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Heart failure risk for diabetes patients

Action urged as audit finds people with diabetes at much greater risk of heart conditions and stroke
WebMD UK Health News
Medically Reviewed by Dr Sheena Meredith
69x75 heart disease blood test

10th December 2012 - People with diabetes are almost 65% more likely to have heart failure than the rest of the population in England and Wales, the latest figures show.

They are also at significantly higher risk of other potentially fatal conditions such as a heart attack, angina and stroke.

The findings come in the National Diabetes Audit, which is one of the world's largest assessments of diabetes and its complications. The survey analyses the care people with diabetes received in 2010-11.

Campaigners for better diabetes care are describing the findings as "shocking".

Mortality risk

The Audit shows that people with diabetes have a 40% higher risk of dying than those in the general population. The excess risk of dying is much higher (135%) among those with type 1 diabetes than those with type 2 (36%).

Women were at a greater relative risk of dying than men.

From April 2010 to March 2011, 45,001 people with diabetes were admitted to hospital at least once with heart failure - a total of 2.27% of diabetes patients. That means that they were 64.9% more likely to be admitted with heart failure than the general population.

There are regional variations in this extra burden of risk, with someone living in the most deprived fifth of areas in England and Wales over 60% more likely to be admitted to hospital with heart failure than someone living in the least deprived areas.

Heart failure is most likely in people from South Asian backgrounds and least likely in those from black ethnic groups.

Health complications

Among other complications, the Audit finds that patients are:

  • 48% more likely to have a heart attack
  • 25% more likely to have a stroke
  • 144% more likely to need a kidney transplant or dialysis
  • 331% more likely to need a minor amputation, such as a toe
  • 210% more likely to require a major amputation, such as losing a leg above or below the knee

The Audit calls for a concentrated effort in preventing type 2 diabetes and reducing complications in those with the disease by improving preventative diabetes care. It also calls on health managers in areas where care standards are lagging behind other parts of the country to prioritise boosting targets.

Dr Bob Young, the Audit's lead clinician, tells BootsWebMD: "It's about organising care and making sure that everybody is aware of the importance of that - and that the services are organised and delivered in such a way that patients can benefit from them."

Dr Young, consultant diabetologist and clinical lead for the National Diabetes Information Service, adds: "It does require, as with all conditions, a partnership between the person that's got diabetes and their care providers; so there's a big role for the people who've got the condition as well - that they can only discharge their own responsibilities if they're working with health services that are appropriately organised for them."

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