UK – 24,000 with diabetes 'are dying needlessly'
24,000 with diabetes ‘are dying needlessly’: Fewer than half of patients get vital checks, say MPs
By Jenny Hope
PUBLISHED: 19:01 EST, 5 November 2012 | UPDATED: 19:01 EST, 5 November 2012
Up to 24,000 patients with diabetes are dying needlessly each year despite the NHS spending £3.9billion on their care, warn MPs.
A report from an influential Commons committee says that there is an ‘unacceptable postcode lottery’ of care, with massive variations across the country.
Fewer than half of diabetes patients are given nine basic checks by their GP which can reduce the risk of complications such as blindness, amputation or kidney disease.
Risk: New figures show that less than half of diabetes patients receive the correct checks by their GP
The Public Accounts Committee warns: ‘Most alarmingly, the Department estimates 24,000 people with diabetes die prematurely each year because their diabetes has not been managed effectively.’
Unless care improves significantly, the NHS will incur ever-rising costs and avoidable deaths will continue, it says.
The number of those with diabetes, mostly type 2, is expected to rise from 3.1million to 3.8 million by 2020.
PAC chairman Margaret Hodge said fewer than one in five diabetes sufferers has the recommended levels of blood glucose, blood pressure and cholesterol.
She criticised the lack of mandatory targets to deliver diabetes care, as there are for cancer, stroke and heart disease.
Across England fewer than half of diabetes patients received the nine recommended checks between 2009 and 2010.
In some primary care trusts, standards actually worsened with fewer than one in ten patients getting proper checks.
Rising problem: The number diabetes patients is expected to rise by 700,000 in eight years
The PAC report says GP practices are being paid for individually monitoring diabetic patients rather than providing the vital nine-point check-up – and this should be changed.
The Department of Health is reviewing annual incentive payments, which could result in practices getting the cash only if they do the full range of checks for at least 75 per cent of patients.
The PAC report comes after the National Audit Office laid bare a decade of failure since minimum standards of care were set in 2001.
Mrs Hodge said progress had been ‘depressingly poor’, with no accountability at local level and no strong leadership.
‘We have seen no evidence that the Department will ensure that these issues are addressed effectively in the new NHS structure.
‘Failure to do so will lead to higher costs to the NHS as well as less than adequate support for people with diabetes.’
Barbara Young, of charity Diabetes UK, said: ‘This sets out how a postcode lottery of care has been allowed to develop that means too many are getting healthcare that’s not good enough.
‘Given the increasingly strong evidence of inadequate care, we cannot understand why the NHS has sleepwalked into this situation.
‘This has led to huge numbers of potentially preventable complications such as amputation, and to many thousands of people dying before their time.’
The Department of Health said: ‘We do not accept the conclusion services are “depressingly poor” as there has been progress. But we know there has been unacceptable variation and we’re determined to put that right.’
THE NINE CRUCIAL CHECKS
All diabetes patients should receive nine crucial tests from their GP at an annual review, including:
– Weight
– Blood pressure
- Smoking status
- A marker for blood glucose called HbA1c
- Protein in the urine (for kidney damage)
– Creatinine levels in the blood (for kidney damage n cholesterol levels
– Tests to assess whether eyes have been damaged and
– Foot examinations.
If left unchecked, diabetes can lead to blindness, kidney failure and increase a person’s risk of cardiovascular problems such as heart attacks and stroke.
Comments (63)
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The thing with my diabetes is I get so much mixed information from dieticians, diabetic nurses, doctors etc that I dont believe any of them now, some say no bananas, some say bananas ok, what do yuo believe. At my last check up in April 2012 the nurse said to me “the EU guidlines had changed in March 2012 and we are now giving you insulin” so, apparently ive gone from being able to control it with food and keeping the blood readings low to full insulin prescription and I’m still only diabetes type 2. Apparently, insulin is good for preventative measures too! Well, I dont think so, Im not going to be told by EU when I should take insulin, had I gone for my check up in February they would have been happy with my sugar control as they were before, which makes all this a mockery to me. How come the EU are telling type 2 to take inuslin anyway? Cant our own doctors/diabetic nurses decide?
– hellsbells , london, 06/11/2012 16:51
The biggest problem with any form of diabetes and other illnesses is the lack of solid info regarding diet and supplements. NHS says eat plenty of carbs, less dairy and more starch, some will say eat less carbs and more fat. Neither is healthy for your liver. The ideal is more raw veg and veg fibre, no white flour, pastries, cakes or biccys, chips, crisps etc and sugary foods. People need to be taught how the liver just can’t cope with all the bad food and drink we shove into our mouths. The other problem is diabetics are left alone to deal with the problem, blindly eating without checking their sugar levels, thinking they can eat and drink the same rubbish only to trot back to the doc’ with complications. Its no good just to cut down on the bad food, we have to cut those unnecessary foods from the diet if we want to live and feel healthy, and check our own sugar levels to keep control. Six monthly, yearly checks with out a clear diet guide are a disaster for anyone with this problem.
– sunseeker12 , Somerset, 06/11/2012 16:13
We have GP’s who are paid pretty well but we still feel the need to pay them extra amounts to hit targets. Ideally, I would like to have a GP who prescribes me what I need as an individual, not mass medicate a population based on extra payments made. Each patient has a different risk/benefit ratio and as an individual needs to be informed of their options. Instead of these targets, would it not be better to inform the public on what they should expect from their GP and let the patient take it up with the GP. We all have a duty to be aware of our health care and it’s all out there if you choose to look.
– Gimley , Somerste, 06/11/2012 15:44
I am a diabetes type 2 patient and live in Poole Dorset. My GP’s and Poole general Hospital have been truely excellent in looking after me. I had a heart bypass graft BEFORE i was diagnosed with diabetes type 2 and have suffered in the past with a slipped disc. Again the help I had was excellent. I can only write as I have found it!
– Old Contemptible , Poole, United Kingdom, 06/11/2012 15:02
The major problem isn’t that diabetes patients are missing out on these checks. The problem is the NHS deliberately prevents them from carrying the most important test of all – their blood sugar level. Many patients with T2 are simply denied access to blood testing strips, despite the fact there is a wealth of research which shows all patients with diabetes enjoy better outcomes if they can regularly test their blood sugar. In other worse, the NHS actively forces people with T2 to do worse – intentionally! Adding to this is then the majority of doctors and dieticians then instruct people with diabetes to cut down on the only foods which do NOT raise blood sugar and eat more of the foods that do!
– Doug , London, United Kingdom, 06/11/2012 14:56
@Jenny You missed have missed the word “most” 😉 A lot of fat guilty readers it would seem. If they’d run a mile inside of clicking “vote down” it would save the country a fortune. It’s no mystery that the massive prevalence of obesity and type 2 diabetes go hand-in-hand. Don’t shoot the messenger.
– Mike Lovell , Chicago, 06/11/2012 14:29
As usual the major issue seems to be confusing type 1 and type 2 diabetes and trying to treat them as the same with the same advice and diets.They are totally different diseases needing different approaches. Also the approaches are different in differing parts of the country, unfortunately in too many areas the advice being given is old fashioned, and like most things training budgets have been cut so GPs and even specialist diabetes nurses are not being kept up to speed on new research and developments. I would urge all type 1’s to ask about DAPHNE, it is simple to implement and has improved my condition beyond belief, cutting my insulin requirements by some 70-75%, lost most of the excess weight and making my overall control very good, all tests are now “normal, and I am now able to work on cutting out blood pressure and cholesterol medication.
– Paul E , Colchester, 06/11/2012 14:28
Nothing cures type 1 diabetes but insulin is a vital tool. Never stop your insulin. I believe big pharma IS hiding a cure. I also believe type 1 diabetes needs renaming.
– Weena , kent, United Kingdom, 06/11/2012 14:23
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From regular three monthly nail trimming and a once every twelve months “diabetic check” our Chiropody department has gone to at least five monthly trimmings – you can always ring for a cancelation, but might not get one – it still provides the yearly check but the year is usually a couple of weeks longer.
– gigi , liverpool, 06/11/2012 16:58
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