NHS Diabetes: Treatment Targets

An earlier post summarised the NHS’s lack of success in ensuring that diabetics received all nine diabetes care processes specified in the NICE Clinical Guidelines: five risk factors - weight (BMI), blood pressure, smoking, glucose levels (HbA1c), and serum cholesterol and four tests for early complications - digital eye photography, laboratory urine microalbumin: creatinine ratio, serum creatinine and foot nerve and circulation examination.

http://www.lowcarbdiabeticuk.blogspot.co.uk/2012/11/nhs-diabetes-care-processes.html

The NICE guidelines also specify treatments target standards: HbA1c ≤ 7.5%, total cholesterol ≤ 5 mmol/l and a blood pressure target of < 140/80 for those patients without a recorded eye, kidney or vascular disease (EKV-) and < 130/80 for those patients with a recorded eye, kidney or vascular disease.

Given that the HbA1c upper limit is dangerously high and almost all diabetics are prescribed statins and blood pressure tablets it is of some interest to note what percentage of people registered with diabetes achieve all 3 target standards. From:

http://www.ic.nhs.uk/webfiles/Services/NCASP/Diabetes/201011%20annual%20reports/National_Diabetes_Audit_2010_2011_Report1_Care_Processes_And_Treatment_Targets_V3.pdf

% of patients achieving all 3 target standards

	England	Wales
Type 1	11.6	9.2
Type 2	20.4	18.7

Do we regard this as acceptable?

John