Diabetes findings are riddled with errors say experts

A report by experts from the Royal College of GPs and NHS Diabetes found “substantial evidence” that people are being miscoded, misclassified and misdiagnosed on GPs’ lists.

For every 500 people identified with diabetes on a GP register, about 65 to 70 need checking for errors.

The researchers outlined new guidance to improve disease recording.

One expert behind the report, Professor Simon de Lusignan from the University of Surrey, said they accepted about 50,000 people diagnosed with diabetes do not have the disease, and another 50,000 have been classified with the wrong type.

Some errors came from data entry mistakes, while others results from a lack of understanding among doctors or other staff .

Greater obesity has also made it more difficult to differentiate between type 2 – which is linked to unhealthy lifestyles – and type 1 but such errors can have a “considerable impact on patient care”.

This is despite the fact that “accurate diagnosis is critical for the appropriate treatment for the person with diabetes”, the report says.

It said “the most widespread misunderstanding” among health professionals was changing somebody’s diagnosis from type 2 to type 1 when they have to be given insulin.

“This, potentially, could have a considerable impact on patient care as the guidelines for insulin use in type 2 are very different from those in type 1.”

About 2.8 million in the UK have diabetes. Another 800,000 are believed to have the condition but do not know it.

The report says rarer types of diabetes, such as maturity onset diabetes of the young (Mody), which is likely to be inherited, are frequently misdiagnosed as type 1. This often results in patients, many of them children, getting insulin injections when tablets would give them better blood sugar control.

Prof de Lusignan said that while errors had been found, the UK was “ahead of the curve” when it comes to collecting information in primary care but urged GPs to check their registers yearly to identify people who have been misdiagnosed, misclassified or miscoded.

Prof Kamlesh Khunti, from the University of Leicester, and chair of the of the guidelines working group, said people diagnosed as diabetic may be in the earlier stage of pre-diabetes.

He insisted that for most people, receiving a misdiagnosis, being misclassified or miscoded would not affect their treatment.

He said he was confident the report represented significant progress in understanding why errors happen and avoiding future mistakes.