Mapping Prediabetes to Diabetes… diabetes results in about 70 amputations a week in England, 80 per cent of which are potential

Following the recent shocking report from the US that at current rates half of all Americans will have diabetesA disorder caused by insufficient or absent production of the hormone insulin by the pancreas, or because the tissues are resistant to the effects. within the next ten years, the UK Department of Health have mapped out the variation in diabetes spend across the country. This shows a distinct 'postcode lottery' for the 2.3M people in England with Diabetes.

The National Institute for Clinical Excellence (NICE) reports:

Patients with diabetes face a postcode lottery of care, with a 35-fold variation across England in the number of diabetics who are receiving all nine of the NICE key care processes, according to the NHS Atlas of Variation.

The Atlas, a new initiative published today by the Department of Health, maps the variations in health spending and outcomes across England. It comprises of 34 maps indicating high and low spenders among the 152 primary care trusts (PCTs).

NICE recommends in its guidance on type-2 diabetes that all patients with diabetes receive nine crucial tests from their GP at an annual review of their diabetes management. These include measurements of weight, blood pressureThe pressure of blood within the arteries., smoking status, a marker for bloodA fluid that transports oxygen and other substances through the body, made up of blood cells suspended in a liquid. glucoseA simple sugar that is an important source of energy in the body. called HbA1cAn abbreviation for glycated haemoglobin, a measure of how well glucose levels have been controlled over the previous three months or so in a person with diabetes. It is expressed as a percentage., urinary albuminA type of chemical called a protein, formed in the liver., serumThe clear fluid that separates from blood when it clots. It contains salts, glucose and proteins. creatinineA product of the breakdown of creatine in muscle (creatine itself is fromed from the breakdown of protein)., cholesterolA substance present in many tissues and an important constituent of cell membranes although high concentrations of a certain type of cholesterol in the blood are unhealthy., and tests to assess whether the eyes and feet have been damaged by diabetes.

Treating these risk factors reduces the development of complications, and the early identification of complications allows patients to receive treatment to slow progression to heart disease, strokeAny sudden neurological problem caused by a bleed or a clot in a blood vessel., and blindness. The Atlas found considerable variation, 35-fold across the country, among the number of patients who are receiving the NICE key care processes at their annual check-up.

Almost a quarter of people with diabetes were found to be missing out on the foot checks they need, and diabetes results in about 70 amputations a week in England, 80 per cent of which are potentially preventable.

US Diabetes Explosion

According to a new report from the health insurer, United Health Group, more than 50 percent of Americans could have diabetes or prediabetes by 2020 if current trends continue, but there are also practical solutions for slowing the trend.

New estimates show diabetes and prediabetes will account for an estimated 10 percent of total health care spending by the end of the decade at an annual cost of almost $500 billion – up from an estimated $194 billion this year.

The report suggests key solution steps including lifestyle interventions to combat obesityExcess accumulation of fat in the body. and prevent prediabetes from becoming diabetes and medication control programs and lifestyle intervention strategies to help improve diabetes control.

Simon Stevens, executive vice president, UnitedHealth Group, and chairman of the UnitedHealth Center for Health Reform & Modernization said: “What is now needed is concerted, national, multi-stakeholder action. Making a major impact on the prediabetes and diabetes epidemicA sudden outbreak of infection that affects a large proportion of a population. will require health plans to engage consumers in new ways, while working to scale nationally some of the most promising preventive care models. Done right, the human and economic benefits for the nation could be substantial.”