Diabetes

Introduction

Diabetes mellitus or simply ‘diabetes’ is a chronic and progressive condition, resulting in too much sugar in the blood stream.  This is due either to a lack of insulin (a hormone or signal controlling body sugars) or the body’s unresponsiveness to insulin.

Diabetes increases the risk of developing other serious health problems such as circulatory problems (stroke, heart attacks, poor blood supply to limbs), infections, eye problems (diabetes is the lead cause of blindness), kidney disease, nervous system complaints and in some cases coma.  Good blood sugar control is essential to prevent or slow down these complications.  It can be divided into two types:

Type 1

  • Usually starting in childhood or early adulthood
  • The body is unable to make enough insulin
  • Requires insulin replacement

Type 2

  • Reduced insulin or a lack of response to insulin
  • Associated with obesity

Classically, diabetes is a disease found in older age groups but it is increasing in the young.

What are the big issues?

Diabetes affects approximately 2.8 million people in the UK with an estimated 1 million people undiagnosed.  This emerging epidemic disproportionably affects ethnic minorities, the socially deprived and is closely related to obesity.

After the last national diabetes audit, the BBC described it as the ‘diabetes time bomb’; reflecting upon the escalating future costs to the NHS due to disease complications.

In Warwickshire, 5% of the population have diabetes.  In Coventry, it is slightly more at 5.5%.  Over a quarter of people in Warwickshire are obese, increasing to almost a third in Nuneaton & Bedworth.  It is likely that these cases registered with GPs in Warwickshire are just the tip of the iceberg.

Depression is twice as common in diabetic patients (as with all chronic health conditions) and leads to significant reduction in individual disease control.

What do people say?

It is generally accepted amongst support groups and health care professionals that early diagnosis and introduction of treatment is essential to care for individuals with diabetes and reduce their risk of developing complications.

A Diabetes Needs Assessment for Warwickshire PCT in 2009 highlighted the need to integrate diabetes services across Warwickshire.  It was found that diabetic services were fragmented across the county.

What do we need to do?

  • Emphasis on early detection of diabetes within primary care to prevent complications including prioritising at risk groups; the socially deprived and ethnic minorities.
  • Tackle obesity by encouraging uptake of exercise prescription schemes.
  • To integrate services across the county and provide equal access.
  • Improve access to dietetic services to bring patient experience in line with current NICE guidance.
  • Prompt access for diabetic foot care with adequate provision of podiatrists.
  • Improve patient education to empower individual responsibility for disease management.

Who needs to know?

  • Diabetes specialists
  • General Practitioners
  • Individuals
  • NHS Warwickshire
  • Practice nurses
  • Public Health
  • Schools and colleges
  • Warwickshire County Council

Further information