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National Diabetes Audit: Less than half of diabetes patients achieving blood pressure targets

October 30, 2013: New figures show over 1.2 million patients had not met the blood pressure target of less than 140/80 for the 2.3 million patients with diabetes in England and Wales whose blood pressure was recorded.

Today's audit report shows wide variation in achieving the 140/80 blood pressure target between Clinical Commissioning Groups (CCGs) and Local Health Boards (LHBs). Some CCGs and LHBs met this target in 53 per cent of cases but in others it was met in less than 44 per cent of cases.

The National Diabetes Audit 2011-2012 records the three NICE recommended treatment targets that should be monitored and met for patients with diabetes which are glucose control, blood pressure and serum cholesterol.

Diabetes is a major risk factor for cardiovascular disease and most people with Type 2 diabetes have high blood pressure. Blood pressure that is not controlled properly increases the risk of heart attacks, heart failure and stroke.

The audit is the largest of its kind in the world and presents 2011-2012 findings for the care of almost 2.5 million people with diabetes, an 11 per cent increase in participation on the previous year. It is managed by the Health and Social Care Information Centre (HSCIC) in partnership with Diabetes UK and is commissioned by the Healthcare Quality Improvement Partnership (HQIP).

The National Diabetes Audit 2011-2012 covers data recorded by 88 per cent of GP practices across England and Wales. The key findings show:

  • Diabetes was more prevalent in men than in women in each age group.
  • Over half of patients diagnosed with Type 1 diabetes did not receive all diabetes checks (56.8 per cent, or 117,800 out of 207,570) and over a third of patients with Type 2 diabetes did not receive all checks (37.4 per cent, or 819,980 out of 2.2 million).
  • Younger patients were less likely than older patients to receive all of the annual checks. Just over one third (34.0 per cent) of patients aged 20 to 29 years received all checks.
  • For all patients with diabetes that participated in the audit, blood pressure targets of 140/80 were achieved in 48.1 per cent of cases, slightly higher than the 2010-2011 achieved rate of 44.6 per cent.

Dr Bob Young, clinical lead for the audit, said:

"Today's audit shows how much scope there is for reducing heart disease and stroke in people with diabetes by achieving the blood pressure treatment target more often."

You can access the full report here http://www.hscic.gov.uk/catalogue/PUB12421

ENDS


Notes to editors

1. The Health and Social Care Information Centre (HSCIC) was established on April 1 2013 as an Executive Non Departmental Public Body (ENDPB). The trusted source of authoritative data and information relating to health and social care, HSCIC plays a fundamental role in driving better care, better services and better outcomes for patients.

It supports the delivery of IT infrastructure, information systems and standards to ensure information flows efficiently and securely across the health and social care system to improve patient outcomes. Its work includes publishing more than 130 statistical publications annually; providing a range of specialist data services; managing informatics projects and programmes and developing and assuring national systems against appropriate contractual, clinical safety and information standards.

2. Diabetes UK is the leading UK charity that cares for, connects with and campaigns on behalf of all people affected by and at risk of diabetes. For more information visit www.diabetes.org.uk. In the UK, there are 3.7 million people with diabetes, including an estimated 850,000 people that have Type 2 diabetes but do not know it.

3. The Healthcare Quality Improvement Partnership (HQIP) is led by a consortium of the Academy of Medical Royal Colleges, the Royal College of Nursing and National Voices. Its aim is to promote quality improvement, and in particular to increase the impact that clinical audit has on healthcare quality in England and Wales. HQIP hosts the contract to manage and develop the National Clinical Audit and Patient Outcomes Programme (NCAPOP). Their purpose is to engage clinicians across England and Wales in systematic evaluation of their clinical practice against standards and to support and encourage improvement in the quality of treatment and care. The programme comprises more than 30 clinical audits that cover care provided to people with a wide range of medical, surgical and mental health conditions.

4. According to the Quality and Outcomes Framework (QOF) - 2011-2012, 2.6 million people in England aged 17 and above have Type 1 or Type 2 diabetes. Diabetes comprises a group of disorders with many different causes, all of which are characterised by a raised blood glucose level. This is the result of a lack of the hormone insulin and/or an inability to respond to insulin. Insulin in the blood, produced by the pancreas, is the hormone which ensures that glucose (sugar) obtained from food can be used by the body. There are two main types of diabetes: Type 1 diabetes and Type 2 diabetes. In people with Type 1 diabetes, the pancreas is no longer able to produce insulin because the insulin-producing cells (beta-cells) have been destroyed by the body's immune system. Without insulin to move glucose from the bloodstream to the body's cells, glucose builds up in the blood and is passed out of the body in the urine. In people with Type 2 diabetes, the beta-cells are not able to produce enough insulin for the body's needs. The majority of people with Type 2 diabetes also have some degree of insulin resistance, where the cells in the body are not able to respond to the insulin that is produced.

5. The results in the report are calculated using NDA methodology and should not be compared directly with other reports where different methodologies may have been used. In addition, the NDA methodology for 2011-2012 has been revised. In order to accurately report time series analysis, last year's NDA data has been reprocessed according to the this new methodology, which means there may be slight differences in the data published in last year's report. The diabetes checks measured in the 2011-2012 audit are Blood Pressure, Body Mass Index, Cholesterol, Foot checks,HbA1c (Blood Sugar), Serum Creatinine, Smoking and Urine Albumin. The 2011-2012 audit does not measure completion of eye screening which had been included in previous years.

6. Numbers above 100 have been rounded to the nearest 10.

7. For non-media enquires about the NDA or diabetes information and services HSCIC contact diabetes@hscic.gov.uk.

8. CCG comparisons have used the 5th and 95th percentiles to compare regional variation, that is, the top and bottom 5 per cent have been removed and the remaining range compared.

9. For media enquiries and interview requests please call 0845 257 6990 or contact: media@hscic.gov.uk

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