Many PCTs are not actively trying to identify those who may have diabetes
Government targets for improving diabetes care may be missed as local health providers are failing to offer key services, a top charity has warned.
Fewer primary care trusts (PCTS) had a scheme to identify those at risk of the disease in 2007 than did in 2006, Diabetes UK says in a new report.
While some of England's 1.9m diabetes patients receive "excellent" care, the picture, the charity said, is patchy.
It says a 10-year government plan for better care by 2013 is in jeopardy.
In a report examining the progress made in achieving the National Service Framework (NSF), set out in 2003, the charity said the government needed to make PCTs "truly accountable" for delivery of the services.
While the identification of people with diabetes was a key feature of the plan, in 2006 60% had such a scheme, but this had fallen to 57% a year later.
Support for people with diabetes, who manage much of their own care, was also one of the standards set, but the charity's survey found 36% of PCTs did not require doctors to draw up a care plan.
It also found "emotional and psychological support" for adults with the condition was lacking among the majority of PCTs.
However, the charity did report some improvements, including in the regular surveillance of patients for the complications of the disease.
"While there has been progress against the standards outlined in the National Service Framework for Diabetes, this is not sufficient and there is still a significant amount to do before the NSF vision of high quality diabetes services for all is achieved," the charity wrote.
"If progress in improving standards continue to vary across England, the NHS will not achieve the standards in the NSF by 2013."
It called on the government to "refocus NHS efforts".
Type I: destroys pancreas cells that make insulin, so patients rely on injections
Type 2: non-insulin dependent diabetes usually occurs in those over 45 and overweight
Over 2.3m people with diabetes diagnosed in the UK
Estimated 500,000 people do not know they have it
Health Minister Ann Keen said the number of people getting tests and measurements to help prevent or delay the complications of diabetes "is rising year on year".
"In the last two years alone we have identified an extra 200,000 people with undiagnosed diabetes.
"However, we know we still have a long way to go to ensure that everyone with diabetes receives high quality care that meets individual needs and goals. We are currently reviewing the progress made on the NSF for Diabetes and a report will be published in the summer."
The PCT network, meanwhile, said it acknowledged there was work yet to be done.
But director David Stout added that PCTs also had to "tailor the level of service around the needs and competing priorities of the whole community they serve using the national service framework as a guide for best practice".