Quarter of people with diabetes in England are undiagnosed
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《英国医生杂志》
Nearly one in every four people with diabetes are undiagnosed or do not have the condition noted in their medical records, a clinical audit of all healthcare sectors in England published this week has found.
The first year of the National Diabetes Audit collected information on more than 250 000 people in England for 2003-4, with data given by 20% of primary care trusts, including more than 1700 general practices, 47 hospital trusts, and 58 specialist paediatric units. It compared the number of people diagnosed and registered with diabetes with a prevalence model developed by the Yorkshire and Humber Public Health Observatory, which predicted that 4.26% of the population in the areas taking part in the audit would have diabetes.
Results showed that 3.25% of the audit population were registered with diabetes, only 77% of the number predicted. There was considerable regional variation in different practices, ranging from 50% to more than 90% of the predicted number being recorded. Women were less likely to be diagnosed with diabetes than men.
The audit report warned, "Ensuring people with diabetes are correctly diagnosed and on a register is the starting point for establishing an effective programme of systematic care. People who do not have their diagnosis recorded on practice registers will be unlikely to receive the routine care and monitoring required to minimise long term complications." It recommended that diabetes networks, primary care trusts, and GPs' practices should aim to register more than 90% of the number of people predicted to have diabetes and should collaborate with secondary care providers to ensure diabetes registers are complete.
The audit also assessed whether patients achieved treatment targets. Just over half (56%) of patients registered in the audit achieved an HbA1c of less than 7.5%, the primary target concentration for glucose control recommended in NICE's clinical guidelines, and 23% achieved the secondary target of less than 6.5%. In the audit of specialist paediatric units, only 15% of children with diabetes achieved the primary target HbA1c of less than 7.5%, and 65% achieved a minimum of 9.5%.
Fewer than half of diagnosed people were receiving eye tests, and just more than one in every five patients with diabetes (21%) achieved the blood pressure target recommended in UK guidelines of at most 135/75 mm Hg. Eighty four per cent achieved the target of less than 160/100 mm Hg. For total cholesterol, 61% of people achieved the target of less than 5 mmol/l—11% more men than women achieved the cholesterol target. The audit recommended that service providers should aim to achieve upper quartile rates for each of the treatment targets.(Susan Mayor)
The first year of the National Diabetes Audit collected information on more than 250 000 people in England for 2003-4, with data given by 20% of primary care trusts, including more than 1700 general practices, 47 hospital trusts, and 58 specialist paediatric units. It compared the number of people diagnosed and registered with diabetes with a prevalence model developed by the Yorkshire and Humber Public Health Observatory, which predicted that 4.26% of the population in the areas taking part in the audit would have diabetes.
Results showed that 3.25% of the audit population were registered with diabetes, only 77% of the number predicted. There was considerable regional variation in different practices, ranging from 50% to more than 90% of the predicted number being recorded. Women were less likely to be diagnosed with diabetes than men.
The audit report warned, "Ensuring people with diabetes are correctly diagnosed and on a register is the starting point for establishing an effective programme of systematic care. People who do not have their diagnosis recorded on practice registers will be unlikely to receive the routine care and monitoring required to minimise long term complications." It recommended that diabetes networks, primary care trusts, and GPs' practices should aim to register more than 90% of the number of people predicted to have diabetes and should collaborate with secondary care providers to ensure diabetes registers are complete.
The audit also assessed whether patients achieved treatment targets. Just over half (56%) of patients registered in the audit achieved an HbA1c of less than 7.5%, the primary target concentration for glucose control recommended in NICE's clinical guidelines, and 23% achieved the secondary target of less than 6.5%. In the audit of specialist paediatric units, only 15% of children with diabetes achieved the primary target HbA1c of less than 7.5%, and 65% achieved a minimum of 9.5%.
Fewer than half of diagnosed people were receiving eye tests, and just more than one in every five patients with diabetes (21%) achieved the blood pressure target recommended in UK guidelines of at most 135/75 mm Hg. Eighty four per cent achieved the target of less than 160/100 mm Hg. For total cholesterol, 61% of people achieved the target of less than 5 mmol/l—11% more men than women achieved the cholesterol target. The audit recommended that service providers should aim to achieve upper quartile rates for each of the treatment targets.(Susan Mayor)