The National Audit Office has issued a report that concludes that diabetes services in England are not delivering value for money. The report finds that, despite some improvements since 2006–07, there is poor performance against expected levels of care, low achievement of treatment standards and high numbers of avoidable deaths. In 2009–10, there were an estimated 3.1 million adults with diabetes in England. The number of people with the condition is expected to increase by 23% to 3.8 million by 2020. According to the report, only half of people with diabetes received the recommended standards of care in 2009-10, even though the proportion has increased from 36% in 2006-07. The standards, which the Department of Health originally set in 2001, state that people with diabetes should receive nine basic care processes each year. These care processes can reduce their risk of diabetes-related complications such as blindness, amputation and kidney disease. As well as diminishing quality of life, diabetic complications place a significant burden on the NHS. The risk of developing diabetic complications can also be reduced if people with diabetes achieve recommended treatment standards to control blood glucose, blood pressure and cholesterol levels. However, fewer than one in five people with diabetes are achieving recommended standards for controlling all three of these levels. It is estimated that up to 24,000 people die each year from avoidable causes related to their diabetes. The report concluded that with better management of people with diabetes, the NHS could save £170 million a year.