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Health Conditions

General Practice

NHS National Services Scotland ISD Scotland & NHS National Services Scotland

Diabetes

Diabetes mellitus is a long-term condition in which the level of glucose in the blood is raised leading to abnormal fat metabolism and other complications. In Scotland, there were just over a quarter of a million people with known diabetes in Scotland recorded on local diabetes registers in 2012 (see Scottish Diabetes Survey 2012), but there are also thought to be nearly 50,000 with undiagnosed diabetes (see ScotPHO website). There are two main types of diabetes: type 1 and type 2. Type 1 often develops before the age of 40 and usually during the teenage years. In type 1 diabetes the pancreas does not produce any insulin (the hormone that regulates blood glucose levels), and patients need to take insulin injections for life. In type 2 diabetes, the body does not produce enough insulin, or the body's cells do not react to it (insulin resistance). Type 2 is far more common than type 1, and typically affects people over the age of 40 (although increasingly younger people are affected as well). It is often associated with being overweight or obese, and people of South Asian, African-Caribbean or Middle Eastern origin are more frequently affected. More information on diabetes can be found on the NHS Choices website.

There is no cure for diabetes, so treatment aims to keep blood glucose levels as normal as possible and to keep symptoms under control. Diabetes requires to be monitored closely and this will largely be done in primary care. Practice Team Information (PTI) can provide estimates of the number of consultations and number of patients consulting a GP or practice-employed nurse for diabetes in Scotland. The clinical codes used in data recording for PTI mean that it is not possible to reliably distinguish between patients with type 1 or type 2 diabetes. The figures published here therefore refer to both types combined.

Number of patients consulting

The figure below shows the estimated number of patients in Scotland (per 1,000 patients registered with a practice) who consulted either a GP or practice-employed nurse for diabetes at least once in the year ending 31 March 2013, by gender and age group. The chart shows that in most age groups relatively more males than females consulted for diabetes, and that rates largely increase with age.

These figures and comparable figures for 2003/04 to 2011/12 are provided in an Excel file (see link at the bottom of this page), which also contains 95% confidence intervals for all estimates. The Excel table shows a total estimate of around 247,000 patients seen in the most recent year for diabetes, with a 95% confidence interval between 235,000 and 258,000 patients. Fairly wide confidence intervals reflect limited precision of the estimate, and can be expected when variation between practices is large (in particular for any estimate based on relatively small numbers).

The Scottish Public Health Observatory (ScotPHO) website provides more information on diabetes from a number of sources. It also provides useful links to other sites, among these for the annual Scottish Diabetes Survey. The most recent survey was carried out in 2012 and links to this and previous surveys can be found at the publications section of the Diabetes in Scotland website. This survey found an overall prevalence rate in 2012 of 4.9% in Scotland. The all ages/both genders estimate from PTI of the number of patients consulting in 2011/12 was 44.6 per 1,000 registered patients, which is broadly consistent with the survey findings.

Diabetes1 - estimated number of patients in Scotland consulting a GP or practice nurse
at least once in the financial year 2012/132 per 1,000 patients registered3; by gender and age group

Histogram showing estimated number of patients consulting for Diabetes in 2011/12 by age group and gender. Figures increase with age and are typically higher for males than for females, peaking at 165/1,000 registered patients in males aged 75 and over.

1 Based on ISD's Read Code Grouping (RCG) 'Diabetes'.
2 Based on 60 PTI practices that submitted complete GP and practice nurse data for the year ending 31 March 2013. Figures are standardised to the Scottish population by deprivation.
For further information see the Statistical Notes.
3 Population source: Community Health Index (CHI) record, as at 30 September 2012.

Number of consultations

The figure below shows the estimated numbers of consultations in Scotland for diabetes for the ten financial years 2003/04 to 2012/13, by staff discipline. The underlying figures are provided in an Excel file (see link at the bottom of this page) in the sheet "consultations_gppn", which also contains 95% confidence intervals for all estimates. As mentioned before, the figures published here refer to type 1 and type 2 diabetes combined.

The chart shows that the majority of the patient contacts were with a nurse rather than with a GP, and data from the years 2003/04 to 2005/06 suggests that district nurses also play a major part in caring for patients with diabetes. The estimated numbers of GP and practice nurse contacts for diabetes have risen gradually over the ten-year time period, with a slight dip in 2007/08. The apparent dip is a consequence mainly of a decrease in the number of practice nurses contacts being recorded for the PTI data scheme (a particular issue in 2007/08), potentially because of a shift to diabetes clinics being run by nurses employed by the Board rather than the practice (Board-employed nurses do not usually record data for PTI).

Diabetes1 - estimated number of consultations with a GP or practice-employed nurse in Scotland
in the financial years 2003/04 to 2012/132; by staff discipline3

Stack bar showing the estimated number of consultations by GPs and practice nurses (also district nurses and health visitors in the first 3 years) for Diabetes, for financial years 2003/04 to 2011/12. The number of consultations with a GP has been relatively steady around 200,000-220,000 per year (although lower in 2006/07-2007/08), but the number of consultations with a practice nurse has increased, particularly over the last four years. The total number of consultations (GP and practice nurse together) was nearly 780,000 in 2011/12.

1 Based on ISD's Read Code Grouping (RCG) 'Diabetes'.
2 Based on 59, 53, 51, 49, 48, 58, 60, 59, 59 and 60 PTI practices that submitted complete GP and practice nurse data for the years ending 31 March 2004 to 2013, respectively, and 46, 44 and 44 practices submitting complete district nurse and health visitor data for the years ending 31 March 2004, 2005 and 2006, respectively. Figures are standardised to the Scottish population by age, gender, and deprivation. Population source: Community Health Index (CHI) record, as at 30 September 2003, 2004, 2005, 2006, 2007, 2008, 2009, 2010, 2011 and 2012 respectively. For further information see the Statistical Notes.
3 Health visitor and district nurse data are not available from the financial year 2006/07 onwards.

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