Overseen by NHS Digital, the National Diabetes Audit is used to assess the efficacy of diabetes care in England, Wales and the Isle of Man. The full report for 2016/17 was published on 14th March 2018.

The audit analyses information provided by 95.3 percent of primary care providers, and specifically looks to answer five key questions:

  1. Are all patients recorded on a practice diabetes register?
  2. What percentage of patients received the key processes of diabetes care as outlined by NICE?
  3. What percentage of patients achieved targets for glucose control, blood pressure and blood cholesterol?
  4. What percentage of patients are offered and attend a structured education course?
  5. What are the rates of acute and long term complications (disease outcomes) for diabetes patients?

Diabetes is on the rise

Since 1996, 2.1 million people have received a diabetes diagnosis, taking the number of people living with the condition to approximately 3.5 million.

So, why are diabetes rates increasing? And why is it a problem?

Dr Bob Young, clinical lead for the National Diabetes Audit, spoke to The Diabetes Times about the most recent audit, ‘the problem is in our overfed and sedentary society’ he explained, ‘we’re pushing down the age of diagnosis of type 2 diabetes. So people who are going to get type 2 diabetes, will probably get it, but what this data shows is if you get type 2 diabetes in your sixties, the health impact is much less than if you get it when you’re younger[...]’

The NDA findings

The audit highlights several important points about the different groups of people living with various types of diabetes. People in two groups in particular - young people and those also diagnosed with a severe mental illness (SMI) - were found to be less likely to be accessing the level of care set out by NICE guidelines.

The NDA reports:

  • People of working age and younger are almost half as likely to achieve treatment targets as their older counterparts.
  • Young people less frequently complete care processes and are most likely to face negative outcomes than those diagnosed later in life.
  • Those diagnosed with type 2 diabetes are twice as likely to also be diagnosed with a severe mental illness (SMI) than those with type 1 diabetes or the general population.
  • Those living with diabetes and SMI are also more likely to experience higher levels of social deprivation, and are also more likely to be from ethnic minorities.

Why is the NDA important?

The NDA supplies primary care providers with comparable information which can drive measurable improvements to the services currently being offered; generating key recommendations for care providers

These recommendations recognise the need for improvements in engagement with young people. The report suggests that GP practices and specialist services, ‘seek new approaches to improving management for those overall doing worst,’ in particular with ‘people of working age and younger.’

However, the key recommendations do not mention specific actionable factors for those living with SMI or from an ethnic minority background.

You can read the full report here.