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Diabetic patients - at higher risk of death

Audit shows huge disease risk linked to diabetes

Jo Carlowe

Monday, 10 December 2012

People with diabetes are at higher risk of fatal conditions than the general population.

This is the finding from the National Diabetes Audit published today. The audit results reveal that diabetics are at a much greater risk of potentially fatal conditions like heart attack, angina and stroke and of needing amputations.

The authors of the audit say diabetes must be made a top healthcare priority.

According to the National Diabetes Audit, which analysed the care of nearly two million people with diabetes in 2010/11 in England and Wales, in 2010/11 - 45,000 people with diabetes suffered heart failure – 17,700 (65%) more than the number expected (27,300).

Its latest findings, which are standardised to take into account differences between the general and diabetic populations, also show that people with diabetes in England and Wales are 48% more likely to suffer a heart attack - 14,500 people with diabetes suffered this complication in 2010/11 – when 9,800 of such cases were expected.

They are 25% more likely to suffer a stroke - 17,900 people with diabetes suffered this complication in 2010/11 – when 14,300 of such cases were expected.

In addition, 144% are more likely to need renal replacement therapy - 9,800 people with diabetes needed this treatment in 2010/11 – when 4,000 were expected.

Some 331% are more likely to need a minor amputation - 3,000 people needed this treatment in 2010/11 – when 700 of such cases were expected and 210% were more likely to need a major amputation - 1,700 people with diabetes suffered this complication in 2010/11 – when 600 of such cases were expected.

The audit also showed that people with diabetes had a 40% higher risk of death than the general population: 65,700 people with diabetes died in 2011 – when 47,000 such deaths were expected. Taking into account patients not captured in the audit, it is estimated there were 22,200 excess deaths in England and 1,900 in Wales among people with diabetes.

The excess risk is much higher among people with Type 1 diabetes – at 135% compared to 36% for people with Type 2 diabetes. For patients captured in the audit, this equates to 3,100 people with Type 1 diabetes dying in 2011 when 1,300 such deaths were expected, and 60,900 people with Type 2 diabetes dying when 44,600 deaths were expected.

Women with diabetes were at a greater relative risk of death than men with the condition: at 142%T for Type 1 and 40%T for Type 2 for women, compared to 130% and 33% respectively for men.

Commenting on the findings, the audit lead clinician Dr Bob Young said: “These results highlight the huge impact of diabetes on disability and premature death. Much can be done to reduce these risks if all health care sectors work together with people who have diabetes. Some districts have appreciably lower diabetes related complications than others. Improving treatment for diabetes should be a top priority for all clinical services.”

Barbara Young, Chief Executive of Diabetes UK, described the findings as "shocking".

“This report is not just a wake-up call for diabetes-related heart disease. It lays bare how people with diabetes are at greatly increased risk of complications such as amputation, stroke, kidney failure and blindness. As well as the devastating effect these are have on people’s quality of lives, diabetes is causing too many people to die as a result of these complications of stroke, heart disease and kidney disease. Giving priority to tackling diabetes is a must for the Government and NHS if it to make any significant impact on reducing the number of people dying early in the UK."

Thought to be the largest of its kind in the world and now in its eighth year, the audit is managed by the Health and Social Care Information Centre (HSCIC) in partnership with Diabetes UK and commissioned by the Healthcare Quality Improvement Partnership (HQIP).

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