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National Diabetes Audit shows diabetes care needs new approach

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The latestNational Diabetes Audithas shone a spotlight on the care of younger diabetes patients. It reveals that diabetes patients under the age of 40 are receiving fewer vital checks and hitting treatment targets less often than older age groups.This audit should act as a wake-up call to the NHS that it needs to take action. If younger people are missing their checks and failing to reach their treatment targets, this is putting them at increased risk of developing serious life-threateningcomplications, such as amputation, kidney failure and heart disease, which devastate lives and are very costly to the NHS.Put simply, younger people who develop diabetes end up living longer with the condition. Surely they should be receiving just as good care as those who are older.  After all, if they get the help and support they need throughout their lives then they are far less likely to develop the serious complications which make up 80 per cent of the NHS’s current budget spend on diabetes.We hear from many people with diabetes in their 30s and 40s who tell us that patchy care and lack of structured education when they were younger has already resulted in life-changing complications. Things need to change for the next generation but the figures tell us that this just is not happening. Alarmingly, it appears things are not getting better for young people; they are actually getting worse.The audit, which has analysed the care of over two million people with diabetes in England and Wales, has not only highlighted the poor care that young people with diabetes are receiving and which you can read more about in our news story. There are other statistics within its 33 pages that make for equally shocking reading.For instance, the percentage of all people with diabetes receiving their annual checks has actually declined, with just 59.9 per cent getting them this year compared to 60.5 per cent the previous year and 60.6 per cent the year before that.These checks are vital in that they measure things like blood pressure and cholesterol, alongside checking for early signs of complications such as kidney failure and foot problems.Worryingly, there has also been a significant decline in the number of people with Type 1 diabetes receiving their eight checks, down from 43.2 per cent to 41.3%.But while more people with Type 2 diabetes are getting their checks, it is still a worrying picture.  The percentage of people with Type 2 receiving all eight care processes has also declined, from 62.6% last year to 61.9% this year.There are also substantial numbers of people with exceptionally high risk glucose levels (17.0 per cent of people with Type 1 and 7 per cent of people with Type 2 have an HbA1c equal at 86mmol/mol or above).Diabetes education is another area where there are concerns. The National Institute for Health and Care Excellence (NICE) recommends that all people with diabetes be offered a structured education programme because they are really important for making sure people have the knowledge they need to manage their condition. However, the audit shows that just 18.4 per cent of those newly diagnosed with diabetes are recorded as being offered the chance to have this education.  We know that access to a variety of learning and support to enable people with diabetes to manage their condition from diagnosis and throughout their life living with it needs to be more available and accessible.Each Clinical Commissioning Group – the health organisations responsible for health in local services in local areas – will need to review the performance of its own services in delivering the NICE-recommended care processes and outcome measures and put in place an action plan for improvements to be made as yet again there are huge regional variations in care. We recognise that change on this scale cannot happen overnight, but the audit acts as a powerful tool to give local teams the data to deliver the changes needed and the CCGs and providers have a significant role to play in making the change happen – or we will be in the same position next year.The time has come for the NHS to show it is serious about dealing with diabetes. People with diabetes – from the youngest to the eldest - deserve a new approach.You can view the full report at:http://www.hscic.gov.uk/pubs/natdiabetesaudit

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