General practitioners are treating more cases of diabetes
Most diabetes prevalence studies have been carried out in one
locality and have generally been point prevalence studies. Hence, although
the prevalence of diabetes in England and Wales is increasing, [1] time
trend data on prevalence, and future projections based on sound data, are
both lacking. We recently estimated the prevalence of diabetes in England
and Wales between 1994-98 using data on the treatment of diabetes from 210
general practices with a combined list size of 1.2 million. [2][3]
We found that the overall prevalence of diabetes based on treatment
rates during this period increased from 1.99% to 2.43% in males and from
1.69% to 2.04% in females. This striking increase in the prevalence of
diabetes in primary care during a relatively short period is likely to be
due to a combination of factors. These include better case ascertainment,
rising levels of obesity, an ageing population, and an increase in both
the size and average age of the ethnic minority population. Overall, 29,
48 and 24 percent of males with diabetes, and 26, 48 and 26 percent of
females respectively were diet controlled, treated with oral hypoglycaemic
drugs only, or treated with insulin.
We estimated that there were about 1.15 million people with a
diagnosis of diabetes mellitus in England and Wales in 1998. If age
specific diabetes prevalence rates increase by a modest 30% over the next
25 years (less than predicted by many authorities), then the number of
people with diabetes will increase by 70% to 1.96 million by 2023. If age-
specific prevalence rates increase by more than 30%, then the increase in
the number of cases will be even larger.
Our findings illustrate the potential size of the diabetes epidemic
facing England and Wales. The epidemic will have major implications for
the NHS, which will have to provide diabetic services for these patients,
as well as dealing with the clinical and psychosocial complications
resulting from diabetes. We would therefore reinforce the need to tackle
the underlying causes of this epidemic and in particular the need to
increase levels of physical activity and reduce levels of obesity in our
society.
Azeem Majeed, Professor of Primary Care
University College London
Angela Newnham, Senior Lecturer in Public Health Medicine
King’s College London
Kamlesh Khunti, Senior Lecturer in General Practice
University of Leicester
References
1. Pinkney J. Prevention and cure of type 2 diabetes. BMJ 2002; 325:
232-3.
2. Newnham A, Ryan R, Khunti K, Majeed A. Prevalence of diagnosed
diabetes mellitus in general practice in England and Wales, 1994 to 1998.
Health Statistics Quarterly 2002; 14: 5-13.
Rapid Response:
General practitioners are treating more cases of diabetes
Most diabetes prevalence studies have been carried out in one
locality and have generally been point prevalence studies. Hence, although
the prevalence of diabetes in England and Wales is increasing, [1] time
trend data on prevalence, and future projections based on sound data, are
both lacking. We recently estimated the prevalence of diabetes in England
and Wales between 1994-98 using data on the treatment of diabetes from 210
general practices with a combined list size of 1.2 million. [2][3]
We found that the overall prevalence of diabetes based on treatment
rates during this period increased from 1.99% to 2.43% in males and from
1.69% to 2.04% in females. This striking increase in the prevalence of
diabetes in primary care during a relatively short period is likely to be
due to a combination of factors. These include better case ascertainment,
rising levels of obesity, an ageing population, and an increase in both
the size and average age of the ethnic minority population. Overall, 29,
48 and 24 percent of males with diabetes, and 26, 48 and 26 percent of
females respectively were diet controlled, treated with oral hypoglycaemic
drugs only, or treated with insulin.
We estimated that there were about 1.15 million people with a
diagnosis of diabetes mellitus in England and Wales in 1998. If age
specific diabetes prevalence rates increase by a modest 30% over the next
25 years (less than predicted by many authorities), then the number of
people with diabetes will increase by 70% to 1.96 million by 2023. If age-
specific prevalence rates increase by more than 30%, then the increase in
the number of cases will be even larger.
Our findings illustrate the potential size of the diabetes epidemic
facing England and Wales. The epidemic will have major implications for
the NHS, which will have to provide diabetic services for these patients,
as well as dealing with the clinical and psychosocial complications
resulting from diabetes. We would therefore reinforce the need to tackle
the underlying causes of this epidemic and in particular the need to
increase levels of physical activity and reduce levels of obesity in our
society.
Azeem Majeed, Professor of Primary Care
University College London
Angela Newnham, Senior Lecturer in Public Health Medicine
King’s College London
Kamlesh Khunti, Senior Lecturer in General Practice
University of Leicester
References
1. Pinkney J. Prevention and cure of type 2 diabetes. BMJ 2002; 325:
232-3.
2. Newnham A, Ryan R, Khunti K, Majeed A. Prevalence of diagnosed
diabetes mellitus in general practice in England and Wales, 1994 to 1998.
Health Statistics Quarterly 2002; 14: 5-13.
3. http://www.azmaj.org/PDF/Diabetes.pdf
Competing interests: No competing interests