Diabetes projected to increase significantly over the next twenty years

A recent news report¹ states that it was previously thought that there were about 500,000 people in Britain suffering from diabetes without being formally diagnosed, but new estimates from Diabetes Health Intelligence data have suggested that 820,000 adults in England alone could have undiagnosed diabetes. Diabetes UK said that if the rest of the UK was considered, this figure increases to 1.1 million people. If the trend continues, hospitals and nursing staff could be overwhelmed with cases by 2030 when some 5.5 million people could be living with either Type I or Type II diabetes in the UK.

Also an article² published in the Diabetic Medicine journal in April 2011 states that the total number of adults in England with diabetes is projected to rise to 4.6 million by 2030 and an ageing population and increasing prevalence of obesity imply that the prevalence of diabetes will continue to rise and health services should be planned accordingly.

With these worrying figures it is welcoming to see campaigns such as the one which has been organised by Diabetes UK Cymru and Community Pharmacy Wales which will see every pharmacy in Wales offering free risk assessments for 2 weeks in June to try to find the thousands of people with diabetes who are undiagnosed. The assessments aim to identify people who are at risk of developing the condition over the next 10 years.

The assessments look at risk factors such as body mass index, waist size, ethnicity and family history. Where appropriate, those at risk will be advised how they can reduce that risk by improving their lifestyle. Those identified by the assessments as most at risk will be referred for a diabetes test. A similar initiative in 2009 saw more than 20,000 people undergo assessments, people who more than likely would never have thought of making an appointment with their GP to assess if they were at risk of diabetes.

UK diabetic statistics show that people with diabetes are twice as likely to be admitted to hospital as the general population and once admitted, are likely to have a length of stay that is up to twice the average. If not diagnosed early or managed properly diabetes can lead to medical conditions related to obesity or complications including heart disease, stroke and kidney damage, so there is a major need for detection and monitoring of diabetic patients.

Glucose testing is the most common method for detecting the early signs of diabetes, however there are many more tests which can aid diabetes diagnosis such as Cystatin C, Microalbumin and Glycated Albumin. Inflammation has also been linked with diabetes because glucose acts as an irritant to arterial walls and with diabetics having chronically elevated glucose levels, this causes irritation which leads to chronic inflammation. Therefore testing for C-Reactive Protein (CRP) and cytokines could also be of benefit. HbA1c is currently one of the best ways to monitor diabetes; it indicates blood glucose levels for the previous two to three months, thus showing if the individuals’ glucose level has been kept under control.

The various tools that are available for the detection, monitoring and research of diabetes will play an important role in dealing with the projected rise in diabetic patients that will occur in the years ahead.



² The Association of Public Health Observatories (APHO) Diabetes Prevalence Model: estimates of total diabetes prevalence for England, 2010–2030
N. Holman1, N. G. Forouhi2, E. Goyder3, S. H. Wild4

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