The NHS may be facing a diabetes time bomb involving the future care of hundreds-ofthousands of younger patients, concludes a recent audit of diabetes in England and Wales.
Nearly 300,000 children and younger adults with diabetes have high risk, and 144,000 dangerously high risk, blood sugar levels that will lead to high levels of severe and disabling complications such as kidney failure, limb amputation and stroke, according to the National Diabetes Audit 2010. Children and younger adults (aged 0 to 54) are also less likely than older adults (aged 55 to 69) and the elderly (aged 70 and over) to receive all the basic care checks required to monitor their condition; leading to concerns that a large number of youngsters will require substantial hospital care in a matter of years. The audit also shows that obesity is more prevalent among children and younger adults with diabetes than older adults and the elderly. Among younger adults with Type 2 diabetes, nine out of 10 are overweight or obese; the highest prevalence within any age group. Commissioned by the Healthcare Quality Improvement Partnership (HQIP) and managed by The NHS Information Centre, the audit is the largest of its kind in the world. It includes data from more than 80% of the estimated 2.34 million people aged 17 and over with diagnosed diabetes in England. The audit also includes data from all seven Local Health Boards in Wales, where participation has almost trebled in three years. The audit showed that high risk blood sugar levels are more common in younger people and in the socially deprived. However, overall 800,000 people with diagnosed diabetes have high risk levels and are at risk of complications. Fewer younger adults, compared to other age groups receive all nine recommended basic care processes annually, such as blood pressure, blood sugar and foot checks. Overall, the percentage of patients receiving every process is improving each year, but two thirds of Type 1 patients and almost half of Type 2 patients still do not receive all nine. The audit also found that the prevalence of diabetes, especially Type 2 diabetes, is rising each year; in particular in deprived communities. It also identified substantial regional variation in both the prevalence and treatment of complications – such as kidney failure and dialysis. The diabetes problem is a global one. A recent study has identified that 350 million adults in the world suffer from diabetes. The international study collated and analysed worldwide data on diabetes since 1980 found that the number of adults with the disease reached 347 million in 2008, more than double the number in 1980. The research, published in The Lancet, revealed that the prevalence of diabetes has risen, or at best remained unchanged, in virtually every part of the world over the last three decades. 70% of the rise was due to population growth and ageing, with the other 30% due to higher prevalence. The proportion of adults with diabetes rose to 9.8% of men and 9.2% of women in 2008, compared with 8.3% of men and 7.5% of women in 1980. The global study was led by Professor Majid Ezzati from Imperial College London and co-led by Dr. Goodarz Danaei from the Harvard School of Public Health, in collaboration with The World Health Organization and a number of other institutions.
