Wide variation in control of diabetes sparks call for improved care

Diabetes patients face a 'postcode lottery' variation in care and nearly 200,000 are living with severe complications as a result of the condition, charity Diabetes UK has revealed in a call for improved care.

200,000 people are living with severe complications of diabetes (Photo: iStock)
200,000 people are living with severe complications of diabetes (Photo: iStock)

Fresh analysis of data from the National Diabetes Audit (NDA) 2012/13 shows that just under 200,000 people in England and Wales are living with severe complications – such as amputation, heart attack and stroke – as a result of diabetes, according to Diabetes UK.

The charity warned that the high numbers revealed the ‘frightening scale’ of the condition, and highlighted the ‘urgent need’ for the NHS to prioritise diabetes care.

Regional figures from the NDA also uncovered a postcode lottery of services, with the proportion of patients who have their diabetes under control ranging from 27% in the lowest CCG area to just 48% in the highest.

Diabetes UK chief executive Barbara Young said: ‘With the numbers of people with diabetes rising at an alarming rate, it is vital that the government and the NHS act urgently to end the postcode lottery of diabetes care.

Diabetes postcode lottery

‘It is an absolute tragedy that almost 200,000 people a year are suffering debilitating and life threatening diabetes complications such as heart attacks, amputations, and stroke that could be prevented with better care and support.

‘Unless this happens,’ she added, ‘thousands more people a year will be condemned to entirely avoidable debilitating complications and early death, and the future sustainability of the health service will be at great risk.’

But the GPC warned that it was ‘simplistic’ to say that better care would reduce complications.

GPC clinical and prescribing subcommittee chairman Dr Andrew Green said: ‘Unfortunately, it is incorrect to say that these could be prevented with better care and support – no degree of care can ever prevent complications, all that can be done is to reduce the likelihood of them occurring. While this is undoubtedly a worthwhile aim, the impression given that complications result from poor care is simplistic.’

Prevent causes of diabetes

There are ‘two great challenges’ to improve diabetes outcomes, he added. ‘The first is to ensure that the prospects for people with diabetes are the same standard everywhere, this is by no means due to GP care alone, but dependent also on other aspects of the NHS and social care systems.

‘The second challenge is to prevent the seemingly inexorable rise in diagnoses, and that in turn will require governmental willingness to attack the underlying causes of obesity, which will inevitably involve confrontation with the powerful food and drink industries.’

Diabetes complications are costly to the NHS, amounting to £8bn a year. The disease accounts for 10% of the total primary care prescribing budget.

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