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Publication, Part of

Report 1: Care Processes and Treatment Targets 2020-21, Full Report

Audit, Survey, Other reports and statistics

Definitions

Diabetes

Diabetes is a condition where the amount of glucose in the blood is too high because the pancreas doesn’t produce enough insulin.  Insulin is a hormone produced by the pancreas that allows glucose to be used as a body fuel and other nutrients to be used as building blocks. There are two main types of diabetes: type 1 diabetes (no insulin); type 2 diabetes (insufficient insulin).

Urine Albumin-to-Creatinine Ratio (UACR)

UACR is a ratio between two measured substances urine albumin and urine creatinine. Unlike a urine dipstick test for albumin, UACR is unaffected by variation in urine concentration.

Specialist Service

This is a service (often hospital based but sometimes delivered in a community setting) which includes diabetes specialists working in multidisciplinary teams. These teams usually comprise physicians (diabetologists), diabetes specialist nurses and dieticians; it may also include clinical psychologists.

Annual Review

This is a GP appointment where the annual NICE recommended Care Processes are undertaken

Care Processes (NICE recommends all of these at least once a year)

Blood Pressure

A measurement of the force driving the blood through the arteries. Blood pressure readings contain two figures, e.g.130/80. The first is known as the systolic pressure which is produced when the heart contracts. The second is the diastolic pressure which is when the heart relaxes to refill with blood.

BMI measurement

Body mass index is calculated from weight and height and used to classify body weight as underweight, normal, overweight or obese

Serum creatinine

A blood test used to measure kidney function.

Urinary albumin

This urine test detects the earliest stages of kidney disease.

Cholesterol

This blood test measures a type of fat that can damage blood vessels.

Foot risk surveillance

This examination checks the blood supply and sensation (feeling) in the feet. Loss of either is a risk for foot disease.

Smoking Status

This records whether the person is a smoker. Smoking increases the diabetic risk for heart attacks and stroke.

HbA1c 

A blood test for average blood glucose levels during the previous two to three months.


Treatment Targets (NICE defines target levels to reduce risks of complications for people with diabetes)

HbA1c

The closer this is to normal (less than 42mmol/mol) the lower is the risk of all long term complications of diabetes.

Cholesterol

Reducing cholesterol levels lowers the risk of heart attacks and strokes.

Blood Pressure

High blood pressure is a risk for heart attacks and strokes; it also drives progression of eye and kidney disease.

Primary prevention of CVD

The prescription of statins for people with diabetes aged 40 to 80 years with no history of heart disease to reduce the risk of cardiovascular disease.

Secondary prevention of CVD

The prescription of statins for people with diabetes (any age) with a history of heart disease to reduce the risk of cardiovascular disease.

Combined prevention of CVD

The prescription of statins for people with diabetes that fall into either of the primary or secondary prevention groups.

Meeting all 3 treatment targets

Having HbA1c ≤58mmol/mol, blood pressure ≤140/80 and for people falling in the combined prevention CVD group, receiving statins.

(people with diabetes under 12 years of age are only required to meet the HbA1c target)

Clinical Commissioning Group (CCG)

Clinical Commissioning Groups (CCGs) commission most of the hospital and community NHS services in the local areas for which they are responsible.

Commissioning involves deciding what services are needed for diverse local populations, and ensuring that they are provided.

CCGs are assured by NHS England, which retains responsibility for commissioning primary care services such as GP and dental services, as well as some specialised hospital services. Many GP services are now co-commissioned with CCGs.

Local Health Board (LHB)

Local Health Boards (LHBs) are administrative units of NHS Wales, set up to effectively plan services for the populations of their respective local authorities. The boards have the responsibility of financing hospital trusts, GPs, dentists, and other healthcare professionals to provide these services.

Severe Mental Illness (SMI)

Severe mental illness (SMI) refers to people with psychological problems that are often so debilitating that their ability to engage in functional and occupational activities is severely impaired.

Type 2 and other diabetes

In addition to people with type 2 diabetes, includes those with maturity-onset diabetes of the young (MODY), other and non-specified diabetes types.

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Last edited: 15 April 2024 3:33 pm