This site is intended for healthcare professionals only


Diabetes Digest

Issue:

Share this article

Increased mortality risk in people who do not receive all NICE-recommended care processes

People with diabetes have a higher mortality risk if their records of routine care indicate several missing annual care processes. Individuals who are missing these care processes represent an at-risk group, and efforts to specifically engage them, as well as to minimise barriers to completing the care processes, would likely yield positive results.

This retrospective cohort study sought to assess whether completion of the nine annual NICE-recommended care processes was associated with mortality over the subsequent decade of follow-up, taking into account the levels of the parameters measured. The study population included all participants in the 2009/2010 National Diabetes Audit who were aged 17–99 years. Individuals were followed up until death or 31 December 2019.

Data on 179 105 people with type 1 diabetes and 1 397 790 with type 2 diabetes were analysed. Results in those with type 1 diabetes are summarised here. Overall, 45.0% received all eight care processes (retinal examinations were not evaluated due to unreliability of the data), while 34.2% received 6–7 processes and 20.8% received ≤5 processes. Lower age, non-white ethnicity and higher HbA1c were associated with lower likelihood of receiving all eight processes.

The all-cause age- and sex-standardised mortality rates (per 1000 person-years) were 33.5, 34.4 and 30.7 in those who received ≤5, 6–7 and 8 care processes, respectively. After adjustment for age, sex, ethnicity, diabetes duration and socioeconomic deprivation, as well as smoking, HbA1c, blood pressure, cholesterol and BMI, the risk of all-cause mortality was 38% greater (hazard ratio, 1.38; 95% confidence interval, 1.29–1.47) in those who received ≤5 care processes compared with those who received all eight.

The associations between care process completion and mortality were consistent between those with type 1 and type 2 diabetes, and were independent of whether care was routinely received in the primary or secondary setting. Regarding the individual care processes, measurement of BMI, HbA1c and cholesterol had the greatest effect on mortality risk.

The authors conclude that people with diabetes have a higher mortality risk if their records of routine care indicate several missing annual care processes. Individuals who are missing these care processes represent an at-risk group, and efforts to specifically engage them, as well as to minimise barriers to completing the care processes, would likely yield positive results.

Click here to read the study in full.

Related content
;
Free for all UK & Ireland healthcare professionals

Sign up to all DiabetesontheNet journals

 

By clicking ‘Subscribe’, you are agreeing that DiabetesontheNet.com are able to email you periodic newsletters. You may unsubscribe from these at any time. Your info is safe with us and we will never sell or trade your details. For information please review our Privacy Policy.

Are you a healthcare professional? This website is for healthcare professionals only. To continue, please confirm that you are a healthcare professional below.

We use cookies responsibly to ensure that we give you the best experience on our website. If you continue without changing your browser settings, we’ll assume that you are happy to receive all cookies on this website. Read about how we use cookies.