People with diabetes are 48% more likely to suffer a heart attack than the general population, according to one of the largest research projects into the health and care of people with the disease.
The national diabetes audit, published on Monday, examined the NHS's treatment of almost 2 million people with diabetes in England and Wales in 2010-11. It paints a worrying picture of how the condition sharply increases the risk of other complications, some potentially fatal.
The audit, undertaken by the NHS's Health and Social Care Information Centre, the charity Diabetes UK and the Healthcare Quality Improvement Partnership, also found people with diabetes were 65% more likely to have heart failure, 144% more at risk of needing kidney dialysis or a kidney transplant, 210% more likely to have a leg amputated above or below the knee , 331% more likely to need part of a foot removed and 25% more at risk of suffering a stroke.
The findings have increased calls for the NHS to improve the care of people with diabetes, as numbers rise sharply, mainly as a result of the increase in obesity.
It found they were 48% more likely to have a heart attack, for example. In 2010-11 a total of 14,500 people with diabetes suffered a heart attack compared with the 9,800 that would be expected to occur in the general population.
In 2011 65,700 people with diabetes died, compared with the 47,000 that would have been anticipated in the general population – equivalent to an extra risk of 40%. Those with type 1 diabetes have a far greater extra risk of dying early (135%) than those with type 2 (36%).
About 90% of the UK's 3.7m cases involve type 2 diabetes, which is closely linked to people's lifestyles, especially obesity, whereas type 1 is an auto-immune condition unrelated to people's behaviour. Diabetes UK believes there are 850,000 people with undiagnosed diabetes.
Barbara Young, Diabetes UK's chief executive, said it was shocking that people with diabetes were almost 50% more likely to have a heart attack. She said many of the cases could be prevented with better education, treatment and care.
"This report is not just a wake-up call for diabetes-related heart disease. It lays bare how people with diabetes are at greatly increased risk of complications such as amputation, stroke, kidney failure and blindness. As well as the devastating effects these are having on people's quality of lives, diabetes is causing too many people to die as a result of these complications of stroke, heart disease and kidney disease," said Young.
The NHS needed to do more to ensure that many more patients received checks that all are meant to receive to help them manage their condition, such as of their cholesterol and blood pressure. Care is so variable that 80% of the £10bn a year the NHS spends treating diabetes goes on complications – "a tragic example of short-termism that barely half of people with the condition are getting the nine checks that could prevent many of these complications", added Young.
Jeremy Hunt, the health secretary, said that while care of diabetes had improved "there is still unacceptable variation and we are determined to put that right". Government-imposed changes to the GP contract for 2013-14 for England's 36,000 family doctors would mean that GPs would receive payments in return for doing more to help people with diabetes achieve better control of their glucose, blood pressure and cholesterol levels, and for sending them for a dietary review, for example.
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