The England and Wales National Diabetes Audit is the largest annual clinical audit in the world and the most comprehensive of its kind. It gives information on how much of NICE policy is being implemented.
In the 2013-15 populations the percentage of registered diabetics has risen to 5.1% although it is thought that 7.1% of men and 5.3% of women have the condition from the Health Survey for England 2014.
Nine care processes are recommended by NICE. Overall 39% of type one diabetics and 59% of type two diabetics got all of the checks covered in the audit. Worryingly only 27% of type ones under the age of 40 got all the necessary checks. There is a large range in variability in performance. For type ones in some areas 17% had all the checks and the best managed 62%.
Overall diabetics have a good chance of getting their bloods taken and blood pressure taken. The offer of structured education for newly diagnosed type one patients rose from 17% to 76%. Although 78% of type twos are offered structured education, only 5% take it up.
Only 30% of type one diabetics have glycaemic values of 7.5% HbA1c or 58 mmol/mol. Only 8.7% of type ones got 6.5% or 48 mmol/mol or below. 29% of type twos achieved this target.
The quality of care seems to be worse for type one diabetics especially in the younger age groups. Most of these people will be seen by hospital teams rather than a General Practitioner. The reasons why structured education is sidelined by patients is also mysterious.
Based on an article by Steve Chaplin Medical Correspondent for Practical Diabetes March 2016.