Almost 60 per cent of people with diabetes are not meeting their cholesterol targets despite the vast majority of them now getting it checked at least once a year, according to a new analysis by Diabetes UK.
While we welcome the news that 91.6 per cent of people with diabetes in England are now getting the annual check, according to National Diabetes Audit data, we are concerned that the large numbers of people missing their cholesterol targets means that these checks are not leading to improved outcomes for many people.
Increased risk of heart disease
This is a concern because people with both Type 1 and Type 2 diabetes are more likely to develop heart disease than the rest of the population, with cardiovascular disease accounting for 44 per cent of deaths in people with Type 1 diabetes and 52 per cent in people with Type 2. People with Type 2 diabetes also have twice the risk of stroke within the first five years of diagnosis compared with the general population.
15 healthcare essentials
We have warned healthcare professionals and their patients not to be complacent about the annual cholesterol check, which is one of the 15 healthcare essentials that everyone with diabetes should receive.
We are using the one-year anniversary of the launch of the healthcare essentials to highlight the danger of them becoming a ‘box-ticking exercise’ and emphasising that any problems they identify – including poor cholesterol control – should be acted on.
With poor cholesterol control, for example, the increase in use of statins over the last decade means that making improvements should now be relatively straightforward in most cases, but it is unclear why this has not happened.
Both healthcare professionals and people with diabetes should make sure that the annual health check leads to meaningful action to bring high cholesterol under control.
Barbara Young, Chief Executive of Diabetes UK, said, "If people with diabetes have poor cholesterol control then they are at far higher risk of heart disease and stroke than someone who has poor cholesterol control but does not have diabetes. This is why these findings are so worrying.
"The first step in the journey"
"It is not clear why the high number of people having their annual cholesterol check is not translating into better cholesterol control, but it is an issue that is putting the health of hundreds of thousands of people at risk. We need to emphasise that annual cholesterol checks have to be the start of a process of improving unhealthy levels.
"As with all our 15 healthcare essentials, which are based on official NICE guidance, taking a measurement is only the first step in the journey. Once poor cholesterol control is identified, the healthcare professional and the patient should work together to bring it under control. This should involve a personal target that will significantly reduce their risk of developing cardiovascular disease; it is also important to explain exactly why unhealthy cholesterol levels are so dangerous for someone with diabetes.
"It will often be appropriate to prescribe medication such as statins, but it is no good doing this without explaining both the importance of taking the medication regularly, and the potentially devastating consequences of not doing so.
"Other ways people can help improve their cholesterol levels include losing weight, exercising daily, reducing alcohol consumption, stopping smoking and eating a healthy diet, low in fat. We want to urge people to get the support they need to self-manage and enable them to live long and healthy lives."
We recognise that some people do suffer from side effects such as muscle cramps if they take statins, but the vast majority of the population tolerate them well, and the benefits are well established. There is also other medication available.