Diabetes care in England is in a "state of crisis" with less than half of people with the condition getting the basic minimum care, a new report warns.
According to the State of the Nation 2012 report, published by Diabetes UK, there are some areas where just 6% of people with diabetes are getting the regular checks and services recommended by the National Institute for Health and Clinical Excellence (Nice).
The report details how not getting these checks has helped fuel a rise in rates of diabetes-related complications such as amputation, blindness, kidney failure and stroke.
These complications account for about 80% of NHS spending on diabetes and are one of the main reasons that treating diabetes costs about 10% of the entire NHS budget, Diabetes UK said.
The report also shows that a National Service Framework for diabetes - setting out the healthcare which diabetes patients should get - has been in place for 11 years but has not become a reality.
Diabetes UK is calling on the Government to urgently deliver a plan to implement these standards.
Barbara Young, chief executive of Diabetes UK, said: "We already know that diabetes is costing the NHS a colossal amount of money, but this report shows how in exchange for this investment we are getting second rate healthcare that is putting people with diabetes at increased risk of tragic complications and early death.
"Whether showing the number of children with Type 1 diabetes who are only diagnosed at accident and emergency or highlighting the thousands of preventable diabetes-related amputations performed every year, the report shows that diabetes healthcare has drifted into a state of crisis.
"It is a compelling case for change. Above all, the wide variation in standards of care shows the need for a national plan to be put in place for giving people with diabetes the kind of healthcare that can help prevent complications, as well as a greater focus on preventing Type 2 diabetes."
Care Services Minister Paul Burstow said: "There is still much to be done to help tackle diabetes and root out poor care. That is why we are working on a new long term conditions strategy with diabetes as an exemplar. Our focus is on prevention and education, with more done to get earlier diagnoses and to help people manage their conditions themselves. This report and our new strategy will help local NHS services act so that diabetics get the care they need and deserve."