Thousands of diabetes-related deaths could be avoided with better care: UK Report

By Dr. Ananya Mandal, MDDec 15 2011

According to a new report up to 24,000 diabetes-related deaths could be avoided in England each year, if patients and doctors better managed the condition. This is the first-ever audit of patient deaths from diabetes. It says that basic health checks, a good diet and regular medication could prevent most of the deaths.

Diabetes UK said it was vital the 2.3 million sufferers had top quality care. The Department of Health in England said shocking variations in care and an unacceptable death toll were evident. The report, by the NHS Information Centre, compared information about people with diabetes in England with data from death records.

About a third of people in the UK affected do not realize they have the condition. This means their bodies cannot use glucose properly. If they do not manage it, they can develop potentially fatal complications like heart or kidney failure.

By following up the ‘cohort’ of 1.4 million people with diabetes over the next year, the researchers found 49,282 deaths. As the ‘participation rate’ was 68%, taking the estimated prevalence of diabetes in England, it was estimated that the total annual number of deaths of people with diabetes was between 70,000 and 75,000. This represents about 15-16% of the 460,000 deaths that occur annually in England. The study estimated that a third of them were dying from causes that could be avoided if their condition were better managed. That includes basic health checks from doctors, and patients taking medication and keeping to a healthy diet.

For patients with Type 1, the risk of dying was 2.6 times higher than it was for the general population. With Type 2, the risk was 1.6 times higher. But in younger age groups, the risk was far greater. Women between the ages of 15 and 34 with Type 1 diabetes were nine times more likely to die than other women of the same age. Men in the same age group were four times more likely to die if they had the condition.

The National Diabetes Information Service said the number of people with the condition was rising, so if nothing was done, the number of deaths would also increase. “Many of these deaths could be prevented,” said Dr Bob Young, diabetologist and spokesman for the National Diabetes Information Service. “Doctors, nurses and the NHS working in partnership with people who have diabetes should be able to improve these grim statistics.”

Diabetes UK described the figures as alarming. “We know that half of people with Type 2 and more than two thirds of people with Type 1 diabetes are not receiving the care they need to stay healthy,” said Barbara Young, Diabetes UK chief executive. “It is imperative we take action now to stop even more lives being needlessly cut short. We will be holding the NHS to account wherever it fails to deliver high-quality care,” she said.

The Department of Health in England said the audit had revealed shocking variations in care, and an unacceptable death toll. Care services Minister Paul Burstow said, “Our plans to roll out tele-health to improve the lives of three million people will play an important part in helping those with diabetes manage their condition better. Armed with the results of this audit, I expect the NHS to learn from the best. It's not rocket science - integrated health care can help people manage their diabetes, and stay well and out of hospital.”

An expansion of Telehealth, which lets patients use technology to monitor their condition while at home and so avoid regular trips to hospital or to see their GP, would help diabetics manage their condition better, as would greater integration of health and social care services, Burstow added.