Ignorance of life threatening condition puts more diabetics at risk - Beith

10.45.00am BST (GMT +0100) Fri 30th May 2008

Alan Beith MP and the Liberal Democrats in Northumberland are calling for greater screening for diabetes after worrying new figures revealed that there has been a steady rise in the number of emergency admissions to local hospitals for a life threatening condition which develops if diabetes remains undetected.

Alan Beith MP said that many people were not aware they were diabetic. Early detection could save lives by preventing diabetic ketoacidosis (DKA), a life threatening form of the illness.

Figures show that in 2002 there were 47 emergency admissions to hospital for DKA in the area of Northumberland Care Trust (PCT). In 2006/7, this had risen to 90 admissions.

The release of the figures comes after a national service framework was set up to ensure that all PCTs offer screening to those most at risk from developing diabetes. Currently, only 57% of PCTs are offering such screening.

Cllr Isabel Hunter, the Executive Member for Health and Well-being on the Northumberland unitary authority, said, "Diabetics are increasingly being put at risk, often because they don't know enough about their condition.

"Too many people don't realise they have diabetes in the first place. We need better education to warn diabetics of the life-threatening dangers of DKA, and also a greater awareness campaign so that people can spot the symptoms of diabetes early. The government simply isn't doing enough.

"Northumberland Care Trust must do all it can to ensure people benefit from the National Service Framework. I strongly feel that local health services should highlight the need for individuals to watch out for any symptoms of diabetes and encourage people concerned they are developing the illness to be screened.

"Early detection will certainly help to save lives."

Diabetic ketoacidosis (DKA) is a life-threatening complication in patients with untreated diabetes. Near complete deficiency of insulin and elevated levels of certain stress hormones combine to cause DKA. It is more common among Type I diabetics, but may also occur in Type II diabetics generally when physiologically stressed, such as during an infection. Patients with new, undiagnosed Type I diabetes frequently present to hospitals with DKA. DKA can also occur in a known diabetic who fails to take prescribed insulin. DKA was a major cause of death in Type I diabetics before insulin injections were available; untreated DKA has a high mortality rate. Onset of DKA may be fairly rapid, often within 24 hours.

Symptoms and Signs:

Sluggish, extreme tiredness.

Extreme thirst, despite large fluid intake.

Constant urination

Fruity smell to breath, similar to nail polish remover or peardrops.

Hyperventilation, at first rapid and shallow, then progressively deeper and less rapid.

Extreme weight-loss.

Oral Thrush may be present, or/ yeast infections that fail to go away, this is because the normal fungal/flora present in oral cavity/cervix in women, the balance is upset and bacterial began to feast on the high sugar from urine output/ dry mouth from extreme thirst.

Muscle wasting.

Agitation / Irritation / Aggression / Confusion

Late signs

At this point, DKA is life-threatening and medical attention should be sought immediately.

Emesis (vomiting), although this is not always a sign of late-stage ketoacidosis, and can occur both in early-stage ketoacidosis and in non-ketoacidic hyperglycaemia.

Confusion.

Abdominal pain.

Loss of appetite.

Flu-like symptoms.

Lethargy and apathy.

Extreme weakness.

Kussmaul breathing ("air hunger"). A type of hyperventilation where patients breathe very deeply at a normal or reduced rate. This is a sign of severe acidosis.

Unconsciousness (diabetic coma) after prolonged DKA. At this stage, speedy medical attention is imperative.

The figures were obtained from a Parliamentary Question from Sandra Gidley MP, Liberal Democrat Health Spokesperson:

To ask the Secretary of State for Health, how many hospital emergency admissions were recorded in England for diabetic ketoacidosis in each of the last five years broken down by (a) age, (b) sex, (c) type of diabetes, and (d) primary care trust.

For Northumberland Care trust the figures are:

Year Number of Emergency Admissions

2006/07 90

2005/06 66

2004/05 54

2003/04 50

2002/03 47

(http://www.publications.parliament.uk/pa/cm200708/cmhansrd/cm080513/text/80513w0024.htm)