Diabetes care improves, but patients still missing out on key tests

17 Jun 2010 03:44 PM More people with diabetes are now receiving all nine of the key tests for diabetes care recommended by NICE, but thousands are still missing out on the essential tests, according to latest figures from the National Diabetes Audit.

All patients should receive nine crucial tests from their GP at an annual review of their diabetes management. These include measurements of weight, blood pressure, smoking status, a marker for blood glucose called HbA1c, urinary albumin, serum creatinine, cholesterol, and tests to assess whether the eyes and feet have been damaged by diabetes.

These tests are essential to ensure that diabetes is controlled. If left unchecked, diabetes can lead to blindness, kidney failure and increase the risk of developing cardiovascular problems such as heart attacks and stroke.

The National Diabetes Audit, which looks at the records of over 1.7 million people with diabetes in England and Wales, found that just over half of patients with type-2 diabetes and a third of patients with type-1 diabetes received all nine tests in 2008/9.

This compares to only 10.6 and 11.9 per cent respectively, six years ago when the first national audit was conducted. However, the latest figures still remain below the recommended target levels set by NICE.

Measuring urine albumin creatinine ratio, which detects the earliest stage of kidney disease, is the test least likely to be carried out, while blood pressure measurement remains the most frequently recorded test at 96.5 per cent in type-2 diabetes and 88.8 per cent in type-1 diabetes.

The Audit also found that social deprivation does not affect the likelihood of all the care processes being completed. However, age does have an effect, with younger people receiving the tests less frequently.

Ethnicity is also associated with differences in completion of all care processes among people with type-2 diabetes, but not in those with type-1 diabetes.

Dr Bob Young, consultant diabetologist and clinical lead for the audit said: "It is encouraging to see the continued commitment of those involved with diabetes care in participating in this audit - which now includes records for 75 per cent of people with diabetes."

"Analysis of those 1.7 million records is vital to understanding and treating diabetes and this year's report shows that, while some improvements have been made, there is still much work to be done to best address a condition which is affecting more and more people every year."

Dr Douglas Smallwood, Chief Executive at Diabetes UK, agreed that more work is needed to improve diabetes care.

"Well over two thirds of people with type-1 diabetes and half of people with type-2 diabetes in England and Wales are missing out on checks that in real terms translate into preventing blindness or lower limb loss, and extending life expectancy through the prevention of kidney failure, stroke and heart disease. More worrying is that these figures are worse for young people", he said.