Analysis of risk factors for pre-diabetes and undiagnosed type 2 diabetes among adults living in private households, using the Health Survey for England.

United Kingdom UK: Diabetes Prevalence: % of Population Aged 20-79 data was reported at 4.280 % in 2017. United Kingdom UK: Diabetes Prevalence: % of Population Aged 20-79 data is updated yearly, averaging 4.280 % from Dec 2017 (Median) to 2017, with 1 observations. United Kingdom UK: Diabetes Prevalence: % of Population Aged 20-79 data remains active status in CEIC and is reported by World Bank. The data is categorized under Global Database’s United Kingdom – Table UK.World Bank.WDI: Health Statistics. Diabetes prevalence refers to the percentage of people ages 20-79 who have type 1 or type 2 diabetes.; ; International Diabetes Federation, Diabetes Atlas.; Weighted average;

This dataset presents the percentage of individuals with type 2 diabetes who have successfully achieved all three key treatment targets recommended by the National Institute for Health and Care Excellence (NICE). These targets include maintaining an HbA1c level of 58 mmol/mol or lower, a blood pressure level of 140/80 mmHg or lower, and, for those at high cardiovascular risk, being prescribed a statin. The dataset provides a valuable measure of effective diabetes management and supports analysis across different population groups and healthcare settings.

Rationale

Achieving all three treatment targets is associated with better health outcomes and reduced risk of diabetes-related complications. This indicator helps assess the quality of diabetes care and supports efforts to improve clinical management and patient outcomes for people living with type 2 diabetes.

Numerator

The numerator includes the number of individuals with type 2 diabetes who have met all three NICE-recommended treatment targets: HbA1c ≤ 58 mmol/mol, blood pressure ≤ 140/80 mmHg, and statin prescription for those at high cardiovascular risk. Data is sourced from the National Diabetes Audit (NDA) and NHS England.

Denominator

The denominator includes all individuals aged 12 and over who are registered with type 2 diabetes at GP practices participating in the National Diabetes Audit. This ensures a consistent and comprehensive population base for calculating the indicator.

Caveats

Data is collected over a 15-month period, from January 1st of the first year to March 31st of the following year. This extended reporting window may affect comparability with other datasets that use different timeframes.

External references

For more information, visit the Public Health England Fingertips Diabetes Profile.

Localities ExplainedThis dataset contains data based on either the resident locality or registered locality of the patient, a distinction is made between resident locality and registered locality populations:Resident Locality refers to individuals who live within the defined geographic boundaries of the locality. These boundaries are aligned with official administrative areas such as wards and Lower Layer Super Output Areas (LSOAs).Registered Locality refers to individuals who are registered with GP practices that are assigned to a locality based on the Primary Care Network (PCN) they belong to. These assignments are approximate—PCNs are mapped to a locality based on the location of most of their GP surgeries. As a result, locality-registered patients may live outside the locality, sometimes even in different towns or cities.This distinction is important because some health indicators are only available at GP practice level, without information on where patients actually reside. In such cases, data is attributed to the locality based on GP registration, not residential address.

Click here to explore more from the Birmingham and Solihull Integrated Care Partnerships Outcome Framework.

Note: This dataset has been archived as of January 2024 after confirmation from NHS Digital that the source dataset is no longer being updated, and there is not a replacement publication for the diabetic ketoacidosis admissions data. This indicator is one measure of the prevention, identification and management of people at risk of developing diabetes and those with the condition. It shows adverse outcomes as annual numbers of emergency hospital admissions for diabetic ketoacidosis and coma. Emergency admissions to hospital can be avoided by identifying people at risk, primary care services interventions, encouraging better diet and exercise, improving self-monitoring and diabetes control and supporting patients and carers in the management of diabetes in the home. It needs local health and care services working effectively together to support people’s health and independence in the community. Type 2 diabetes (around 90 percent of diabetes diagnoses) is partially preventable - it can be prevented or delayed by lifestyle changes (exercise, weight loss, healthy eating). Earlier detection of type 2 diabetes followed by effective treatment reduces the risk of developing diabetic complications. These include cardiovascular, kidney, foot and eye diseases, meaning considerable illness and reduced quality of life. There are some limitations to this data, as raw counts of hospital episodes are subject to population structures (such as numbers of people in older age groups) and other underlying variations. Counts below 5 are removed from the data. The data is updated annually. Sources: NHS Digital (now part of NHS England) - dataset P02177, and commentary from the Office for Health Improvement and Disparities (OHID) Public Health Outcomes Framework (PHOF) indicator 2.17 Recorded Diabetes.

The National Diabetes Audit (NDA) and the National Paediatric Diabetes Audit (NPDA) provide a comprehensive view of diabetes care in England and Wales. They measure the effectiveness of diabetes healthcare against NICE Clinical Guidelines and NICE Quality Standards. The Young People with Type 2 Diabetes report aims to document the number of people with type 2 diabetes up to the age of 40 years, their characteristics and the diabetes care they receive. This is important because adverse diabetes and cardiovascular outcomes are more common in people who develop diabetes at an early age and it is thought the numbers are increasing.

This dataset provides the percentage of individuals aged 40 to 64 who are registered with type 2 diabetes, based on data from GP practices participating in the National Diabetes Audit (NDA). It offers insights into the burden of type 2 diabetes within this age group and supports efforts to monitor and reduce its prevalence through targeted public health interventions.

Rationale The indicator aims to reduce the prevalence of type 2 diabetes among adults aged 40 to 64. Monitoring this age group is critical, as early detection and management of diabetes can significantly reduce the risk of complications and improve long-term health outcomes.

Numerator The numerator is the number of people aged 40 to 64 who are registered with type 2 diabetes at GP practices that participate in the National Diabetes Audit.

Denominator The denominator is the total number of people registered with type 2 diabetes at participating GP practices, regardless of age.

Caveats The data is collected over a 15-month period, from January 1st of the first year to March 31st of the following year. Individuals not registered with a GP practice at the time of data collection are excluded. From 2022–23 onwards, values are not reported where the denominator is 20 or fewer, to protect confidentiality and ensure data reliability.

External references Public Health England - Fingertips: Prevalence of type 2 diabetes

Click here to explore more from the Birmingham and Solihull Integrated Care Partnerships Outcome Framework.

The National Diabetes Audit (NDA) and the National Paediatric Diabetes Audit (NPDA) provide a comprehensive view of diabetes care in England and Wales. They measure the effectiveness of diabetes healthcare against NICE Clinical Guidelines and NICE Quality Standards. This is the second Young People with Type 2 Diabetes report (1). It aims to document the number of people with type 2 diabetes up to the age of 40 years, their patient characteristics and the diabetes care they receive. This is important because adverse diabetes and cardiovascular outcomes are more common in people who develop type 2 diabetes at an earlier age and it is thought the numbers of affected individuals are increasing (2,3).

This dataset provides the percentage of individuals aged 40 to 64 who are registered with type 2 diabetes, based on data from GP practices participating in the National Diabetes Audit (NDA). It offers insights into the burden of type 2 diabetes within this age group and supports efforts to monitor and reduce its prevalence through targeted public health interventions.

Rationale The indicator aims to reduce the prevalence of type 2 diabetes among adults aged 40 to 64. Monitoring this age group is critical, as early detection and management of diabetes can significantly reduce the risk of complications and improve long-term health outcomes.

Numerator The numerator is the number of people aged 40 to 64 who are registered with type 2 diabetes at GP practices that participate in the National Diabetes Audit.

Denominator The denominator is the total number of people registered with type 2 diabetes at participating GP practices, regardless of age.

Caveats The data is collected over a 15-month period, from January 1st of the first year to March 31st of the following year. Individuals not registered with a GP practice at the time of data collection are excluded. From 2022–23 onwards, values are not reported where the denominator is 20 or fewer, to protect confidentiality and ensure data reliability.

External references Public Health England - Fingertips: Prevalence of type 2 diabetes

Click here to explore more from the Birmingham and Solihull Integrated Care Partnerships Outcome Framework.

This dataset provides the percentage of individuals aged 40 to 64 who are registered with type 2 diabetes, based on data from GP practices participating in the National Diabetes Audit (NDA). It offers insights into the burden of type 2 diabetes within this age group and supports efforts to monitor and reduce its prevalence through targeted public health interventions.

Rationale The indicator aims to reduce the prevalence of type 2 diabetes among adults aged 40 to 64. Monitoring this age group is critical, as early detection and management of diabetes can significantly reduce the risk of complications and improve long-term health outcomes.

Numerator The numerator is the number of people aged 40 to 64 who are registered with type 2 diabetes at GP practices that participate in the National Diabetes Audit.

Denominator The denominator is the total number of people registered with type 2 diabetes at participating GP practices, regardless of age.

Caveats The data is collected over a 15-month period, from January 1st of the first year to March 31st of the following year. Individuals not registered with a GP practice at the time of data collection are excluded. From 2022–23 onwards, values are not reported where the denominator is 20 or fewer, to protect confidentiality and ensure data reliability.

External references Public Health England - Fingertips: Prevalence of type 2 diabetes

Localities ExplainedThis dataset contains data based on either the resident locality or registered locality of the patient, a distinction is made between resident locality and registered locality populations:Resident Locality refers to individuals who live within the defined geographic boundaries of the locality. These boundaries are aligned with official administrative areas such as wards and Lower Layer Super Output Areas (LSOAs).Registered Locality refers to individuals who are registered with GP practices that are assigned to a locality based on the Primary Care Network (PCN) they belong to. These assignments are approximate—PCNs are mapped to a locality based on the location of most of their GP surgeries. As a result, locality-registered patients may live outside the locality, sometimes even in different towns or cities.This distinction is important because some health indicators are only available at GP practice level, without information on where patients actually reside. In such cases, data is attributed to the locality based on GP registration, not residential address.

Click here to explore more from the Birmingham and Solihull Integrated Care Partnerships Outcome Framework.

The NHS Diabetes Prevention Programme (NHS DPP) is a joint commitment from NHS England & Improvement, Public Health England (now Office for Health Improvement and Disparities) and Diabetes UK to deliver, at scale, evidence based behavioural interventions that can prevent or delay the onset of type 2 diabetes in adults who have been identified as having non-diabetic hyperglycaemia. This report primarily uses data from English GP practice systems, and data generated by providers of the Diabetes Prevention Programme relating to referrals. The GP data is only for people diagnosed with non-diabetic hyperglycaemia.

This spotlight audit builds on the core National Paediatric Diabetes Audit (NPDA) and looks in detail at the care processes, treatment, and comorbidities of children and young people living with Type 2 diabetes. Some of this reached beyond the scope of the NICE guidelines for the diagnosis and management of Type 1 and Type 2 diabetes. Published in April 2025. Key Messages: The number of CYP with Type 2 diabetes receiving care from a PDU in England and Wales has increased by 88%, from 810 in 2019/20, to 1,521 in 2023/24. CYP with Type 2 diabetes are more likely to come from ethnic minority backgrounds or live in more deprived areas, compared to CYP with Type 1 diabetes and the general population. 41% of CYP with Type 2 diabetes, aged 12 or older had all six key health checks in 2023/24, compared to 66% of CYP with Type 1 diabetes. The national (England and Wales combined) median HbA1c for CYP with Type 2 diabetes in 2023/24 is 50.0 mmol/mol, compared to 52.5 mmol/mol seen in 2019/20. This is lower than that seen in Type 1 diabetes at 60.0 mmol/mol.

The DC was established to investigate the determinants of complications in individuals with type 2 diabetes and to examine the roles of genetic, physiological, and lifestyle factors in the development of complications in these individuals. Participants include adult Singaporeans and permanent residents (aged 21 years and above) with physician-diagnosed type 2 diabetes. Individuals with mental illness, clinically-obvious non-diabetic kidney disease (such as polycystic kidney disease), type 1 diabetes, or diabetes mellitus resulting from endocrinopathies were not included. Data have been collected at three different timepoints: baseline (2004-2010, DC_T1); first follow-up (2010-2016, DC_T2); and second follow-up (2016-2021, DC_T3). The mean age of participants at baseline was 59.7 years, and 50.8% of participants were men. The ethnic composition of the sample was 59.3% Chinese, 22.7% Malay, and 17.3% Indian.

This dataset presents the percentage of individuals with type 2 diabetes who have received all eight recommended care processes as defined by the National Diabetes Audit (NDA). These care processes are essential checks and tests that support effective monitoring and management of diabetes. They include measurements and assessments such as body mass index (BMI), blood pressure, smoking status, HbA1c, cholesterol, urine albumin, serum creatinine, and foot examination for nerve and circulation health. The dataset provides a comprehensive view of how well healthcare providers are delivering routine diabetes care.

Rationale

Receiving all eight care processes is associated with improved monitoring and early detection of complications in people with type 2 diabetes. This indicator helps evaluate the consistency and quality of routine diabetes care and supports efforts to enhance patient outcomes through comprehensive clinical assessments.

Numerator

The numerator includes the number of individuals with type 2 diabetes who received all eight care processes within the audit period. These processes are: BMI measurement, blood pressure check, smoking status recording, HbA1c test, cholesterol test, urine albumin test, serum creatinine test, and foot examination for nerve and circulation health. Data is sourced from the National Diabetes Audit (NDA) and NHS England.

Denominator

The denominator includes all individuals registered with type 2 diabetes at GP practices participating in the National Diabetes Audit. This ensures a consistent and representative population base for calculating the indicator.

Caveats

Data is collected over a 15-month period

Localities ExplainedThis dataset contains data based on either the resident locality or registered locality of the patient, a distinction is made between resident locality and registered locality populations:Resident Locality refers to individuals who live within the defined geographic boundaries of the locality. These boundaries are aligned with official administrative areas such as wards and Lower Layer Super Output Areas (LSOAs).Registered Locality refers to individuals who are registered with GP practices that are assigned to a locality based on the Primary Care Network (PCN) they belong to. These assignments are approximate—PCNs are mapped to a locality based on the location of most of their GP surgeries. As a result, locality-registered patients may live outside the locality, sometimes even in different towns or cities.This distinction is important because some health indicators are only available at GP practice level, without information on where patients actually reside. In such cases, data is attributed to the locality based on GP registration, not residential address.

Click here to explore more from the Birmingham and Solihull Integrated Care Partnerships Outcome Framework.

The National Diabetes Audit (NDA) provides a comprehensive view of diabetes care in England and Wales. It measures the effectiveness of diabetes healthcare against the National Institute for Health and Care Excellence (NICE) Clinical Guidelines and NICE Quality Standards. This NICE guidance is based on evidence that regular systematic review of people with diabetes and achievement of glucose, blood pressure and cardiovascular risk standards maintains health and reduces long term complications.

Type 2 diabetes (T2D) is a complex disorder characterized by high blood sugar, insulin resistance, and relative lack of insulin. The collective effects of genome wide minor alleles of common SNPs, or the minor allele content (MAC) in an individual, have been linked with quantitative variations of complex traits and diseases. Here we studied MAC in T2D using previously published SNP datasets and found higher MAC in cases relative to matched controls. A set of 357 SNPs was found to have the best predictive accuracy in a British population. A weighted risk score calculated by using this set produced an area under the curve (AUC) score of 0.86, which is comparable to risk models built by phenotypic markers. These results identify a novel genetic risk element in T2D susceptibility and provide a potentially useful genetic method to identify individuals with high risk of T2D.

Baseline characteristics of people with incident type 2 diabetes in 2006 or later with no prior statin use or ASCVD, by ethnicity (complete case analysis).

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Background: Diabetes mellitus affects over 3.9 million people in the United Kingdom (UK), with over 2.6 million people in England alone. More than 1 million people living with diabetes are acutely admitted to hospital due to complications of their illness every year. Cardiovascuar disease is the most prevalent cause of morbidity and mortality in people with diabetes. Diabetic retinopathy (DR) is a common microvascular complication of type 1 and type 2 diabetes and remains a major cause of vision loss and blindness in those of working age. This dataset includes the national screening diabetic grade category (seven categories from R0M0 to R3M1) from the Birmingham, Solihull and Black Country DR screening program (a member of the National Health Service (NHS) Diabetic Eye Screening Programme) and the University Hospitals Birmingham NHS Trust cardiac outcome data.

Geography: The West Midlands has a population of 5.9 million. The region includes a diverse ethnic, and socio-economic mix, with a higher than UK average of minority ethnic groups. It has a large number of elderly residents but is the youngest population in the UK. There are particularly high rates of diabetes, physical inactivity, obesity, and smoking.

Data sources:
1. The Birmingham, Solihull and Black Country Data Set, University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom. They manage over 200,000 diabetic patients, with longitudinal follow-up up to 15 years, making this the largest urban diabetic eye screening scheme in Europe. 2. The Electronic Health Records held at University Hospitals Birmingham NHS Foundation Trust is one of the largest NHS Trusts in England, providing direct acute services and specialist care across four hospital sites, with 2.2 million patient episodes per year, 2750 beds and 100 ITU beds. UHB runs a fully electronic healthcare record for systemic disease.

Scope: All Birmingham, Solihull and Black Country diabetic eye screened participants who have been admitted to UHB with a cardiac related health concern from 2006 onwards. Longitudinal and individually linked with their diabetic eye care from primary screening data and secondary care hospital cardiac outcome data including • Demographic information (including age, sex and ethnicity) • Diabetes status • Diabetes type • Length of time since diagnosis of diabetes • Visual acuity • The national screening diabetic screening grade category (seven categories from R0M0 to R3M1) • Diabetic eye clinical features • Reason for sight and severe sight impairment • ICD-10 and SNOMED-CT codes pertaining to cardiac disease • Outcome

Website: https://www.retinalscreening.co.uk/

IntroductionThis study aims to explore the risk factors in the progression of gestational diabetes mellitus (GDM) to type 2 diabetes mellitus (T2DM).Material and methodsRelevant studies were comprehensively searched from PubMed, Web of Science, Cochrane Library, and Embase up to March 12. Data extraction was performed. Differences in risk factors were presented as odds ratios (OR) and corresponding 95% confidence intervals (CI). The quality of the included studies was assessed through the Newcastle-Ottawa Scale and the Agency for Healthcare Research and Quality scale.ResultsThis meta-analysis encompassed 46 studies involving a total of 196,494 patients. The factors most strongly associated with the risk of developing T2DM following GDM were the use of progestin-only contraceptives (odds ratio [OR]: 2.12, 95% confidence interval [CI] = 1.00–4.45, P = 0.049), recurrence of GDM (OR: 2.63, 95% CI = 1.88–3.69, P < 0.001), insulin use during pregnancy (OR: 4.35, 95% CI = 3.17–5.96, P < 0.001), pre-pregnancy body mass index (BMI) (OR: 2.97, 95% CI = 2.16–4.07, P < 0.001), BMI after delivery (OR: 4.17, 95% CI = 2.58–6.74, P < 0.001), macrosomia (OR: 3.30, 95% CI = 1.45–7.49, P = 0.04), hypertension (OR: 5.19, 95% CI = 1.31–20.51, P = 0.019), and HbA1c levels (OR: 3.32, 95% CI = 1.81–6.11, P < 0.001). Additionally, age (OR: 1.71, 95% CI = 1.23–2.38, P = 0.001), family history of diabetes (OR: 1.47, 95% CI = 1.27–1.70, P < 0.001), BMI during pregnancy (OR: 1.06, 95% CI = 1.00–1.12, P = 0.056), fasting blood glucose (FBG) (OR: 1.58, 95% CI = 1.36–1.84, P < 0.001), 1-hour oral glucose tolerance test (OGTT) (OR: 1.38, 95% CI = 1.02–1.87, P = 0.037), and 2-hour OGTT (OR: 1.54, 95% CI = 1.28–1.58, P < 0.001) were identified as moderate-risk factors for the development of T2DM.ConclusionThe systematic review and meta-analysis identified several moderate- to high-risk factors associated with the progression of T2DM in individuals with a history of GDM. These risk factors include the use of progestin-only contraceptives, pre-pregnancy BMI, BMI after delivery, macrosomia, hypertension, persistently elevated levels of HbA1c, fasting blood glucose (FBG), 1-hour and 2-hour oral glucose tolerance tests (OGTT), age, and family history of diabetes. Our findings serve as evidence for the early prevention and clinical intervention of the progression from GDM to T2DM and offer valuable insights to guide healthcare professionals in formulating customized management and treatment strategies for female patients with diverse forms of GDM.Systematic review registrationhttps://www.crd.york.ac.uk/PROSPERO/, identifier CRD42024545200.

Background.

Diabetes mellitus affects over 3.9 million people in the United Kingdom (UK), with over 2.6 million people in England alone. Each year more than 1 million people with diabetes are acutely admitted to hospital due to complications of their illness. This includes Diabetic emergencies such as Diabetic Comas, Hypoglycaemia, Diabetic ketoacidosis, and Diabetic Hyperosmolar Hyperglycaemic State. Diabetic emergency management is often not compliant with national guidelines, and there is a pressing need to improve patient care. This dataset includes 65,506 people and 168,706 spells, designed to support research which improves diabetic emergency and unplanned care.

Other causes for admission include diabetic ulcers, neuropathies, kidney disease and associated co-morbidities such as infection, cerebrovascular disease and cardiovascular disease. This dataset includes acute all diabetic admissions to University Hospitals Birmingham NHS Trust from 2000 onwards refreshed to include new admissions as they occur.

PIONEER geography The West Midlands (WM) has a population of 5.9 million & includes a diverse ethnic & socio-economic mix.

EHR. UHB is one of the largest NHS Trusts in England, providing direct acute services & specialist care across four hospital sites, with 2.2 million patient episodes per year, 2750 beds & an expanded 250 ITU bed capacity during COVID. UHB runs a fully electronic healthcare record (EHR) (PICS; Birmingham Systems), a shared primary & secondary care record (Your Care Connected) & a patient portal “My Health”.

Scope: All patients admitted to hospital from year 2002 and onwards, curated to focus on Diabetes. Longitudinal & individually linked, so that the preceding & subsequent health journey can be mapped & healthcare utilisation prior to & after admission understood. The dataset includes highly granular patient demographics & co-morbidities taken from ICD-10 & SNOMED-CT codes. Serial, structured data pertaining to acute care process (timings, staff grades, specialty review, wards and triage). Along with presenting complaints, outpatients admissions, microbiology results, referrals, procedures, therapies, all physiology readings (pulse, blood pressure, respiratory rate, oxygen saturations and others), all blood results(urea, albumin, platelets, white blood cells and others). Includes all prescribed & administered treatments and all outcomes. Linked images are also available (radiographs, CT scans, MRI).

Available supplementary data: Matched controls; ambulance, OMOP data, synthetic data.

Available supplementary support: Analytics, Model build, validation & refinement; A.I.; Data partner support for ETL (extract, transform & load) process, Clinical expertise, Patient & end-user access, Purchaser access, Regulatory requirements, Data-driven trials, “fast screen” services.

This dataset shows the percentage of patients with non-diabetic hyperglycaemia who took up an offer to participate in the NHS Diabetes Prevention Programme (DPP). The indicator reflects engagement with preventative services aimed at reducing the risk of developing type 2 diabetes. Data is sourced from the National Diabetes Audit (NDA) and includes patients registered at participating GP practices.

Rationale

The NHS Diabetes Prevention Programme is a key initiative to reduce the incidence of type 2 diabetes by supporting individuals at high risk through lifestyle interventions. Monitoring the uptake of DPP courses helps assess the reach and effectiveness of the programme and supports efforts to improve early intervention and reduce long-term health complications.

Numerator

The numerator is the number of patients with non-diabetic hyperglycaemia who were offered and did not decline a DPP course, as recorded by GP practices participating in the National Diabetes Audit.

Denominator

The denominator includes all patients with non-diabetic hyperglycaemia registered at GP practices that participated in the National Diabetes Audit.

Caveats

Some individuals with diabetes may be excluded from the dataset if they were not registered with a GP practice at the time of data collection. This may affect the completeness of the data and the accuracy of the reported uptake rate.

External References

More information is available from the following source:

National Diabetes Audit - NDH & DPP

Click here to explore more from the Birmingham and Solihull Integrated Care Partnerships Outcome Framework.