This Audit makes interesting reading. All complications of diabetes apart from eye disease are more common with increasing social deprivation with a two fold increase between the least and most deprived. Even more striking are the large differences in the rates of complications between regions with up to two fold difference for kidney failure. This variance suggests that significant improvements could be made and I think that also follows from a knowledge of the pathophysiology. It depends whether you are a glass half full or a glass half empty person on how you respond to the albuminuria testing data. This has improved from only 20% of registered patients having an ACR in 2003/04 to 62% in 2007/08. That's still nearly 40% of the people who are known to have diabetes who are not getting satisfactory kidney care, let along those who have not yet been identified with diabetes. There are clear opportunities to work locally, regionally and nationally with primary care and diabetes colleague to improve the kidney care of those with diabetes.