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Complication rate for diabetes patients leads to higher death rates

One in five people admitted to hospital for angina; stroke; heart attack; and heart failure have diabetes

29 January, 2015

*HSCIC must be quoted as the source of these figures

*Regional information is available from this audit

In 2013 there were 23,986 premature deaths in England and Wales due to diabetes as compared to the general population. Those with Type 1 diabetes were 131 per cent more likely to die in 2013 than their peers without the condition, and those with Type 2 diabetes were 32 per cent more likely to die.

These additional deaths are largely preventable and develop after years of exposure to high glucose, high blood pressure and high cholesterol which are all signs of poorly managed diabetes and make complications such as heart attack and stroke more likely, according to the National Diabetes Report: Complications and Mortality. The report was published today by the Health and Social Care Information Centre (HSCIC) and is commissioned by the Healthcare Quality Improvement Partnership (HQIP) as part of the National Clinical Audit Programme3.

The report assessed the likelihood of a person with diabetes being admitted to hospital for each of a range of diabetic complications, as compared to somebody without diabetes. It also shows the proportion of all people admitted to hospital for each condition who also had diabetes, measured in Finished Consultant Episodes (FCEs)5.

The complications were angina; myocardial Infarction (heart attack); heart failure; stroke; major amputation6; minor amputation6; and renal replacement therapy (dialysis or transplantation).

The analysis showed that people with diabetes were:

  • 139 per cent more likely to be admitted to hospital with angina (24 per cent of all FCEs for the condition)
  • 94 per cent more likely to be admitted to hospital with myocardial infarction (20 per cent of all FCEs for the condition)
  • 126 per cent more likely to be admitted to hospital with heart failure (24 per cent of all FCEs for the condition)
  • 63 per cent more likely to be admitted to hospital with a stroke (17 per cent of all FCEs for the condition)
  • 400 per cent more likely to be admitted to hospital for a major amputation (36 per cent of all FCEs for the condition); and 817 per cent more likely to be admitted with a minor amputation (50 per cent of all FCEs for the condition)
  • 272 per cent more likely to be admitted to hospital for renal replacement therapy (ESKD) (31 per cent of all FCEs for the condition)

The report reveals a significant variation in the number of diabetic patients experiencing these complications and in mortality for patients with diabetes across the UK.

pdf icon NDA complications and motality map [126kb]

Dr Bob Young8, Clinical Lead for the National Diabetes Audit said: "The findings show that high complication rates for patients with diabetes lead to increased hospital admissions and also increase mortality.

"If we can prevent these complications from occurring then this would have a huge impact on the number of hospital admissions across the NHS.

"Whilst it is pleasing to see that complication rates are slowly decreasing year on year, there is still much work to be done. In particular, areas with the highest complication rates should examine their practice to see if more can be done to improve outcomes for patients with diabetes."


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). It is England's trusted data source, delivering high quality information and IT systems to drive better patient services, care and outcomes. Its work includes publishing more than 220 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 or at risk of diabetes. It helps people manage their diabetes effectively by providing information, advice and support. Diabetes UK campaigns with people with diabetes and with healthcare professionals to improve the quality of care across the UK's health services. It funds pioneering research into care, cure and prevention for all types of diabetes. It works to stem the rising tide of Type 2 diabetes - through risk assessment, early diagnosis, and by communicating how healthy lifestyle choices can help many people avoid or delay its onset.

  3. About HQIP, the National Clinical Audit Programme and how it is funded:

    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 holds the contract to manage and develop the National Clinical Audit Programme, comprising more than 30 clinical audits that cover care provided to people with a wide range of medical, surgical and mental health conditions. The programme is funded by NHS England, the Welsh Government and, with some individual audits, also funded by the Health Department of the Scottish Government, DHSSPS Northern Ireland and the Channel Islands.

  4. The National Diabetes Audit (NDA) is considered to be the largest clinical audit in the world.

  5. A Consultant Episode is the time a patient spends in the continuous care of one consultant. Patients may have more than one Finished Consultant Episode (FCE) during a single hospital stay if, for example, they are transferred from one a consultant to a different specialist consultant.

  6. Major amputation is surgical removal of the leg above the ankle. Minor amputation is surgical removal of toes or part of the foot below the ankle.

  7. 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.

  8. Bob Young is Clinical Lead for the National Diabetes Audit & NCVIN (National Cardiovascular Intelligence Network) and is a Consultant Diabetologist & CMIO Diabetes & Endocrinology, at Salford Royal Foundation NHS Trust.

  9. For media enquiries to the HSCIC please call 0300 30 33 88 or email

  10. For media enquiries to Diabetes UK, please call 0207 424 1165 or email

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