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Diabetes care ineffective despite better access to services


Many people with diabetes are not receiving effective care despite having greater access to healthcare services, latest figures have revealed.

Data from the 2008-09 national diabetes audit, published today by the NHS Information Centre, shows that more than 90 per cent of people with diabetes in England and Wales are in contact with their healthcare teams at least once a year.

But blood sugar and blood pressure treatment targets are not being met and the number of people developing end stage renal disease has almost doubled in six years.

The audit reveals that blood pressure targets were not met in more than half of patients with diabetes, more than a third had poor blood sugar control, and a third did not have a vital urine test to identify early signs of diabetic kidney disease.

These are three of the nine key care processes that the National Institute for Health and Clinical Excellence recommends should be received by all patients with diabetes.

According to the audit results only a third of people with type 1 diabetes, and just half of those with type 2, received all nine.

The situation was worst among young people. Of those aged 16 to 39, just 20 per cent with type 1 diabetes and 35 per cent with type 2 received all the tests.   

The audit also revealed that the overall prevalence of diabetes has increased by 25 per cent over the past six years and more than 50 per cent of people with type 2 diabetes are now obese.

Diabetes UK policy manager Gavin Terry said there is “little good news” from the audit.

“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 saving a person’s sight, preventing limb amputation and extending life expectancy through the prevention of kidney failure, stroke and heart disease,” he said. “More worrying is that these figures are worse for young people.”

Consultant diabetologist and clinical lead for the audit Dr Bob Young said that while improvements have been made in diabetes care “there is still much work to be done to best address a condition which is affecting more and more people every year”.


Readers' comments (4)

  • You can have all the targets you want, but at the end of the day if patients do not play their part in managing their illness, no target will ever be met. It is a symptom of this damned nanny state that people never seem to accept their responsibility and expect that no matter how badly they behave someone will always pick up the pieces and someone else will always be blamed. Young people with diabetes are notoriously famous for not complying with their treatment, and yet nurses are always being blamed for these people, 'not being cared for'. It used to be said that if you don't care about yourself, why expect others to care for you. everyone has to take responsibility and young diabetics are no different, so just pack it in beating up on nurses when targets are not met, we do the best we can but you can't make a silk purse from a pigs ear.

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  • Not just younger people either. I agree that people need to take responsibility for their condition, in fact unless they do there is no helping them no matter how much of a nanny state we live in. We give people information and we give them choices and as long as they have capacity then there is not much more that can be said about it.

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  • I am appalled by the blatant victim blaming in the previous posts. I have a family member who at 39 has been diagnosed with renal failure and had never had a simple urinalysis done at her GP surgery and no access to specialist diabetic nurses due to cuts in funding. Her diabetes has been severly disrupted for the past 5 yrs by undiagnosed gastroparesis despite being seen by a GI consultant 5 yrs ago who commented that although she could find nothing wrong her stomach didn't seem to be emptying very well and left it at that. If it wasn't for a urine test that we did at home and research on the internet that turned up gastroparesis she would still be non the wiser. I agree that patients need to take part in managing their own conditions, but do we also have to diagnose ourselves? To add insult to injury she has repeatedly had "non compliant with treatment" written in her notes as her thyroid levels were so low despite being on high levels of Thyroxine, whereas it is now clear that due to the gastroparesis her medication was not being absorbed. I am convinced that these assumptions and other negative attiudes such as those expressed above will have in no small way contributed to the inadequate treatment she has received.

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  • My daughter is a type 1 diabetic, she nearly died due to imcompetence of a training doctor, although I am aware of the amount of brilliant GP's and the work they do. She's compliant, but now has diabetic retinopathy. It doesn't seem fair.

    My neighbour was diagnosed as a type 2 diabetic last year. He was sent home after a simple comment about he had diabetes. Many patients do NOT understand diabetes, especially newly diagnosed and are left for many weeks without any input, and how can they understand, when we need training ourselves? Patients in hospitals are not dealt with appropriately when they come in for treatment - WHY ARE WE NOT USING TAKING URINE SAMPLES AND DIPPING IT FOR KETONES WHEN WE KNOW IT'S DETRIMENTAL?

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