People with diabetes are at increased risk of serious complications including heart disease, kidney failure, loss of vision, and premature death. Fortunately, the risk can be reduced through a combination of screening for risk factors (like high HbA1c and high blood pressure) and offering evidence-based interventions. There is also a need to screen people every year for signs of early damage to blood vessels and nerves.

Reducing risk and screening for complications

International guidelines recommend that people with type 1 diabetes and type 2 diabetes are offered nine annual care “processes”:

  1. HbA1c
  2. Lipids (such as cholesterol)
  3. Creatinine (a blood test that tells you how well your kidneys are working)
  4. Albuminuria (measures tiny amounts of protein in the urine which indicate early damage to the kidneys from diabetes
  5. Blood pressure
  6. Body mass index based on height and weight
  7. Smoking status
  8. Foot exam
  9. Retinal exam

Health care systems need to improve

A recent study from the United Kingdom among people with type 1 diabetes and type 2 diabetes found that individuals with five or fewer recorded care processes had a risk of premature death one-third higher than people who had at least eight care processes. The findings were similar between people with type 1 diabetes and type 2 diabetes, at all ages, and across socioeconomic groups.

These new findings emphasize the importance of annual care processes, as people with diabetes who have fewer routine care processes have higher risk of premature mortality. Further research is needed to determine if different approaches to providing care may improve outcomes.


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