Over the last six years there has been a 25% jump in the number of people in the UK with diabetes but many services are not up to scratch, leaving patients at higher risk from developing complications associated with the disease.
The National Diabetes Audit for 2008/09 has revealed that the vast majority of patients with diabetes - 90% - were seen by a healthcare professional about their disease during the year, and yet glucose and blood pressure targets are not being met and in many cases patients are not receiving crucial tests that could uncover potentially serious associated conditions.
Of the records containing a glucose measurement, only 66.6% of patients with type 2 diabetes and 28.6% of patients with type 1 diabetes in England achieved the recommend HbA1C level of under 7.5%, which means that, overall, 40% of patients with the disease have a high risk of developing complications such as blindness, stroke and heart attack, the report warns.
In addition, the Audit found that, despite significant improvement in adherence to the current guidelines, still only about half of type 2 diabetes patients and a third with type 1 forms received all nine care processes recommended by the National Institute for Health and Clinical Excellence during the year.
Of these, the test most commonly missed was the urine test, with just 68.1% of type 2 diabetes patients and 51.3% with type 1 receiving this despite the fact that it provides an important early warning system for diabetic kidney disease. In parallel, the Audit revealed a shocking 20% increase in people with diabetes needing dialysis or a kidney transplant, placing a substantial strain on health resources.
'Little' to celebrate
“There is little good news from this latest audit,” said Douglas Smallwood, Chief Executive of Diabetes UK. “Well over two thirds of people with Type 1 diabetes and half of people with Type 2 diabetes in England and Wales are missing out on checks that in real terms translate into preventing blindness or lower limb loss, and extending life expectancy through the prevention of kidney failure, stroke and heart disease”.
The health service already spends around £1 million an hour on treating diabetes and its complications, and with the snowballing prevalence of the disease, Smallwood urged the new government to “address this unacceptable provision of care and avert a disastrous future health crisis, the economic implications of which would buckle the NHS”.