A small number of people have had their diabetes wrongly diagnosed, prompting the publication of a new tool to help GPs improve the diagnosis, classification and coding of the condition.
A new report by the Royal College of General Practitioners (RCGP) and NHS Diabetes, gives advice and support to all clinicians involved in diagnosing diabetes and offers free, downloadable practice audit tools.
In the UK, diabetes affects approximately 2.8 million people and more than one million people are thought to have undiagnosed type 2 diabetes. Numbers of people predicted to have the condition are set to rise sharply over the next 20 years.
In preparing the report Coding, Classification and Diagnosis of Diabetes: A review of the coding, classification and diagnosis of diabetes in primary care in England, an audit found that 5.2% of patients had an inaccurate diagnosis for the condition.
A pilot of audit tools to improve diagnosis, classification and coding of diabetes was carried out across five GP practices with 1,600 people on diabetes registers. The pilot found that 2.2% of people diagnosed with diabetes did not have it, 2.1% of people were classified with the wrong type of diabetes and 0.9% of people had their type of diabetes coded as indeterminable.
The newly published report and resources for GPs contain the results of a systematic review examining existing evidence on misdiagnosis, misclassification and miscoding, and the results of an analysis of two primary care databases of nearly one million patients establishing the extent of misdiagnosis, misclassification and miscoding.
As well as pragmatic guidelines for diagnosis and classification, the resource also contains audit tools to improve diagnosis.
Dr Clare Gerada, chair of the RCGP and a practising GP in London, said: “Diabetes is a growing concern for GPs and their teams and it is crucial that patients receive the correct diagnosis so that they can start to receive the appropriate treatment and care.
“The report found that the overwhelming majority of people are correctly diagnosed with what is increasingly recognised as a very complex condition.
“However in a few cases people have been misdiagnosed, misclassified or miscoded with diabetes. The new guidelines and audit tools will be of great benefit to doctors and patients and we will be working very closely with our members and other primary care colleagues to introduce them into widespread clinical practice.”
Dr Rowan Hillson, national clinical director for diabetes, said: “It is reassuring that the vast majority of people with diabetes are correctly diagnosed.
“In a few complex cases people may have been misdiagnosed with diabetes or the type of diabetes misclassified, but this shouldn’t significantly affect their treatment.
“However, with 2 million people diagnosed with diabetes in England and the numbers predicted to go much higher, the classification algorithm and audit tools provided today make a valuable contribution to help GPs with diagnosis, classification and coding of diabetes.”