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Obesity and diabetes

Audit reveals England and Wales diabetes risk

The report highlights regional variations in diabetic risk and outcomes.
Diabetics at 330% greater risk of some complications than general population
Report shows variation in diabetes outcomes in England and Wales

A national audit has revealed the toll of diabetes in England and Wales, finding that people with the condition were at a 40% higher risk of death than the general population, and were 65% more likely to suffer heart failure.

Dr Bob Young, clinical lead for the National Diabetes Information Service, who performed the audit, said that it demonstrated the need for improvement in the treatment of diabetes.

“These results highlight the huge impact of diabetes on disability and premature death,” said Young. “Much can be done to reduce these risks if all health care sectors work together with people who have diabetes.”

The National Diabetes Information Service recommends that the audit’s findings should be used by local health groups to prioritise and target efforts to improve their diabetes outcomes.

In 2010/11 – the period during which the audit took place – diabetic patients were 48% more likely to have a heart attack: 14,500 people with diabetes suffered from the complication, whereas in a comparable non-diabetic population, 9,800 heart attacks would have been expected.

Diabetics were also 25% more likely to suffer a stroke, with 17,900 occurrences during the audit period, compared to 14,300 expected cases.

They were also 331% more likely to need a minor amputation, and 210% more likely to need a major amputation, than the general population.

The risk of death was higher among people with type 1 diabetes: there were 3,100 deaths in the type 1 diabetic population where 1,300 were expected, leading to a 135% excess risk, compared to 60,900 deaths in the type 2 diabetic population, where 44,600 were expected, leading to a 36% excess risk.

Young noted that there was considerable local variation in diabetes-related complications, with some areas having significantly rates of morbidity and death.

“Improving treatment for diabetes should be a top priority for all clinical services,” he said.

Health secretary Jeremy Hunt told the BBC: "People with diabetes should be able to expect excellent care from the NHS and they will get it more consistently in future.

"I know there has been progress, but there is still unacceptable variation and we are determined to put that right."

The audit makes four main recommendations for the treatment of diabetes on a national level:

  • Clinical services and commissioners should invetigate innovative approaches to reverse the rising trend of diabetic ketoacidosis, which is particularly prevalent in the socially-deprived and in young women.
  • Clinical services for diabetes and vascular disease need to co-operate in seeking new approaches to better manage this large disease burden.
  • Clinical services should consider focussing approaches to improvement in high risk groups.
  • Preventing type 2 diabetes and reducing diabetic complications by improving the delivery of preventive diabetes care in people diagnosed with both type 1 and type 2 diabetes would appreciably reduce diabetes related premature mortality.

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