INEQUALITIES in the care of diabetes patients across Scotland are widening, according to a new report.
It also reveals that people from socially deprived areas are most likely to end up in hospital or die from diabetic ketoacidosis (DKA) as a result.
The study from Diabetes UK showed that cases of the life-threatening DKA – a complication of type 1 diabetes that occurs because of a severe lack of insulin in the body – have been steadily increasing since 2004. A team of researchers led by Dr Joe O’Reilly at the University of Edinburgh used National Records of Scotland data to track people with a diagnosis of type 1 diabetes from 2004 to 2018, investigating how many were hospitalised and/or died as a result of “DKA events” over the 14-year period.
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They found that among the 37,939 people with type 1 diabetes identified, more than a quarter (27%) experienced what is known as a DKA event.
There were 30,427 DKA hospital admissions and 472 deaths recorded from 2004 to 2018 and, of those treated for DKA in hospital, 45% experienced at least one additional DKA event.
Rates of deaths from DKA were found to be more than twice as high in 2018 compared to 2004, from 95 to 204 deaths per 100,000 person years.
People living in more socially deprived areas had higher rates of DKA hospitalisations and deaths throughout the study period than those from less deprived areas.
Women were found to have higher rates of hospitalisations than men.
O’Reilly, an epidemiologist/biostatistician at the University of Edinburgh, said: “These findings highlight the importance of reducing the impact of deprivation on diabetes care and preventing incidents of DKA, which are priorities in the Scottish Government’s Diabetes Improvement Plan. More positively, we observed a marked reduction in the rate of DKA events in 10-19 year olds, and this is potentially associated with recent improvements in blood sugar levels that have been seen in this group.”
Director of Diabetes Scotland Angela Mitchell added: “Dr O’Reilly’s research reinforces the urgent need to address the deep-rooted inequalities that persist within diabetes care in Scotland.
“It is time for a renewed and focused effort to end the disparities in diabetes care, and to address avoidable deaths from DKA.”
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