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Diabetes

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Background
Diabetes mellitus is a common chronic condition that causes significant morbidity and mortality if not properly diagnosed and managed. The number of people with diabetes on the island of Ireland is expected to increase because our population is growing, it is ageing, and obesity rates are rising.

To help monitor this important condition, Ireland and Northern Ireland’s Population Health Observatory (INIsPHO) initiated a programme of work on diabetes to identify the best available method for estimating population prevalence on the island.
 
The work was overseen by the Irish Diabetes Prevalence Working Group established by the Observatory. This is the first time that representatives from the charities, key professional organisations, and government agencies have come together to look at this issue on the island.

At present, there is no agreed method for estimating the number of people on the island who have diabetes. Such estimates are critical for the development of national diabetes strategies and diabetes services planning and delivery.

A model to estimate population prevalence has been developed in England as a joint initiative of the York and Humber Public Health Observatory, Brent NHS and School of Health and Related Research (ScHARR,University of Sheffield). This Pho-Brent-ScHARR (PBS) spreadsheet model generates estimates of the number of cases (both diagnosed and undiagnosed) at various geographical levels.

Phase I of the model applies age/sex/ethnic group specific estimates of diabetes prevalence rates, derived from epidemiological population studies, to resident populations based on the 2001 census. Phase II of the model adjusts for area-based socio-economic deprivation. Forecasts for a number of scenarios reflecting different population trends and changes in obesity rates are also available.

Aims
The aims of this project are to:

  • adapt the PBS population prevalence model to describe age/sex/ethnicity patterns of diabetes (both diagnosed and undiagnosed cases) at various geographical levels across the island;
  • use the prevalence estimates to describe the patterns of implicitly undiagnosed diabetes;
  • use the prevalence estimates to forecast future trends using various scenarios based on population projections and possible trends in obesity; 
  • explore the feasibility of incorporating the prevalence estimates into clinical audit and clinical support tools.

This project is testing a methodology that could be used to estimate the population prevalence of other chronic conditions. Collaborating on the project are York and Humber Public Health Observatory, ScHARR, and the key agencies represented on the working group.

Progress report (updated February 2008)
The launch of the first report of the Irish Diabetes Prevalence Working Group, entitled Making Diabetes Count, was held in June 2006 in the Royal College of Physicians in Ireland. Details of the PBS model, its adaptation to the island and key findings from the report were outlined at the event.

The report provides comprehensive population prevalence estimates based on the English model. The estimates are disaggregated by age, sex and ethnicity. Estimates are provided for the island at varying geographical levels.

In Ireland, estimates are available at national and Health Service Executive (HSE) region and local health office area levels. In Northern Ireland, estimates are produced at regional, Health and Social Service Board (HSSB), Local Government District (LCD) and health board locality levels.

The launch of the second report entitled Making Diabetes Count: What does the future hold? was held in June 2007 at the Belfast office of the Institute of Public Health in Ireland (IPH).

This report looked at developing forecasts of the population prevalence of diabetes for the years 2010 and 2015, based on possible changes in our population profile and trends in Body Mass Index (BMI) distribution. The forecasts are available at local and regional levels.

Systematically developed forecasts are useful to describe changing patterns of diabetes in the population and are essential to support rational planning and the development of services.

The tables containing the population prevalence diabetes estimates and forecasts are available on the INIsPHO eData website.

Contact: Lorraine Fahy

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