Diabetes sufferers at unnecessary risk of dying

Up to 24,000 people with diabetes are dying each year from causes that could be avoided through better management of their condition.

The first ever report into mortality from the National Diabetes Audit also found death rates among women aged 15 to 34 with diabetes are up to nine times higher than the average for this age group.

Poor management of a patient’s condition; such as not receiving basic healthcare checks, leading an unhealthy lifestyle and not taking medication appropriately, can increase the risk of death from causes including critically high or low blood sugar, heart failure or kidney failure. Good diabetes care greatly reduces the risk of heart failure or kidney failure, while good diabetes education can help people with diabetes to reduce their risk of dangerously high or low blood sugar.

Today’s report shows about three quarters of the 24,000 people with diabetes who die each year are aged 65 and over. However, the gap in death rates between those who have and do not have diabetes becomes more and more extreme with younger age.

About one in 3,300 women in England will die between the ages of 15 to 34; but this risk increases nine-fold among women with type 1 diabetes to one in 360, and six-fold among women with type 2 diabetes to one in 520.

A similar picture is true for young men with diabetes; men aged 15 to 34 in the English population are much more likely to die than women – at one in every 1,530; but this risk rises four-fold for men with type 1 diabetes to one in 360, and by just under four-fold among those with Type 2 diabetes to one in 430.

This means two young people aged 15 to 34 may be dying each week from avoidable causes.

The findings echo conclusions made earlier this year by the National Diabetes Audit, which found nearly 450,000 children and younger adults (aged 0 to 54) with diabetes have high risk blood sugar levels that could lead to severe complications. The audit, which is managed by the NHS Information Centre and commissioned by the Healthcare Quality Improvement Partnership (HQIP), also found this age group was the least likely to receive all the basic care checks required to monitor their condition.5, 6

Today’s report into mortality analysed data for 2.5 million people recorded between 2003/04 and 2009/10 in the National Diabetes Audit; linked to death certificate data from the Office of National Statistics. Cause of death has not been analysed.

The report also found:

  • There is a strong link between deprivation and increased mortality rates. Among under-65s with diabetes; the number of deaths among people from the most deprived backgrounds is double that of those from the least deprived backgrounds.
  • Death rates among people with diabetes vary according to where they live.7 London has the lowest rates for both type 1 and type 2 diabetes, at 1.8 per cent and 1.2 per cent respectively, while the highest rate for both type 1 and type 2 diabetes was in the North East, at 2.4 and 1.7 per cent respectively.

Audit lead clinician Dr Bob Young, consultant diabetologist and clinical lead for the National Diabetes Information Service, said: “For the first time we have a reliable measure of the huge impact of diabetes on early death. Many of these early deaths could be prevented. The rate of new diabetes is increasing every year. So, if there are no changes, the impact of diabetes on national mortality will increase. Doctors, nurses and the NHS working in partnership with people who have diabetes should be able to improve these grim statistics.”

Barbara Young, Chief Executive of Diabetes UK, said: “These figures are incredibly alarming as there is no reason why people with diabetes cannot live long and healthy lives if they receive the right care and support to help them manage their conditions.

“Self-management is very important, but it is also vital that people with diabetes receive the care they need to help them manage their condition in the first place. We know that half of people with Type 2 and more than two thirds of people with Type 1 diabetes are not receiving the care they need to stay healthy, so it is imperative we take action now to stop even more lives being needlessly cut short.

“That’s why we have launched our 15 healthcare essentials campaign to ensure people with diabetes receive the care they need to stay healthy and we will be holding the NHS to account wherever it fails to deliver high-quality diabetes care.”

The report can be accessed at www.ic.nhs.uk/nda