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Diabetes

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Diabetes is a serious condition caused by an inability to make any or enough insulin, which prevents the body from using glucose. It can reduce a person’s life span and can impact significantly on their quality of life.

An estimated 2.35 million people have diabetes in the UK and this is predicted to grow to more than 2.5 million by 2010. It is believed that there are 1 million more people who may have diabetes without knowing it.

It accounts for an estimated 5% of all NHS expenditure and can lead to complications including kidney failure, coronary heart disease, stroke, blindness and foot amputation.

A National Service Framework for Diabetes was published in two parts in 2001 and 2003, and sets out standards for the care of people with diabetes, regardless of where they live. The standards are meant to be met by 2013. Sue Roberts was also appointed as ‘diabetes tsar’ or national clinical director for diabetes.

The NSF standards include preventing and identifying diabetes; helping patient to help themselves; providing high quality care for adults, young people and children; effective care for diabetic emergencies and diabetes in hospitals; support for pregnant women with diabetes; identifying and then treating complications; and providing support.

Growing obesity levels in the UK are thought to have caused a rise in type 2 diabetes.

The real cost for people who have diabetes is shown by the impact of reduced life expectancy and quality of life. Life expectancy is reduced, on average, by more than 15 years in people with type 1 diabetes, and between five and seven years in people with type 2 diabetes (at age 55 years).

Other impacts include:
- Adults with diabetes have heart disease death rates about two to four times higher than adults without diabetes
- The risk of stroke is two to four times higher among people with diabetes
- Diabetes is the most common cause of non-traumatic lower limb amputation
- Diabetes has become the single most common cause of end stage renal disease
- Impotence may affect up to 50% of men with longstanding diabetes
- About 30% of patients with type 2 diabetes develop overt kidney disease.

In primary care, the Quality and Outcomes Framework (QOF) – the system that financially rewards primary care practices for meeting targets in certain areas – has helped identify and treat diabetes better. Specialist diabetes nurses play an important role in managing diabetes in primary care settings.

Updated: September 2006

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