Annual diabetes checks reduce mortality risk for people with diabetes

 13 July 2017

People with diabetes who have had annual diabetes checks regularly in the preceding seven years have a mortality rate which is half the rate of those who have not, according to the latest publication from the National Diabetes Audit 2015-16.¹

In five-year age groups, ranging from 35-39 to 70-74, the mortality rate was half the rate for people with diabetes who had had the annual NICE-recommended checks consistently in the previous seven years compared to those that had not.

This information has been included for the first time in part 2b of The National Diabetes Audit 2015-16, Report 2: Complications and Mortality. It was published today by NHS Digital in two parts; a (complications of diabetes) and b (associations between disease outcomes and preceding care.) The Healthcare Quality Improvement Partnership (HQIP) commission the audit as part of the National Clinical Audit Programme, which is managed by NHS Digital in collaboration with Diabetes UK.

Part 2a of the report covers mortality and complications up until March 2016. It found that for people with diabetes, the risk of death was increased at all ages, in both men and women, compared to the general population. Younger people are at greater relative risk of premature death than older people.

Those who appeared in the 2013-14 audit, including people with both Type 1 and Type 2 diabetes, were 32.1 per cent more likely to die prematurely than their peers in the general population.

For people with Type 1 diabetes, the additional risk of death was 127.8 per cent higher than the wider population. It was 28.4 per cent higher for those with Type 2 diabetes.

The report also contains the numbers of people being admitted to hospital for a range of conditions associated with diabetes.

A total of 29.2 per cent of all emergency and non-emergency hospital admissions for cardiovascular conditions were for people with diabetes.

Vascular outcomes also accounted for a higher proportion of deaths among people with diabetes.

Among 102,010 people with diabetes who died in 2015, 33.4 per cent died from a vascular outcome, which includes coronary heart disease, heart failure and stroke. Within the general population, a vascular outcome was the cause of 28.5 per cent of all deaths in 2015.

Read the full report. ¹⁰

^ENDS

1. The National Diabetes Audit 2016-16 Report 2 has been published in two parts. Report 2a covers complications of diabetes. It does not include diabetic eye disease or hypoglycaemia because presently there are no reliable records of these that the NDA can access. Most other cardiovascular and diabetes specific complications are included. Report 2b investigates the associations between disease outcomes and preceding care. Limited resources and time mean that these investigations are constrained to just a few disease outcomes; Heart Failure, Kidney Failure and Death.

2. NHS Digital is the national information and technology provider for the health and care system. Our team of information analysis, technology and project management experts create, deliver and manage the crucial digital systems, services, products and standards upon which health and care professionals depend. During the 2015/16 financial year, NHS Digital published 294 statistical reports. Our vision is to harness the power of information and technology to make health and care better. Find out more about our role and remit at www.digital.nhs.uk

3. The Healthcare Quality Improvement Partnership (HQIP).The National Diabetes Audit is commissioned by the Healthcare Quality Improvement Partnership (HQIP) as part of the National Clinical Audit Programme (NCA). 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 NCA 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. Diabetes UK is the leading UK charity that campaigns on behalf of all people affected by and at risk of diabetes. For more information on all aspects of diabetes and access to Diabetes UK activities and services, visit www.diabetes.org.uk.

5. NICE, the National Institute for Health and Care Excellence, provides national guidance and advice to improve health and social care. This includes recommending nine annual checks, known as care processes, for people with diabetes.

6. Percentages have been rounded to one decimal place.

7. The increased risk of mortality data is covered in Report 2a of the publication and refers to people who appeared in the 2013-14 National Diabetes Audit and who were then followed up for one calendar year (2015). They were compared to the general population who do not have diabetes, as defined as never having appeared in the audit. 57,800 deaths were observed in the diabetic population. 43,800 deaths were expected if the diabetic population had the same mortality rate as the general population without diabetes.

8. Two cohorts of people with diabetes aged 20 years and above and alive as at 31^st March 2013 were chosen to evaluate how full care process completion and significantly reduced care process completion are associated with the outcomes of people with diabetes. This is covered in Report 2b of the publication. Three care processes - measurement of blood glucose, blood pressure and serum cholesterol, were included for this analysis. The cohorts of people and their care process completion were tracked over a period of seven years between the 2006-07 and 2012-13 audit periods. A follow up period was used to identify if the patient died during 2013-14 or 2014-15. The complete care processes cohort had the three key care processes checked every year. The incomplete care processes cohort had no more than 12 of a possible 21 checks of the three care processes over the seven year period. The difference in mortality rate for the complete care process group and incomplete care process group by age band can be seen on page 42-43 of the 2b report.

9. Additional deaths among people with diabetes develop after years of exposure to high glucose, high blood pressure and high cholesterol, which are all signs of poor management of the condition and make complications such as heart attack and stroke more likely.

10. Any media enquiries to NHS Digital, please contact [email protected] or telephone 0300 30 33 888.