Press Release: All-island working group announce first ever detailed estimates of the number of people living with diabetes north and south

Report finds 67,063 adults over age 20 in Northern Ireland have diabetes

Working Group strongly recommends national diabetes registers on the island, North and South

Monday, 12 June – According to a report published today by the Institute of Public Health in Ireland’s all-island Population Health Observatory, 40,489 women and 26,573 men are living with diabetes in Northern Ireland with almost a quarter (23.5%) of these undiagnosed.  For the first time, detailed diabetes estimates broken down by age, sex and ethnicity at a national and sub-national level are available.  To ensure better diabetes care in Northern Ireland, authors of the report - the Irish Diabetes Prevalence Working Group – strongly recommend the set up of a national diabetes register.

Dr Kevin Balanda, Associate Director of the Institute and Chair of the Irish Diabetes Prevalence Working Group said, “Without doubt, the model we have adapted from England to the island provides a more systematic approach to develop estimates of the number of people with diabetes.  But we were faced with a number of limitations, primarily, an information gap, which needs to be addressed in order to develop more accurate estimates and plan for a future where the numbers of diabetes cases are set to rise.” 

“Chief among our recommendations is the urgent need to develop a national diabetes register in the North which will enable us to establish how many cases of diabetes are undiagnosed.  We were able to do this, to some extent, based on data collected as part of the new General Medical Services contract but a register devoted exclusively to diabetes would provide more detailed information which in turn would facilitate deeper analysis.  An early diagnosis of diabetes and the appropriate management of the condition is essential to reduce the occurrence of serious complications down the road. 

We need to focus on filling in the information gaps now particularly in relation to overweight/ obesity rates and the number of diagnosed cases of diabetes, we can re-apply the model to Ireland and gain an even better picture of diabetes prevalence and crucially, the number of people who are not yet diagnosed with the condition.”

The report, entitled, ‘Making Diabetes Count’ estimates:

• Nearly a quarter (23.5% or 15,821) of diabetes cases in people aged 17 and over are undiagnosed;
• 5,768 people in Northern Ireland have Type 1 diabetes including 3,278 men and 2,491 women;
• 62,287 people have Type 2 diabetes including 23,790 men and 38,497 women;
• Diabetes is more common in women (6.3%) than men (4.5%);
• The prevalence of diabetes increases with age with nearly 30 times more people diagnosed with diabetes aged 60 years (14%) and over as those in the 20 – 29 year old bracket (0.5%);
• At 12.4%, prevalence is highest amongst the ‘Asian’ ethnic group, followed by ‘Black’ (8.4%) and ‘White’ (5.4%) ethnic groups;
• Across the Health and Social Services Boards in Northern Ireland, prevalence varies only slightly.  It is highest in the Eastern Health and Social Services Board (5.6%) and lowest in the Northern Health and Social Services Board (5.2%).  The authors attribute this to the fact that there are relatively more people from at-risk ethnic minority groups and older people in the Eastern Board.

Kate Fleck, National Director of Diabetes UK Northern Ireland said, "We welcome today's report as a first step in defining the prevalence of diabetes throughout Ireland, both North and South.  Diabetes UK Northern Ireland has been recommending the establishment of a diabetes register as an essential building block in ensuring appropriate resourcing of diabetes services.  It is important for the work to continue especially with the rising trend in obesity and the subsequent link to the rising prevalence of diabetes."

Dr Balanda continued, “Until today, national diabetes estimates for Northern Ireland and the Republic of Ireland have been based on the application of international averages to the population here.  Reliable detailed sub-national estimates have not been available which has hampered the planning of services for the prevention, care and monitoring of diabetes.”

“According to the World Health Organisation, in 1985, 30 million people in the world had diabetes.  With this figure expected to rise to 366 million in by 2030, a systematic approach was needed to estimate the number of people with the condition in this country, in particular those who are undiagnosed.  A systematic approach is crucial to rationally plan the development of services at a local and regional level”.

Accurate estimates of the population prevalence of diabetes are essential to identify need, to plan and deliver services in a rational way, and to monitor performance.  The Working Group acknowledges that the model has limitations and in addition to the set up of diabetes registers, further research is also recommended to fill information gaps in the following areas:

• The establishment of a comprehensive All-Ireland system for monitoring obesity and the factors that influence it;
• Diabetes registers should include information about the residence of patients to allow socio-economic factors to be taken into account.

The publication of today’s report also marks the first attempt to systematically estimate population prevalence across the population of Ireland by a range of representatives from government agencies, professional organisations and relevant charities.  The Working Group includes representatives from , the Department of Health, Social Services and Public Safety (Northern Ireland), Department of Health and Children Trinity College Dublin, University College Cork, various HSE areas, the Irish Endocrine Society, the Northern Ireland Consultant Group in Endocrinology and Diabetes and the charities, the Diabetes Federation of Ireland and Diabetes UK Northern Ireland. 

The next stage of the Working Group’s work will look at the number of new cases emerging as a result of changes in our population profile and trends in obesity.

Dr Balanda concluded, “Based on this model, at 5.4% the prevalence of diabetes in Northern Ireland is lower than the estimate for England (6.1%).  This is largely due to the fact that currently, we have a younger population than England and a much larger percentage of people in England belong to ethnic groups at a higher risk of developing the condition.  But there is no doubt that the number of people with diabetes on the island is on the increase because our population is growing, it is ageing and obesity rates are rising.”

The model applied by the Working Group to Ireland has been rigorously tested in England and was developed by Yorkshire and Humber Public Health Observatory (YPHO), Brent NHS Primary Care Trust, and the University of Sheffield School of Health and Related Research (SchARR).  It accounts for age, sex, ethnicity and socio-economic factors, factors that are known to affects the prevalence of diabetes.  The PBS Model used in today’s report represents the first attempt to systematically estimate population prevalence across the island of Ireland.

ENDS

Notes to Editor:
1. Making Diabetes Count.  A systematic approach to estimating population prevalence on the island of Ireland in 2005.  April 2006.  Published by The Institute of Public Health in Ireland.
2. The Institute of Public Health in Ireland is an all-island body, the aim of which is to combat health inequalities and influence public policy in favour of health.  Its remit is to ‘promote co-operation for public health between the Republic of Ireland and Northern Ireland’ including the area of monitoring and surveillance.  www.publichealth.ie
3. Ireland and Northern Ireland’s Population Health Observatory (INIsPHO) is housed in the Institute of Public Health to help meet growing health information requirements in Northern Ireland and the Republic of Ireland.  It aims to support those working to improve health and reduce health inequalities by producing and disseminating health intelligence, and strengthening the research and information infrastructure on the island of Ireland. 

About diabetes:
Diabetes Mellitus, or diabetes as it is more commonly known, occurs when the sugar (glucose) level in the blood is too high.  This happens when the body is not burning up carbohydrates properly due to a defect in the pancreas, the gland that produces insulin.  Insulin is the hormone which keeps blood sugar levels within the normal healthy range.  Diabetes may be present either when no insulin is made or when insulin is made but not working properly.

There are two types of diabetes - type 1, or insulin dependent diabetes, which usually occurs before the age of 35.  A person with type 1 diabetes makes no insulin and therefore needs to inject insulin to regulate blood sugar levels and remain healthy.  Type 2, or non-insulin dependent diabetes usually occurs in adults after the age of 40 and is extremely common in old age.  In this case, the person with diabetes makes some insulin, but this does not function properly.  Usually associated with being overweight, this condition responds well to weight loss through dietary regulation.  Sometimes weight loss is not enough and tablets are required to help the person's own insulin to work.  
Source: Diabetes Federation of Ireland, www.diabetesireland.ie
 

Contact: Arlene McKay, IPH Communications Officer +44 (0)28 90648494