The prevalence of all hypoglycaemic episodes in hospital, both mild and severe, has decreased from 26 per cent in 2011 to 20 per cent in 2016.
Mild hypoglycaemia has fallen by five percentage points, from 23 per cent in 2011 to 18 per cent in 2016. Severe hypoglycaemia, which is more serious because it can cause loss of consciousness, has fallen from 11 per cent in 2011 to eight per cent in 2016.
The 2016 National Diabetes Inpatient Audit report (NaDIA), published today by NHS Digital, also shows that there has been an overall reduction in the prevalence of the most severe, life-threatening hypoglycaemia which requires injectable rescue treatment for inpatients with diabetes5. This has fallen from 2.2 per cent in 2011 to 1.7 per cent in 2016.
Other findings in the report show:
The NaDIA measures the quality of diabetes care provided to people who are admitted to hospital, and covers issues such as staffing levels, medication errors, patient harms and patient experience. There were 209 sites in England and Wales participating in the 2016 survey and data was submitted for 15,774 inpatients - 500 more than in 2015 (15,229).
The audit is carried out by NHS Digital, in collaboration with Diabetes UK7 and commissioned by the Healthcare Quality Improvement Partnership (HQIP) as part of the National Clinical Audit Programme.
Other findings in the 2016 NaDIA include:
Inpatient-onset hyperglycaemic emergency:
Audit lead clinician, Dr Gerry Rayman, said:
“The audit continues to play an important role in changing the standards of hospital care for patients with diabetes and driving forward changes that can save lives, improve inpatient experiences and save money for hospital trusts.
“We have seen a number of successes which include falls in the instances of hypoglycaemic episodes, unnecessary insulin infusions and hospital-acquired foot ulcers. These are, in part, due to the take up of new and more efficient ways of working. The number of hospital sites with care improvement initiatives such as Electronic Patient Records and Electronic Prescribing has increased since 2013, and diabetes Mortality and Morbidity meetings are now held in 53 per cent of sites.
“Each year, we have seen inpatient numbers increasing steadily and, today, around a third of inpatients in a few hospitals have diabetes. There has been little change in staffing levels to accommodate this rise and while overall satisfaction with care is high, the audit shows that there is more work to be done. The audit is stimulating people to ask questions about their hospital care which will also help to drive forward improvements.
“Improvements in medicine management, identifying those at risk, educating other health care professionals and implementing best practice will be a focus for specialist teams within hospitals who are committed to delivering an excellent service to patients with diabetes, despite the many demands upon them.”
“While we can celebrate the achievements of the NaDIA, we must continue to focus on reducing preventable and serious complications including severe hypoglycaemia hospital acquired foot ulceration, diabetic ketoacidosis and hyperosmolar hyperglycaemic state.”