National Diabetes Inpatient Audit highlights "shocking" failings in hospital care
27 June 2013
Hospital inpatients with diabetes are developing potentially life-threatening complications at a "shocking" rate, according to a report published today.
The National Diabetes Inpatient Audit (NaDIA) found that, in a five-day period, more than 60 people with diabetes developed diabetic ketoacidosis (DKA), which results from a severe shortage of insulin.
The report also found that the majority of hospitals in the survey made medication errors, with more than a third of inpatients experiencing a medication error during the period of the study.
In addition, NaDIA found that, of the inpatients who should have seen a specialist diabetes care team, only three in five actually saw one. In the same period, one in five patients experienced a mild hypo, and one in ten experienced a severe hypo.
Health and Social Care Information Centre
NaDIA is based on data collected over a five-day period in September 2012 from hospitals in England and Wales. The study involved 13,410 patients with diabetes in 136 trusts in England and six local health boards in Wales. Over this period, 15.3 per cent – around one in seven – of inpatient beds were occupied by people with diabetes.
NaDIA is managed by the Health and Social Care Information Centre, working in collaboration with Diabetes UK and commissioned by the Healthcare Quality Improvement Partnership.
"Serious questions about basic levels of care"
Bridget Turner, Director of Policy and Care Improvement, Diabetes UK, said, "It is appalling that some people with diabetes are being so poorly looked after in hospitals that they are being put at risk of dying of an entirely preventable life-threatening condition.
"Even a single case of DKA developing in hospital is unacceptable because it suggests that insulin has been withheld from that person for some time. The fact that this is regularly happening raises serious questions about the ability of hospitals to provide even the most basic level of diabetes care.
Profoundly disturbing picture
"But the small minority of people who become seriously ill through neglect is just the tip of the iceberg. In every aspect of hospital diabetes care that this report examines, the picture that emerges is profoundly disturbing. Medication errors are being made with alarming regularity, large numbers of people are not getting foot checks that we know can help prevent amputation, while one in 10 people’s blood glucose level is dropping dangerously low during their hospital stay.
"Put together, this adds up to a situation where in too many cases hospitals are doing people with diabetes more harm than good. This is a scandal and the really shocking thing is that it’s a scandal we have known about for some time but which there has never been any serious focus on bringing to an end.
One in seven inpatients
"People with diabetes are crying out for diabetes care in hospitals to improve and the Government has a key role in showing the leadership to make this happen. Firstly, we need to see diabetes inpatient specialist nurses in every hospital, and all medical staff in hospitals need a basic understanding of how to look after people with diabetes. After all, people with diabetes account for over one in seven hospital inpatients.
"These are the kind of changes that could make a real difference to ensuring that people finally start getting the care they are entitled to, which in turn could have a significant impact on the number of people with the condition who die before their time."