GPs improve diabetes outcome for third year

GPs have improved outcomes for diabetes patients for the third year running, says the National Diabetes Audit (NDA).

The report for 2005/6 shows that the number of patients achieving the cholesterol and BP targets stipulated in NICE clinical guidance on diabetes have increased. Twenty-seven per cent of patients achieved the BP target of 135/75mmHg, compared with 25 per cent in 2004/5.

The proportion of patients hitting the total cholesterol target of 5mmol/l or less increased by 5 per cent to 73 per cent.

The number of patients achieving HbA1c levels of 7.5 or below in 2005/6 was 41.6 per cent. This was a 2.2 drop from the previous year's audit figure.

Dr Brian Karet, diabetes lead for North Bradford PCT, said: 'I am not surprised by the findings as we know that it is notoriously difficult to manage HbA1c levels in children and adolescents.'

Additionally, lowering glycaemic control in elderly patients is not best practice, he said.

Under the quality framework, GPs are awarded 17 points for ensuring 40-50 per cent of their diabetes patients have HbA1c of 7.5 or less. They are also awarded 11 points for ensuring HbA1c of 10 or less in 40-90 per cent of diabetes patients.

Breakdown of the information included in the report, including 656,000 patient records, shows that those aged 70 to 84 are most likely to hit the NICE HbA1c target. Almost 42 per cent of this group had HbA1c of 7.5 or less, compared with just 15 per cent of those aged 16 to 24.

The NDA has called for GPs to ensure that children and young people with HbA1c levels consistently above 9.5 per cent are offered additional support by their diabetes team in order to help them improve their glycaemic control and minimise the risk of ketoacidosis and other long-term complications.

But the care of paediatric diabetes is the remit of secondary care, not GPs, Dr Karet added.

This year's NDA also suggested communication between primary and secondary care is improving. Only 0.17 per cent of patients recorded as having diabetes were found to be missing from primary care records. This is 19 per cent less than in the previous audit.

Primary care organisations need to ensure secondary care informs GPs of patients with diabetes, NTA has said.

DoH diabetes czar, Sue Roberts said more healthcare professionals were getting involved in the NDA. The number of GP practices that registered increased by 30 per cent this year to 4,972.

Mean prevalence of recorded diabetes in England and Wales has increased to 3.74 per cent from 3.51 per cent, according to the NDA. But 750,000 cases are still thought to be undiagnosed.

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