

1.     Next release of RDS

 

A new release of RDS is planned (subject to outcomes of current testing) for week beginning 24th February. This will deliver:

 

  • Fixes to mitigate the recurring glitches with the RDS admin area and the occasional brief user interface outages which have arisen following implementation of the new distributed technology infrastructure in December 2024.

 

  • Capability to embed content from Google calendar, Google Maps, Daily Motion, Twitter feeds, Microsoft Stream into RDS pages.

 

  • Capability to include simple multiplication in RDS calculators.

 

The release will also incorporate a number of small fixes, including:

  • Exporting of form within Medicines Sick Day Guidance in polypharmacy toolkit
  • Links to redundant content appearing in search in some RDS toolkits
  • Inclusion of accordion headers alongside accordion text in search result snippets.
  • Feedback form on mobile app.
  • Internal links on mobile app version of benzo tapering tool

 

We will let you know when the date and time for the new release are confirmed.

 

2.     New RDS developments

There is now the capability to publish toolkits on the web with left hand side navigation rather than tiles on the homepage. To use this feature, turn on the “Toggle navigation panel” option at the top of the Page settings menu at toolkit homepage level – see below. Please note that publication to downloadable mobile app for this type of navigation is still under development.

The Benzodiazepine tapering tool (https://rightdecisions.scot.nhs.uk/benzotapering) is now available as part of the RDS toolkit for the national benzodiazepine prescribing guidance developed by the Scottish Government Effective Prescribing team. The tool uses this national guidance developed with a wide-ranging multidisciplinary group. This should be used in combination with professional judgement and an understanding of the needs of the individual patient.

3.     Archiving and version control and new RDS Search and Browse interface

Due to the intensive work Tactuum has had to undertake on the new technology infrastructure has pushed back the delivery dates again and some new requirements have come out of the recent user acceptance testing. It now looks likely to be an April release for the search and browse interface. The archiving and version control functionality may be released earlier. We’ll keep you posted.

4.     Statistics

At the end of January, Olivia completed the generation of the latest set of usage statistics for all RDS toolkits. If you would like a copy of the stats for your toolkit, please contact Olivia.graham@nhs.scot .

 

5.     Review of content past its review date

We have now generated reports of all RDS toolkit content that has exceeded its review date by 6 months or more. We will be in touch later this month with toolkit owners and editors to agree the plan for updating or withdrawing out of date content.

 

6.     Toolkits in development

Some important toolkits in development by the RDS team include:

  • National CVD prevention pathways – due for release end of March 2025.
  • National respiratory pathways, optimal cancer diagnostic pathways and cancer prehabilitation pathways from the Centre for Sustainable Delivery. We will shortly start work on the national cancer referral pathways, first version due for release via RDS around end of June 2025.
  • HIS Quality of Care Review toolkit – currently in final stages of quality assurance.

 

The RDS team and other information scientists in HIS have also been producing evidence summaries for the Scottish Government Realistic Medicine team, to inform development of national guidance around Procedures of Limited Clinical Value. This guidance will in due course be translated into an RDS toolkit.

 

7. Training sessions for new editors (also serve as refresher sessions for existing editors) will take place on the following dates:

  • Friday 28th February 12-1 pm
  • Tuesday 11th March 4-5 pm

 

To book a place, please contact Olivia.graham@nhs.scot, providing your name, organisation, job role, and level of experience with RDS editing (none, a little, moderate, extensive.)

 

To invite colleagues to sign up to receive this newsletter, please signpost them to the registration form  - also available in End-user and Provider sections of the RDS Learning and Support area.   If you have any questions about the content of this newsletter, please contact his.decisionsupport@nhs.scot  If you would prefer not to receive future newsletters, please email Olivia.graham@nhs.scot and ask to be removed from the circulation list.

With kind regards

 

Right Decision Service team

Healthcare Improvement Scotland

 

 

Risk factors

The key risk factors for developing type 2 fall into two categories:

Modifiable risk factors

These are risk factors that you can change and control. 

Non-modifiable risk factors

These are risk factors you cannot change yourself. However you can still reduce your risk of developing type 2 diabetes by acting on the modifiable risk factors such as weight loss.

Find out more about each of these types of risk factor by clicking on the links below.

 

Modifiable risk factors

1.Excess body weight

Bathroom scales        tape measure

Your weight plays a large role in developing  type 2 diabetes, especially if your extra weight is around your waist. 

What is a healthy weight to aim for?

This is about working out your Body Mass Index (BMI).  BMI uses your height and weight to work out if you're a healthy weight.  You can work your BMI out for yourself using this NHS tool  – it will show you your target range.

For many people living with obesity, aiming for a healthy BMI may not be realistic. Research shows that  even losing just 5% of extra weight will improve your health. The more weight you lose, the greater the health benefits.

What is a healthy waist size?

BMI  doesn’t look at how much fat you have around the middle. That is why you need to measure your waist too.

Healthy weight size all depends on your gender and ethnicity. For a healthy measurement you need to aim to be less than:

  • 80cm (31.5in) for all women
  • 94cm (37in) for most men
  • 90cm (35in) for South Asian men.

This video from Diabetes UK shows you how to measure your waist size.

2. Physical activity 

physical activity

 It is estimated that 1 in 3 women, and 1 in 4 men in the UK do not undertake enough activity to stay healthy.

It is recommended that we all undertake at least 150 minutes of moderate-intensity exercise, or 75 minutes of high-intensity exercise per week.

Being active can:

  • Contribute to weight loss
  • Increase the way your body uses insulin, reducing the period of time blood glucose levels remain high. 
  • Use fat for fuel in endurance exercise such as running or swimming. This reduces levels of fat around your waist.

Exercise videos

This playlist of short videos from Diabetes UK gives you lots of exercise options to choose from. They range from gentle arm and leg movements to dance and a full body workout.

3. Smoking

smoking

In the UK, 15% of people aged 18 years and over are said to be active smokers. This means that there are  some 7.2 million active smokers that are putting themselves at risk of type 2 diabetes.

Smokers are estimated to be 30% to 40% more likely to develop T2DM than nonsmokers. Cigarette smoke has been found to contain more than 7000 harmful chemicals, many of which can decrease the effectiveness of insulin as a result of  inflammation and damage cells as a consequence of oxidative stress.

Additionally, the nicotine from smoking can reduce the effectiveness of insulin, resulting in active smokers finding it harder to manage blood glucose levels. 

If you have prediabetes or a previous diagnosis of gestational diabetes, you already have an increased chance of developing cardiovascular disease, such as a heart attack, stroke or circulatory problems in the legs.

Combine this with smoking and you make the chances of developing these diseases and their complications even higher.

Help to stop smoking

NHS inform provides a suite of support and resources to help you to stop smoking. This includes the Quit your Way Scotland service. This is staffed by a team of trained advisors who will give you advice tailored to your needs.  

4. Stress 

 stress

Stress  hormones cause an increase in blood glucose levels and reduce the effectiveness of insulin. 

For some people, stress can also trigger overeating behaviours. The change in body chemicals resulting from eating “comfort foods'' can dampen stress related responses and emotions. Over time, this can lead to prolonged levels of comfort eating and, ultimately, an increase in body weight and the development of T2DM. 

Non-modifiable risk factors

1.Age

image of ageing

You’re more at risk of developing type 2 diabetes if you’re:

  • White and over 40 years old
  • African-Caribbean, Black African, or South Asian and over 25 years old.

As we age, our bodies naturally begin to function less efficiently than they did when we were younger. This includes our body becoming less efficient in producing insulin. That can increase our risk of developing type 2 diabetes as we get older. 

2.Genetics

image of DNA

  • You’re two to six times more likely to get type 2 diabetes if you have a parent, brother, sister or child with diabetes.

The genetic risk comes from changes in the parts of our DNA that help to control our blood glucose levels. Some of these changes can reduce our body's ability to release insulin. This leads to increases in blood glucose levels. Over time, elevated levels of blood glucose increases the risk of developing T2DM. 

3.Ethnicity

image representing ethnic diversity

  • Type 2 diabetes is two to four times more likely in people of South Asian descent and African-Caribbean or Black African descent.

While the exact cause of this increased risk among different ethnicities is not fully understood, it is likely that our genetics that are passed down to us and determine who we are play a large role.