National Institute for Health and Clinical Excellence (NICE)
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Majority of people with diabetes 'not meeting cholesterol targets'

More than half of people with diabetes are not having their cholesterol levels adequately controlled, according to a new study.

Charity Diabetes UK analysed figures from the latest National Audit for Diabetes, which revealed 91.6 per cent of people with diabetes are now receiving annual checks for the condition.

Despite this, around 60 per cent of those receiving the checks are not meeting their annual targets for cholesterol, suggesting the checks are not being acted on.

There are currently 3.7 million people in the UK with diabetes, the majority of whom have type 2 diabetes.

People who have the condition are at higher risk of cardiovascular disease - a condition which is linked to 44 per cent of deaths in people with type 1 diabetes, and 52 per cent of deaths in people with type 2 diabetes.

The risk of cardiovascular disease also increases with higher cholesterol levels. This means that a person with diabetes who has high cholesterol is much more likely to develop cardiovascular disease than other members of the population.

NICE's pathway on diabetes says that people with diabetes should have a cardiovascular risk assessment every year as part of routine annual checks.

This risk assessment should include a full lipid profile including high-density lipoprotein (HDL) cholesterol and triglyceride estimations.

If a person is found to be at high risk of cardiovascular disease, they should be offered statins to achieve total cholesterol levels of less than 4.0 mmol/litre, and HDL cholesterol not exceeding 1.4 mmol/litre, or total low-density cholesterol levels of less than 2.0 mmol/litre.

If this treatment does not lower cholesterol levels sufficiently, treatment should be intensified.

Diabetes UK believes that both healthcare professionals and people with diabetes should ensure that meaningful action is taken following health checks to bring high cholesterol under control.

Barbara Young, Chief Executive of Diabetes UK, said: "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."

She added: "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."

NICE's quality standard on diabetes in adults contains statements on annual care planning people and receiving personalised advice on nutrition and physical activity.

Baroness Young continued that exercising daily and eating a healthy diet, low in fat are among actions people can take to help improve their cholesterol levels.

Elsewhere, the publication of a separate study in Diabetes Care has also raised calls for people from black and minority ethnic (BME) groups to be screened earlier for type 2 diabetes.

Researchers found that people from South Asian, African or African Caribbean groups are around twice as likely to develop type 2 diabetes as their European counterparts.

NICE's guidance on preventing type 2 diabetes says certain people should be offered risk assessments earlier.

These include those aged 25-39 from South Asian, Chinese, African-Caribbean or Black African descent, and other high risk BME groups (except pregnant women).

Iain Frame, Director of Research at Diabetes UK said that "people from these communities should be screened earlier than the general population - from the age of 25 rather than 40".

He added: "We know that people from South Asian backgrounds can often be living with the condition for around 10 years before they are diagnosed, which increases the risk of complications such as heart disease, stroke, kidney failure, blindness and amputation."

The NICE pathway on diabetes contains all of NICE's recommendations on the management and prevention of the condition.

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