Many patients with diabetes who end up in hospital are suffering life-threatening complications because their care is not good enough, according to an audit published today.
The National Diabetes Inpatient Audit report says it is shocking that 60 patients in hospitals across England and Wales should have developed diabetic ketoacidosis during the one week survey. The condition, which can be fatal, occurs when a diabetic patient is not given enough insulin.
"It is appalling that some people with diabetes are being so poorly looked after in hospitals that they are being put at risk of dying of an entirely preventable, life-threatening condition," said Bridget Turner, director of policy and care improvement at Diabetes UK, which jointly managed the audit with the health and social care information centre. The audit was commissioned by the Healthcare Quality Improvement Partnership.
Turner called on the government to lead change. "Even a single case of diabetic ketoacidosis developing in hospital is unacceptable because it suggests that insulin has been withheld from that person for some time. The fact that this is regularly happening raises serious questions about the ability of hospitals to provide even the most basic level of diabetes care.
"But the small minority of people who become seriously ill through neglect is just the tip of the iceberg. In every aspect of hospital diabetes care that this report shines a light on, the picture that emerges is profoundly disturbing.
Medication errors are being made with alarming regularity, large numbers of people are not getting foot checks that we know can help prevent amputation, while one in 10 people's blood glucose level is dropping dangerously low during their hospital stay.
"Put together, this adds up to a situation where in too many cases hospitals are doing people with diabetes more harm than good. This is a scandal and the really shocking thing is that it's a scandal we have known about for some time but which there has never been any serious focus on bringing to an end."
Most of the patients with diabetes were admitted for some other reason, but the care of their diabetes was not as good as it should be. A third of patients in England (39.8%) suffered from a medication error, although that was an improvement on 2010, when the figure was 44.5%. In Wales, 36.7% suffered from a medication error.
Less than 60% of patients who should have visited by a specialist diabetes team actually saw one. A third of hospitals in England (32.2%) and nearly half in Wales (47.1%) had no specialist diabetes nurse for inpatients.
Graham
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