How the BBC mangled Diabetes statistics to lay blame on the NHS


3:43 pm - December 14th 2011

by Richard Blogger    


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There is something a bit odd about the shock news released today that people who have a serious (but controllable) medical condition are not expected to live as long as people without it.

The BBC are reporting the news as if no one has ever been aware of it, but I came to the conclusion a year ago that the BBC have an agenda to broadcast as many articles as possible that puts the NHS in a poor light.

Let’s look at what the BBC are saying.

There are three key issues with the story.

1. Diabetes UK say that there are 2.9 million people with diabetes (type 1 and type 2) or 4.45% of the UK population. They also say that 90% of diabetics have type 2 diabetes.

The ONS says that in 2010 there were 493,000 deaths in the UK. Out of a population of 62 million that means slightly under 0.8% of the population. ONS provides detailed tables giving the cause of death.

The figures says that in 2010, 5,223 people died from diabetes.

But the BBC reports:

Up to 24,000 deaths from diabetes could be avoided in England each year, if patients and doctors better managed the condition, a report concludes.

Around 70-75,000 diabetic patients die every year.

This is not the number of people who die from diabetes, this is the number of diabetics who die.

Such people could be dying of cancer, stroke or heart attacks; in other words the same things that everyone else dies of. Diabetes may well exasperate these conditions, but that is not the same as dying from diabetes; ONS says so.

2. The BBC also reports:

For patients with Type 1, the risk of dying was 2.6 times higher than it was for the general population. With Type 2, the risk was 1.6 times higher.

The figures on diabetes mortality are also in a PDF report on their website called Diabetes in the UK 2010: Key statistics on diabetes. Note the date: 2010. In fact, the figures for the reduction in life expectancy comes from a Department of Health report dated 2001. The 11.6% figure comes from a report in 2008. In other words, none of this is new.

3. The BBC report is churnalism of the press release on the NHS Information Centre. The news is not shocking, it is well known, the NHS IC merely have produced a report about something we all knew anyway.

But perhaps the most interesting part of the NHS IC report is this:

There is a strong link between deprivation and increased mortality rates. Among under-65s with diabetes; the number of deaths among people from the most deprived backgrounds is double that of those from the least deprived backgrounds.

There is a clear message here: deprivation causes type 2 diabetes. The BBC didn’t report that, did they?

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Richard is a regular contributor. He blogs more frequently at Conservative Policies Dissected.
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Reader comments


I’m confused – where did the news report “blame the NHS”?

I read a story that said if patients did what their doctors told them to do, then they’ll live longer.

You can argue that some of those ignoring doctors advice are doing so because they can’t afford to eat fresh food etc – but I am genuinely stumped as to how any of this is story can be characterised as an anti-NHS report.

2. Man on Clapham Omnibus

RB

‘There is a clear message here: deprivation causes type 2 diabetes. The BBC didn’t report that, did they?’

The report doesn’t suggest a causal link between deprivation and Diabetes 2, only a link between deprivation and increased mortality due to diabetes. Not the same thing I suggest.

3. Tax Obesity, Not Business

“deprivation causes type 2 diabetes”

Your quote from the NHSIC report does not support that conclusion. “A link” between death from type 2 diabetes and deprivation is a correlation, not a causal connection. Not all people with type 2 are deprived; and not all the deprived have type 2 diabetes. All you can conclude from the quote is that type 2 diabetes is a risk factor for early death among the deprived.

Also, claims of BBC bias — from right and left – are rather tedious. Yes, the BBC has some unconscious blindspots (though the NHS is probably not one of them); but generally it tries very hard to be professional and impartial. True objectivity – the third-person viewpoint of science – is not strictly possible in the reporting of human affairs because all such reporting is done by individuals with a first-person point of view, though we can and do debate the (de)merits of competing first-person perspectives so that we can approach asymptotically towards objectivity.

4. Chaise Guevara

@ 2

Actually, going by the part Robin quoted, it only suggested a link between deprivation and people with type 2 diabetes dying. Which doesn’t actually claim any link with diabetes at all: there would also be a link between diabetic people getting run over by cars and diabetic people dying.

It’s silly to blame the BBC without investigating the situation. I’m dependent on seeing a specialist diabetes nurse. There’s a long waiting list to get an appointment to see one so I looked into it.

There is now only one specialist nurse working out in the community from the diabetes clinic at the local hospital. She has a case load of 200 patients to see either at the hospital or on home visits. When I ask local hospital administrators why this is so, I get told that is the outcome of decisions by the local pathbreaking GP consortium – which is taking over from the NHS Primary Care Trust as part of Lansley’s reforms of the NHS.

This is a glaring example of why independent monitoring of treatment outcomes is essential in order to highlight NHS healthcare failings:

“An atlas published by the Government that maps variations in health spending and outcomes across England has highlighted some significant regional differences including amputation rates among diabetics. . . .

“Amputation rates among diabetics showed one of the most striking variations. Data revealed that the amputation rate for patients with Type 2 diabetes in the South West (3 in 1000 patients) is almost TWICE the rate in the South East. The Charity Diabetes UK was also concerned that the data showed less than half those with the disease (Types 1 and 2) had received nine key healthcare checks.”
http://www.mddus.com/mddus/news-and-media/news/november-2010/nhs-variation-atlas.aspx

Typical BBC. Camerons Pravda.

It will do yo no good BBC, the brownshirts want and will destroy you. Appeasement will not work.

@Man on Clapham Omnibus

Have a look at the original blogpost

This re-states something that was in the Diabetes Audit from last year:

“In those aged 70 years and over, similar numbers of Q1 (12.1 per cent) and Q5 (14.8 per cent) have Type 2 diabetes, but under the age of 55 Type 2 diabetes is more than twice as common in Q5 (3.0 per cent) as Q1 (1.3 per cent). This may reflect lifestyle differences in exercise, diet and weight.”

Q1 is the least deprived quintile of the population, Q5 is the most deprived.

This does say that there is a link between deprivation and type 2 diabetes.

8. Chaise Guevara

@ 7

“This does say that there is a link between deprivation and type 2 diabetes.”

That does, yes.

The UK fourth estate is utterly incapable of dealing with any story that contains numbers because they are entirely innumerate. Absolute levels and variable rates of change are simply beyond their comprehension.

Diabetic care would be helped by patients being advised to eat lower carb, than high carb, lower fat, as my father in law was told, which only exacerbates diabetes and leads to increased need for medication.

Unfortunately far too much supposed ‘science’ is based on correlations, rather than proven causation, and statistics are manipulated. Even risk factors in research papers are manipulated so that you’re told the relative rather than ansolute risks, meaning the information provided is meaningless or creates alarmist headlines.

11. the a&e charge nurse

Tend to agree Richard, there are a number of authorities who claim the MSM have a poor record when it comes to reporting science based stories.

A great deal of ‘Bad Science’ (Ben Goldacre) is expended on this theme, especially the disastrous MMR debacle – a good lecture from John Lister as to why the media is so problematic when reporting health stories can be found here, although it’s not just the BBC who come under the cosh.
http://www.youtube.com/watch?v=c2yOyH9pmJE

I’m curious about the number of deaths. Presumably, the BBC took this figure:

“Up to 24,000 deaths from diabetes could be avoided in England each year”

from the report. But the ONS say only 5,223 people died from Diabetes last year. So, where’s the other 19,000?

14. Chris Kitcher

The bias by the BBC does not surprise me. here in East Anglia we have had two cases recently of biased reporting in respect of hospitals in Ipswich Hospital and the James Pagett Hospital.

In an attempt to redress the imbalance I wrote to the BBC East commenting on significant changes to waiting times locally as well as the £21 million that the local PCT has had to set aside to implement Lansley’s stupidity. As you can guess not a single mention of this.

Who says that we have a free media/press?

“So, where’s the other 19,000?”

Perhaps they were avoided by the correct management of the condition 😉

16. Tax Obesity, Not Business

“…there is a link between deprivation and type 2 diabetes”

A link, yes; but it simply be a correlation, not a causal connexion.

A minor point: ‘deprived’ is a loaded term, as it suggests that some agent is takling things away from the people so described. ‘Poverty’ or ‘disadvantaged’ are much better.

I can’t see what Richard Blogger’s problem with the BBC report actually is.

The NHS website (thanks Tony) says “The National Diabetes Audit suggests that in England there are about 24,000 ‘excess deaths’ a year in people with diagnosed diabetes. This means that each year, around 24,000 more deaths occur among people with diabetes than would be expected to occur if their mortality risk was the same as that of the general population. A press release from the NHS Information Centre, which published the audit report, said these deaths could be avoided through better management of the condition.”

OK. So why is Richard Blogger complaining: “But the BBC reports: Up to 24,000 deaths from diabetes could be avoided in England each year, if patients and doctors better managed the condition, a report concludes” ?

Er, yes, that’s exactly the same as what the NHS is saying.

The NHS report says that these deaths could be avoided by better management. This is not the BBC criticising the NHS, this is the NHS rightly questioning its own role in diabetes management and how it could be improved.

The only “mangling” here seems to be on the part of Mr Blogger.

@ 17:

“So why is Richard Blogger complaining”?

Good question. He may be hyper-sensitive to criticisms of the NHS (which is hardly the best health care system in the developed world). Or perhaps he is angry because he has the misfortune to have type 2 diabetes and it’s all about him (aka the Sue Marsh school of blogging)…

Well it’s nice to be able to speak about something that I know about for a change (as manager of a diabetes clinical network).

The strong correlation between diabetes and deprivation is most likely due to higher levels of obesity and lower rates of physical activity in more deprived areas.

Deaths due to diabetes are massively under-recorded. Diabetes is a major risk factor for cardiac events (which will be noted as cause of death on a death certificate) – someone with diabetes has the same risk as someone who has already had a cardiac event such as stroke or heart attack. Given that cardivascular disease accounts for around 25% of premature deaths, this could well account for the figure of 24,000 deaths being bandied about.

However, as the BBC article does note, 24,000 deaths are a relatively small amount when taking into account the probably around 3 million people now who are diagnosed with the disease. The figures are taken from the National Diabetes Audit which is the largest clinical audit in the world. What the NHS Information Centre has done is review the 2007-08 audit taking into account additional data sources in order to make mortality estimates, which it had not done previously.

So sadly, in this case, it does not appear to be a case of gratuitous NHS bashing. If you do want to get angry, how about Hinchinbrooke Hospital taken over by the hedge fund and venture capital owned Circle Healthcare as a loss making knowledge extracting initial foray into the world of hospital ownership, the NHS Operating Framework 2012/13 which states that all areas at SHA level will have to open up three priority areas to ‘any willing provider’. Ho ho ho.

Looks rather like an an agenda to paint the BBC in the worst possible light. Does this guy work for Murdoch?

I think most people recognise that having public health issues reported in the media is an inherent part of the national-level democratic-concensus economics that are at the heart of how both by the BBC and NHS works.

Maybe there are a majority of people who would really prefer to have their health managed by the likes of the Bank of Scotland (looking good! No problems. Wow, never seen you so healthy! Whoops, what did he die of?).

If that was true, then maybe we would deserve what we get. But it’s not, so we don’t.

Thank you to Danmac @19 for informed commentary.

My take is that the story was badly reported because the BBC journalist didn’t understand the complexity of the story. That comment should not be taken as a swipe at the author; the media does not employ enough sci/med/tech journalists, full stop. Journalists also have to rely on press releases and media representatives of sci/med/tech bodies to give them accurate information and to help ensure that journalists field accurate reports (or to comprehend a story where the journalist takes a different line).

Personal experience of meeting sci/med/tech journalists is that they have a sci/med/tech background, and then they became writers. As sci/med/tech becomes a greater part of our lives, we need more writers.

@ 19 Obesity and lack of exercise do not cause type II diabetes, they are just correlated with it. The common causal factor is poor diet – high intakes of processed carbs and sugars. While its thrown about that obesity causes diabetes, the real causes of both will never be tackled.

What I’d like to know is why the South-West region had almost twice the rate of diabetes amputations as the South-East?

Try the link @5.

@23. Bob B: “What I’d like to know is why the South-West region had almost twice the rate of diabetes amputations as the South-East?”

Dunno, Bob. Perhaps practitioners in the South West believe that it is appropriate.

Like the last person commentating, I am also confused. I see nowhere in the BBC reporting that the NHS is blamed or criticised. If anything I thought there was a risk that diabetics can be criticised for not doing enough to look after ourselves.

Also confusing is this:

“”Up to 24,000 deaths from diabetes could be avoided in England each year, if patients and doctors better managed the condition, a report concludes.

Around 70-75,000 diabetic patients die every year.”” (quote from BBC)

“This is not the number of people who die from diabetes, this is the number of diabetics who die.” (Sentence written by Richard.)

When Richard writes “This is . . . “, does “this” mean the 24,000 or the 70-75,000? If the latter, then he seems to have missed the point of the announcement, which is that some (24k) of the total deaths (70-75k) can be avoided by better management of the condition. I cannot see the point of his sentence. It seems to be evidence of that which he is seeking to debunk rather than support for his debunking.

I think part of the problem may be that Richard might not understand how diabetes works. Alongside the numeric confusion he writes:

“Such people could be dying of cancer, stroke or heart attacks; in other words the same things that everyone else dies of. Diabetes may well exasperate these conditions, but that is not the same as dying from diabetes; ONS says so.”

I assume when he writes “exasperate” Richard means “exacerbate”. Which would mean that a pre-existing condition – such as heart disease – is made worse by diabetes. No. Diabetics are more likely to get a problem like heart disease in the first place. Every diabetic learns as soon as diagnosed that we do not die FROM diabetes but FROM the “complications” of diabetes. Richard is telling us something that every diabetic and every doctor knows.

The word “complications” does not appear in Richard’s text, which makes me wonder if he does not know about this distinction? So when Richard talks of the “exasperating” (exacerbating?) relationship between diabetes and other conditions like heart disease he is in error. It is not that the BBC has got it wrong. Diabetics do not just coincidentally die from “the same things that everyone else dies from”. They die from many conditions BECAUSE of their diabetes. Get it?

Thus, as all the BBC reporting correctly said, if diabetics can be helped to manage their condition better, reducing their blood sugar levels, then fewer will die FROM the complications which arise from diabetes, including heart disease.

As a diabetic I am really disappointed by this article. Guys, please can you ensure better quality stuff in future.

@22

Re obesity causing diabetes – was simplifying here – not obesity per se, but fat stored around the abdomen is thought to increase insulin resistance…links to the peer reviewed papers showing that processed carbs and sugars cause diabetes please, high sugar intake causing diabetes is a myth – though i do understand that it is bad for your teeth

The report I heard on Today emphasised, IIRC, a ninefold increase in the risk of diabetic women in the 18-30 age bracket dying. It was repeated in every headline, but in the actual report the dioabetologist they interviewed explained that, given the generally very low mortality of this group the figure remained very low. It’s exactly as Richard W @9 suggests, the reporters completely failed to examine the statistics in any meaningful way. Is this malice or innumeracy? I tend toward the latter analysis.

28. the a&e charge nurse

[25] “Thus, as all the BBC reporting correctly said, if diabetics can be helped to manage their condition better, reducing their blood sugar levels, then fewer will die FROM the complications which arise from diabetes, including heart disease” – exactly the same could be said for non-diabetics, to the extent that most diseases are influenced by modifiable risk factors (e.g. most hiv transmission, most lung cancers, a fair amount of liver disease, a significant proportion of trauma, etc, etc).

We should also remember that death certificates are not entirely reliable – this study found a “substantial discrepancy between the diagnosis given on death certificates compared with that at hospital necropsy”.
http://jcp.bmj.com/content/55/7/499.full

At least those with end organ damage from type II diabetes have had decades to address lifestyle choices known to precipitate or exacerbate disease – for example it never ceases to astonish me how many people with type II continue to smoke.

The extent of peripheral vascular disease and lower limb amputations could be reduced significantly with this one life style change (not to mention the further complications that arise from reduced mobility)
http://med.uofk.edu/vol2no1/tobacco.pdf

@26

Did a quick search. One article (which references studies), one paper. You may also want to watch Sugar: The Bitter Truth by Robert Lustig which is on youtube. When I say sugar, fructose is the initial culprit, but after the damage is done, excess glucose is also bad too.

http://edrv.endojournals.org/content/30/1/96.full

http://www.nytimes.com/2011/04/17/magazine/mag-17Sugar-t.html?pagewanted=all

23
The south-west has the highest percentage of over 65s and also the highest percentage of smoking adults. Whether this is correlation or causation with the higher incidence of diabetes related amputations is another matter.


Reactions: Twitter, blogs
  1. Cherry McCormack

    How the BBC mangled Diabetes statistics to lay blame on the NHS http://t.co/pXcONNcL

  2. History Geek

    “@libcon: How the BBC mangled Diabetes statistics to lay blame on the NHS http://t.co/6PJVbBcf” as a diabetic this is a must read

  3. AntennaRed

    MEDIA: How the BBC Mangled Diabetes Statistics to Lay Blame on NHS http://t.co/kWJAyvW8 #BBC #NHS #propaganda #statistics #diabetes #lies

  4. cliff prenton

    http://liberalconspiracy.org/2011/12/14/how-the-bbc-mangled-diabetes-statistics-to-lay-blame-on-the-nhs/

  5. Andy Bean

    How the BBC mangled Diabetes statistics to lay blame on the NHS | Liberal Conspiracy http://t.co/dDxQnUu0 via @libcon

  6. Shez

    How the BBC mangled Diabetes statistics to lay blame on the NHS | Liberal Conspiracy http://t.co/HupsnXAH via @libcon

  7. Janet Edwards

    How the BBC mangled Diabetes statistics to lay blame on the NHS | Liberal Conspiracy http://t.co/HupsnXAH via @libcon

  8. Alice Pink

    How the BBC mangled Diabetes statistics to lay blame on the NHS | Liberal Conspiracy http://t.co/HupsnXAH via @libcon

  9. Rattlecans

    'There is a clear message here: deprivation causes type 2 diabetes. The BBC didn’t report that, did they?' http://t.co/AxHjrTE6

  10. AGH

    'There is a clear message here: deprivation causes type 2 diabetes. The BBC didn’t report that, did they?' http://t.co/AxHjrTE6

  11. Jonathan Sadler

    How the BBC mangled Diabetes statistics to lay blame on the NHS | Liberal Conspiracy http://t.co/HupsnXAH via @libcon

  12. Alex Braithwaite

    How the BBC mangled Diabetes statistics to lay blame on the NHS | Liberal Conspiracy http://t.co/ACfLOcyU via @libcon

  13. Tracy Young

    How the BBC mangled Diabetes statistics to lay blame on the NHS | Liberal Conspiracy http://t.co/ACfLOcyU via @libcon

  14. BobbyFlint

    How the BBC mangled Diabetes statistics to lay blame on the NHS | Liberal Conspiracy http://t.co/HupsnXAH via @libcon

  15. Michael

    How the BBC mangled Diabetes statistics to lay blame on the NHS | Liberal Conspiracy http://t.co/cKAThbYP

  16. Catarina Sousa

    great article on liberal conspiracy–> http://t.co/b0y0bPVI

  17. Pedro Pereira

    great article on liberal conspiracy–> http://t.co/b0y0bPVI

  18. Pedro Pereira

    @AlexWGov interesting article on BBC reporting values: http://t.co/N8lcLjv6 – you could do governance for media, they surely need it 😉

  19. liane gomersall

    How the BBC mangled Diabetes statistics to lay blame on the NHS | Liberal Conspiracy http://t.co/r77Xet1L via @libcon





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