Guest blog post by Simon O’Neill, Director of Health Intelligence and Professional Liaison at Diabetes UK.
Diabetes is the number one health threat we face today worldwide. There are now 3.8 million people living with diabetes in the UK, with another 7 million people at high-risk of developing the condition, and the numbers are rising dramatically every year. If current trends continue, by 2025 there will be 5 million people in the UK with diabetes.
Why does that matter? Diabetes is the leading cause of blindness in the working age population; a third of people on dialysis or awaiting a kidney transplant have the condition; over 100 amputations are carried out every week as a direct result of diabetes; last year there were 24,000 excess deaths in people with diabetes, with young women being nine times more likely to die than their peers. These are just some of the complications caused by diabetes.
Yet despite these frightening statistics, many people with the condition are not getting the care or support they need. As a recent Public Accounts Committee report highlighted, diabetes care in England is “depressingly poor”, with barely half of adults with diabetes getting the recommended tests and checks they need to manage the condition. For children, the figures are even worse. In England only one in 20 is recorded as receiving all the routine health checks they should.
We also know that the quality of care and treatment people with diabetes receive varies greatly depending on where they live. In some parts of the country people with diabetes are up to four times more likely to have all the basic care checks than those in other areas. And the rate of children having episodes of diabetic ketoacidosis, a serious condition that requires urgent medical attention and can even result in death, varies from none at all to 30 per cent across paediatric units.
We believe that this is completely unacceptable, as these basic checks and services are vital in highlighting potential complications early enough to do something about them.
So what do we need to do to improve diabetes care? For once money is not the problem, as the NHS is already spending 10% of its entire budget on diabetes. But it is spending the money at the wrong point in the diabetes pathway, spending heavily on managing the devastating diabetes complications, rather than doing more to prevent them from developing in the first place. A huge 80% of NHS diabetes spending goes on treating these complications, many of which could have been prevented if people had got the right care in the first place.
Prevention is always better than cure so a good place to start would be to ensure that the NHS Health Check is delivered more effectively to help identify the 7 million people who are at risk of Type 2 diabetes, so that they can get the lifestyle advice and support they need to prevent it. A national screening programme for Type 2 would be even better. This would help to diagnose the 850,000 people who have Type 2 diabetes but do not know it. Sadly about half of these people are already developing complications by the time they are diagnosed because they may have had undiagnosed diabetes for many years. They would have a much better outlook if their condition was diagnosed earlier, before the complications start to develop.
We also need to ensure everyone knows diabetes is a potentially serious condition. The high profile government-led programmes that we have seen for cancer and heart disease have simply not happened with diabetes. We still hear patients and health care professionals referring to Type 2 diabetes as “mild” when the evidence shows it is anything but. This is why we need a government-backed campaign to raise awareness of the risk factors and symptoms and encourage more people to get screened.
To help people with diabetes develop an awareness of their rights to care and treatment, we have launched our 15 healthcare essentials. This lists the healthcare that every person with diabetes should receive. The 15 healthcare essentials can be accessed online at: http://www.diabetes.org.uk/About_us/Our_Views/15-healthcare-essentials/
Ultimately, we need the emerging NHS bodies and the Government to spell out exactly how they intend to make diabetes a priority. This is why we are calling for a national implementation plan for improved diabetes care. Unless this happens we will continue to see thousands more people die early each year when their lives could be saved.