Improvements in health and reductions in healthcare costs could be achieved if blood glucose, blood pressure and cholesterol treatment targets were met.
In a study published in Diabetes, Obesity and Metabolism, researchers from the Nuffield Department of Population Health assessed the long-term impact of achieving treatment targets for Type 2 diabetes on diabetes-related complications, life expectancy, and healthcare costs.
Diabetes affects 9% of the UK adult population, with Type 2 diabetes accounting for approximately 90% of these cases (ie 5.4 million patients in the UK). Type 2 diabetes is associated with increased risk of complications such as heart disease or stroke that may result in death or severely impair quality of life. An estimated £10 billion, approximately 10% of the National Health Service (NHS) budget, is spent on diabetes annually; 80% of this cost is for treatment of diabetes complications. General practitioners' (GP) practices are encouraged to achieve defined treatment targets for blood glucose, blood pressure and cholesterol.
Mi Jun Keng, a researcher at the Health Economics Research Centre, Nuffield Department of Population Health, University of Oxford, and the lead author of the paper, said ‘Our study found that meeting more treatment targets was associated with lower risk of a range of diabetes-related complications. Patients would live on average seven months more for each additional treatment target achieved.’
The National Diabetes Audit, which measures the effectiveness of diabetes healthcare, has recently reported improvements in achieving defined treatment targets for blood glucose, blood pressure, and cholesterol among people with Type 2 diabetes. However, the percentage of patients who achieve all three targets is relatively low, ranging from 27% to 54% across groups of GP practices in England and Wales.
Dr Apostolos Tsiachristas, co-author of the paper, added ‘Meeting all three treatment targets reduces the costs to the NHS of treating complications by about £1000 per patient. This could lead to substantial savings to the NHS considering the high and increasing prevalence of Type 2 diabetes in England and Wales.’
Professor Borislava Mihaylova, the senior author of the paper noted ‘Our study shows that if the 10% lowest performing GP practices (with about a quarter of their patients meeting the targets) were to reach the target levels achieved by the top 10% performing GP practices (with about half of patients meeting the targets), they would realise an average gain of 30 years of life for every 100 patients or 3.6 months per patient. These benefits would more than double if they could get all their patients to meet all three treatment targets.’
Nikki Joule, Policy Manager at Diabetes UK, said ‘We hope these findings categorically demonstrate to healthcare commissioners that there are significant economic benefits in improving the support people with Type 2 diabetes receive to help them manage their condition. It’s vital that all people with diabetes are given the support they need to meet as many of their treatment targets as possible. This will help people with diabetes live longer, healthier lives and could also save money for our already stretched NHS.’
This research was supported by a research grant from Diabetes UK and study authors received support from the NIHR Oxford Biomedical Research Centre. The study was designed, executed and reported independently from all sources of funding.