More than one in four hospital admissions for heart failure are for people with diabetes
28 November 2013
More than a quarter of admissions to hospital with heart failure involve a patient with diabetes, according to a clinical audit published today.
The National Diabetes Audit found that people with diabetes made up 28 per cent, or 198,200, of 717,100 hospital admissions for heart failure during 2010–12.
The audit, which recorded over two million patients with diabetes, also shows that people with the condition have a 74 per cent greater risk of being admitted to hospital for heart failure when compared to the rest of the population, and had more than four times the odds of dying in the following year.
Across England and Wales, patients with diabetes were found to be over three times more likely to die prematurely; the audit estimates there were 24,900 more deaths in 2012 than expected.
"Epidemic" of diabetes-related complications
Barbara Young, Chief Executive of Diabetes UK, said, "The finding that every fourth person admitted to hospital with heart failure has diabetes is a stark illustration of how we are facing an epidemic of diabetes-related complications. It is deeply concerning that people with diabetes are 74 per cent more likely to develop heart failure than the rest of the population; in many tragic cases this is leading to people dying before their time.
"There is no great mystery about why the rate is so high, as we know that half of people with diabetes have high blood pressure and a quarter have high cholesterol. All those people are at increased risk of heart disease and we need to address this urgently.
Spur to action
"We hope this report is a spur to action for both the NHS and people with diabetes. Given how much higher their risk is, it is vital that people with diabetes have their blood pressure and cholesterol checked at least once a year and that if they are high then they are supported in lowering them.
"While most people do get these two checks, there are still significant numbers who don’t, and this is particularly the case with people with Type 1. But our biggest concern is that too often these checks are not then leading to lower levels of cholesterol and blood pressure; it is only by improving this situation that we will finally start to bring the diabetes-related heart disease epidemic under control."
Dr Bob Young, clinical lead for the audit, said, "This audit is a wake-up call. Heart failure is preventable and treatable. Every health professional should take note of how much more common heart failure is among patients with diabetes and how high the short-term risk of death is."
The National Diabetes Audit is the largest of its kind in the world, and presents 2010–12 findings on deaths, complications and hospital admissions among over 2 million people with diabetes in England and Wales. The audit is managed by the Health and Social Care Information Centre (HSCIC) in partnership with Diabetes UK, and is commissioned by the Healthcare Quality Improvement Partnership (HQIP).
The audit examined health complications associated with the highest risks of death in patients with diabetes and measured death rates from all causes among people with diabetes, compared to the general population.
Key findings from the National Diabetes Audit 2011–12 show:
• Of the 198,100 people in the audit with Type 1 diabetes in England and Wales in 2012, 3,300 died during the year, whereas 1,440 would have been expected among the same number of the general population. This gives a 130 per cent increased risk of death for people with this form of diabetes.
• Of the 1.9million people in the audit with Type 2 diabetes in England and Wales in 2012, 70,900 died during the year, whereas 52,800 would have been expected among the same number of the general population. This gives a 35 per cent increased risk of death for people with this form of diabetes.
• The risk of premature death for people with diabetes compared to their peers in the general population (relative risk) is greatest for women and younger people.
• The inflated death rate for people with diabetes in 2012 (38 per cent) is lower than observed in 2011 (41 per cent). However, it is too soon to know whether this is a trend.