Upload
shannon-atkinson
View
215
Download
0
Embed Size (px)
Citation preview
Diabetes
Health intelligence
Jon Walker
Advanced public health analyst
Surrey County Council
020 8541 7827
Outline
• Prevalence• Prevalence gap• Risk factors• Complications• Care processes
Prevalence diabetes estimated and diagnosed
Current diabetes prevalence
Estimated percentage diagnosed
Prevalence gap
Risk factors
• Age• Deprivation• Ethnic background• Weight/BMI• Waist circumference• Diet• Family history• High blood pressure or history of cardiovascular disease• Polycystic ovary syndrome or who have a history of gestational
diabetes• Mental health conditions or learning disabilities
• Fasting plasma glucose of 5.5–6.9 mmol/l or an HbA1c level of 42–47 mmol/mol [6.0–6.4%]
Guildford and Waverley CCG population
Deprivation
Ethnicity
11
Trend in excess weight among adults
Patterns and trends in adult obesity
Adult (aged 16+) overweight including obese: BMI ≥ 25kg/m2
Source: PHE NOO
12
Trend in obesity prevalence among adults
Patterns and trends in adult obesity
Adult (aged 16+) obesity: BMI ≥ 30kg/m2
Source: PHE NOO
Percentage of adults classified as overweight or obese (2012)
Guildford
Epsom and Ewell
Elmbridge
Waverley
Woking
Mole Valley
Runnymede
Tandridge
Spelthorne
England
Reigate and Banstead
Surrey Heath
0 10 20 30 40 50 60 70 80
National Child Measurement Programme
2007/08 2008/09 2009/10 2010/11 2011/12 2012/13 2013/140%
5%
10%
15%
20%
25%
30%
35%
40%
Percentage excess weight in year 6 (10-11)
England Surrey NHS Guildford and Waverley
Percentage children aged 10-11 having excess weight
Non-diabetic hyperglycaemia
• NCVIN estimates for Surrey CC suggest a prevalence of 11.3% or 106,000 adults (16+) with non-diabetic hyperglycaemia (HbA1c 6.0% - 6.4%)
• Around 19,000 in Guildford and Waverley CCG• 5-10% of people per year with prediabetes will
progress to diabetes, with the same proportion converting back to normoglycaemia (Tabak et al)
Diabetes projections
2015 2020 2025 20300
2000
4000
6000
8000
10000
12000
14000
16000
Crude estimate of number of people projected to have diabetes in Guildford and Waverley CCG
Obesity continues to rise at current rate 2010 obesity levels maintained
Diabetes: the fastest growing health issue
• There are more than 5m people in England at risk of Type 2 diabetes
• Diabetes accounts for 10% of the NHS budget
• Strong international evidence for effectiveness of lifestyle interventions to lower risk
Additional risk of complications
Diabetic retinopathy complications
Aug
ust
Sep
tem
ber
Oct
ober
Nov
embe
r
Dec
embe
r
Janu
ary
Feb
ruar
y
Mar
ch
Apr
il
May
June
July
Aug
ust
Nov
embe
r
Dec
embe
r
Janu
ary
Feb
ruar
y
Mar
ch
Apr
il
June
July
2012/2013 2013/2014 2014/2015
0
1
2
3
4
5
6
7
£0.00
£500.00
£1,000.00
£1,500.00
£2,000.00
£2,500.00
£3,000.00
£3,500.00
£4,000.00
Admitted Patients (April 2012 - July 2014)
Patients - Diabetic retinopathy Cost - Diabetic retinopathy
Pat
ien
ts
Nights in hospital for diabetic foot disease per 1,000 diabetics
Nine NICE annual care processes
• HbA1c• Blood pressure• Cholesterol• Serum creatinine• Urine albumin• Foot surveillance• BMI• Smoking• Eye screening (NHS retinopathy screening)
Percentage patients receiving the eight care processes (2012-13)
Percentage patients receivingcare processes
HbA1c (2013-14)
H81022
H81044
H81031
H81053
H81064
H81647
H81085
H81077
H81006
H81132
H81010
H81035
H81084
H81052
H81062
H81021
H81043
H81029
H81026
H81090
H81076
CCG
0 10 20 30 40 50 60 70 80 90 100
DM007: Last HbA1c is <=59mmol/mol in last 12mths (den. incl. exc.) Last HbA1c is >59mmol/mol in last 12mths (den. incl. exc.)
Diabetes education programmes
Further information• Diabetes community health profile (2013):
http://www.yhpho.org.uk/resource/view.aspx?RID=8470• GP practice profile: http://fingertips.phe.org.uk/profile/general-practice• NCVIN CVD profile – diabetes (2015):
http://www.yhpho.org.uk/default.aspx?RID=203617• Footcare activity profile: http://www.yhpho.org.uk/default.aspx?RID=116836• CVD intelligence pack (2015):
http://www.yhpho.org.uk/ncvinintellpacks/pdfs/09N_SlidePack.pdf• NICE guidance:
– https://www.nice.org.uk/guidance/cg87– https://www.nice.org.uk/guidance/ng17– https://www.nice.org.uk/guidance/ng18– https://www.nice.org.uk/guidance/ph38
• NDA CCG profiles – Report 1 Care processes and treatment targets:
http://www.hscic.gov.uk/catalogue/PUB14970– Report 2 Complications and Mortality:
http://www.hscic.gov.uk/catalogue/PUB16496