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'Unexpected' Rise in Excess Deaths Linked to Diabetes

The number of excess deaths involving people with diabetes in England increased significantly last year compared with pre-pandemic levels, according to an analysis.

A report by Diabetes UK called for urgent Government action to address "fragmented" access to routine care, attributing the unexpected rise to too many people being left to manage their condition alone. 

The charity's annual audit identified 7000 excess deaths involving people with diabetes in 2022, which it said was a rise of 13% compared with the 5-year average prior to the pandemic. Furthermore, the majority of those excess deaths were not attributable directly to COVID-19, it said.

'Worrying' Development

Diabetes UK said that "worryingly", the situation worsened in the first months of 2023, with 1461 excess deaths between January and March, which was three times as high as in the same period in 2022.

Results from an online survey of 11,304 people with diabetes, or those closely connected to them, suggested that 48% experienced difficulties managing their diabetes last year. 

According to the findings, only 47% received all eight of their recommended checks in 2021-22, compared with 57% before the pandemic. If findings from the poll were extrapolated across the population of England, the results could mean that almost 300,000 fewer people with diabetes received all their checks last year compared with 2019-20, the report said.

Asked in the poll why they had experienced difficulties managing their condition in 2022:

  • 50% of respondents mentioned a lack of access to a diabetes healthcare team
  • 38% said it was hard to make appointments for a diabetes check up
  • 52% who had tried to get emotional or psychological support cited difficulties doing so

Diabetes and Deprivation

The findings suggested that difficulties accessing care were more likely to be experienced by those in the most deprived quintiles, with 1 in 3 people in the most deprived areas saying it had been hard to contact their diabetes healthcare team, compared with 1 in 4 for those who were least deprived. And those who were most deprived were almost 50% more likely to have had no contact with their healthcare team last year than people living in the least deprived areas.

Regional variation in the delivery of diabetes healthcare checks was "huge", according to the report, ranging from 25% in the worst performing integrated care board to 62% in the best, whilst at primary care network level, the variation was even more stark, ranging from 10% in the lowest performing to 86% in the best.

The report highlighted "inequity in every aspect of diabetes", with people from South Asian, Black African, and Black Caribbean backgrounds two to four times more likely to develop type 2 diabetes, and frequently at a younger age, than their White European counterparts.

Major Conditions Strategy

Diabetes UK said the Government must focus on diabetes in its major conditions strategy, tackle the backlog in care, reduce health inequalities, and ensure people with diabetes were better supported. It also recommended that ministers implement a strategy to reduce obesity, which must include a commitment to restrict junk food marketing.

A spokesperson for the Department of Health and Social Care said: "The NHS Diabetes Prevention Programme – the largest programme of its kind in the world – has helped over 18,000 people avoid type 2 diabetes through expert advice on healthy eating and exercise.

"We're already helping people make healthier choices by restricting the location of foods high in fat, salt, or sugar and introducing calorie labelling on menus. Our major conditions strategy will cover type 2 diabetes and help to reduce pressure on the NHS.

"Cutting waiting lists is one of the government's top five priorities, and the NHS has virtually eliminated waits of over 2 years for treatment and has cut 18 month waits by over 50% in a year."