GPs' target 'could harm diabetics'
Updated on 06 March 2009
A new target that will earn GPs cash for monitoring people with Type 2 diabetes could harm patients, two doctors have said.
The new aim - which is for tighter control of blood glucose in diabetic patients - will mean tens of thousands of people will have to take more medication, they said.
Furthermore, the move was supported by medical evidence, with three studies in the past year showing it will not provide substantial benefit and may cause patients harm, they added.
The Department of Health said the new target, agreed between Government officials and GPs, would help cut the risk of heart disease in diabetics.
From April, the Quality and Outcomes Framework (QOF) - which rewards GPs financially for aspects of patient care - will require doctors to cut blood glucose levels in half of their Type 2 diabetic patients to below 7%.
In return, GP practices will earn around £3,000 - a similar amount to what they are currently paid for achieving a blood glucose target of 7.5%.
Writing in the British Medical Journal (BMJ), Richard Lehman, a GP in Oxfordshire, and Harlan Krumholz, Professor of Medicine at Yale University School of Medicine in the US, condemned the new target.
They wrote: "Reducing glycated haemoglobin below 7% is not supported by evidence and may even be harmful. Tens of thousands of patients will need to be given additional oral treatment or will be treated with insulin. Treatment with insulin brings with it an increased risk of hypoglycaemia (potentially dangerous low blood sugar levels) and the additional costs of daily blood glucose monitoring and the insulin itself.
"This new target was agreed on by NHS employers and the general practitioners' committee of the British Medical Association (BMA) in October 2008, ironically just when evidence was gathering that tight glucose control in established Type 2 diabetes has little benefit and can even be harmful."
A spokeswoman for the Department of Health said: "Our independent panel has advised that there is a clear relationship between hyperglycaemia and cardiovascular risk. "Better glycaemic control should lead to reduced cardiac risk for those with raised blood sugar levels."
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