Inadequate NHS diabetes care causing patients harm

NHS diabetes care is inadequate and some patients come to further harm due to poor care in hospital a leading specialist says

Dr Gerry Rayman national clinical lead for inpatient diabetes warned many hospitals had no specialist diabetes nurse

He said many hospital patients had diabetes and called the situation quite alarming

The Department of Health said work was under way to improve care standards

Speaking on BBC Radio 4s You and Yours Dr Rayman head of the diabetes service at Ipswich Hospital NHS Trust said quotWe know that one in three hospitals dont have a specialist diabetes nurse which is really quite alarming when we know that one in six people in hospital have diabetes

quotUnfortunately many people in hospital with diabetes do come to harm as a result of Im afraid to say inadequate care in hospitalquot

Diabetes accounts for 11 of all NHS inpatient expenditure and costs the service around pound237bn last year a figure projected to increase to just under pound40bn by 2035

Two types

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Diabetes complications

Diabetes that is not controlled can cause many serious longterm problems
Excess glucose sugar in the blood can damage the blood vessels contributing to heart disease strokes kidney disease impotence and nerve damage
Uncontrolled diabetes is the most common cause of blindness in people of working age
People with diabetes are also 15 more likely to have an amputation than people without the condition
In Type 2 diabetes not enough insulin is produced or the insulin that is made by the body does not work properly

It tends to affect people as they get older and usually appears after the age of 40 but increasingly is seen in younger overweight people It accounts for 90 of all cases

Type 1 diabetes a condition which usually means insulin cannot be produced at all is responsible for the other 10

Adrian Sanders chair of the allparty parliamentary group for diabetes claimed there was plenty of evidence out there to support Dr Raymans assessment

He said the government was aware that a disproportionate number of people occupying hospital beds have diabetes and their hospital stays are longer

He said the government and the last Labour administration had encouraged more support for people with diabetes in primary care

quotThats actually a very good policy for people whose condition doesnt present complications or specialisms And thats why you need specialist care for those who present with specialist problemsquot

Barbara Young chief executive at Diabetes UK said diabetes was a serious condition which could lead to devastating long term complications including blindness kidney failure and amputations

She said quotThe tragedy is that for many people with diabetes complications could have been avoided if the health checks were in place to spot any signs and if the appropriate care and treatment were applied

quotFor example up to 80 of amputation cases due to diabetes could be avoided if problems are identified early enough and treated appropriatelyquot

Personal responsibility

A key area of contention is whether diabetes is an issue for social or personal responsibility with some arguing for tougher regulation of the food industry whilst others argue healthy diet is strictly a matter for the individual

Last week a tenminute rule bill was introduced in the House of Commons by Keith Vaz arguing for the reduction of sugar content in soft drinks by 4

However Paul McArdle of the British Dietetic Association cautioned against putting too much emphasis on sugar in food

He said quotFood labelled suitable for diabetics comes from the misguided principal that everything for people with diabetes is about sugar

quotThe main focus for this group is losing weight and having a healthy diet as this helps people with diabetes manage the condition

quotAround 6090 of type two diabetes is caused by people being overweight with more than half of that being preventable by having a healthy lifestyle

quotThe bigger issue is good food labelling which can enable consumers of food to make healthy choicesquot

Audit for improvement

The Department of Health issued a statement which accepted that good diabetes care was very important in hospital and elsewhere

quotThat is why the National Diabetes Inpatient Audit reviews diabetes management in hospital each year and feeds results back to individual hospitals to take appropriate action

quotNHS Diabetes is working with clinicians through their Inpatient Network to improve care

quotThe Audit has already shown some improvements in care but more needs to be donequot

Date : 28 Apr, 2012
Reference : http://www.bbc.co.uk/news/health-17868067

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