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Women with diabetes are far less likely to be diagnosed than men, reveals a hardhitting audit by the Healthcare Commission.

The commission found 23 per cent of people predicted to have diabetes were missing from GPs' registers ­ with the figure rising to 45 per cent for women over 40.

The report warned women might be missing out on diagnosis because they were less likely than men to attend CHD clinics and claimed the true extent of underdiagnosis was likely to be even greater.

The audit of more than 253,000 patients ­ Europe's largest ever on diabetes care ­ also found 'considerable' regional variation in the proportion of patients recorded on registers, ranging from 50 per cent to more than 90 per cent.

Healthcare Commission chief executive Anna Walker said: 'We expect to see changes as a result of this work.'

She added that participation in diabetes audit would be included as part of PCTs' performance ratings.

GP diabetes experts said there was now a 'good case' for a national screening programme for people at risk of diabetes.

Dr Colin Kenny, acting chair of the Primary Care Diabetes Society, said: 'There is now a good case for targeted screening among at-risk individuals over 40.

'There is good evidence for interventions in people with impaired glucose tolerance and early diabetes.'

A decision on screening is expected by the end of 2005.

The audit found greater collaboration between primary and secondary care could increase numbers on registers by 13 per cent.

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