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Here is an extract from an article by Professor Steve Bain, Academic Clinician, University of Swansea.
The inexorable rise of primary care diabetes over the past 10 years, with a mass transfer of patients from hospital clinics and the creation of community diabetes medical and nurse consultants may now be demonstrating a downside.
A summary of the National Diabetes Inpatient Audit (NaDIA 2011) in England was recently published, this being the third snapshot of inpatient care for people with diabetes. NaDIA 2011 was carried out by diabetes teams in 188 acute sites on a nominated day in October, resulting in data on 11,866 inpatients.
People in hospital with diabetes were older than other patients (median age of 75 years vs 65 years for all patients), more likely to be admitted as an emergency (84.5% vs 80.8%) and had a longer median length of stay (8 nights vs 5 nights).
41.1% of diabetes inpatients were insulin treated with over 80% of these being people with type 2 diabetes (T2DM).
So who is looking after these elderly, acutely unwell diabetes patients on complex anti-diabetes therapies? Well not, apparently, clinicians with a special interest in the condition. 69.1% of sites had no specialist inpatient dietetic provision for people with diabetes, 30.9% had no diabetes inpatient specialist nurses and diabetes consultants were spending only 11.6% of their time on inpatient care. Perhaps this partly accounts for 32.4% of patients experiencing at least one medication error and 65 patients (0.6%) developing diabetic ketoacidosis as an inpatient?
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