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What we know
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| What we know | |||||||||||||||||||||||||||||||||||
| Diabetes is a chronic and progressive disease that impacts upon almost every aspect of life. It can affect infants, children, young people and adults of all ages, and is becoming more common. Diabetes can result in premature death, ill health and disability, yet these can often be prevented or delayed by high-quality care. Diabetes comprises a group of disorders with many different causes, all of which are characterised by a raised blood glucose level. This is the result of a lack of the hormone insulin and/or an inability to respond to insulin. There are 2 main types of diabetes - Type 1 and Type 2. In people with Type 1 diabetes the pancreas is no longer able to produce insulin. Type 1 diabetes develops most frequently in children, young people and young adults. Type 2 diabetes is most commonly diagnosed in adults over the age of 40, although increasingly it is appearing in young people and young adults. Type 2 diabetes is more common - in England 85% of those with diabetes have Type 2 and 15% Type 1. In many cases Type 2 diabetes could either have been prevented or its onset delayed. Prolonged exposure to raised blood glucose levels damages tissues throughout the body by damaging the small blood vessels. The microvascular complications include:
People with diabetes are also at significantly increased risk of developing cardiovascular disease including:
A number of other conditions also occur more commonly in people with diabetes including:
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| What information do we have about the Eastern Board area? | |||||||||||||||||||||||||||||||||||
| In Northern Ireland 3% of the
population are known to have diabetes, a figure which is expected
to double in the next 8 years. Up to a further 25,000 people may have
diabetes but have not yet been diagnosed. A population of 100,000 would have approximately 3,000 people with diabetes of whom 25-30 would be children. The number of cases of diabetes increases with age. 1 in 20 people over the age of 65 has diabetes and 1 in 5 people over the age of 85. General Practice inter-practice audits on
diabetes were carried out by the GP Audit Team of the Eastern Board
in 1995, 1996 and 1998. Results indicate that the prevalence of
diabetes among the participating practices increased from 1.26%
in 1995 to 1.86% in 1998. This increase is likely to be due to both
improved ascertainment and increasing prevalence of diabetes in
the population. The audit information showed that the gender and
age profile of those known to have diabetes has not changed significantly
between the audits. Over 75% of those with diabetes were aged over
50 years. |
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| What is the result of this on our health locally? | |||||||||||||||||||||||||||||||||||
For most people with diabetes, coming to terms with a diagnosis of diabetes can be very difficult. Diabetes can result in ill health, premature mortality and disability including:
Many of these complications can be prevented or delayed through the provision of high quality co-ordinated diabetic care. Avoiding obesity, taking regular exercise and promoting healthy eating reduces the risk of developing Type 2 diabetes. There are 2 worrying trends in the population’s health - increasing levels of obesity are associated with an increase in Type 2 diabetes and the prevalence of obesity continues to rise, more than 1 in 4 adults will be obese by 2010. People with diabetes also highlight the impact of the disease on emotional and mental-wellbeing and point out the need to address this issue as well as the physical effects. Provision of care for those with diabetes has a major impact on the health and social services.
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| Policies | |||||||||||||||||||||||||||||||||||
| The Northern Ireland "Programme for Government" outlined the Northern Ireland Executive’s vision for a cohesive, inclusive and just society and include "Working for a Healthier People" as one of its 5 overarching priorities. The Public Health Strategy for Northern Ireland "Investing for Health" was issued in 2002 and sets out objectives for improving the health of the population and reducing inequalities. In 2001 the Joint Taskforce on Diabetes was established and asked to develop a framework document for diabetes services in Northern Ireland. The Report of the Northern Ireland Taskforce on Diabetes: A Blueprint for Diabetes Care in Northern Ireland in the 21st Century was presented to CREST and Diabetes UK in June 2003. The framework has 18 building blocks of care which are divided into 5 key areas.
This figure sets out the 18 building blocks
and highlights the areas for early action. Diabetes Framework for Northern Ireland Prevention and early detection
Care monitoring and treatment
Planning and managing services
Implementation
Policy development elsewhere
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| What is happening in the Eastern Board area? | |||||||||||||||||||||||||||||||||||
| In 1998
the Eastern Health and Social Services Diabetes Services Steering
Group was established to advise the Board on issues related to diabetes
and service development. The group was in turn helped by the establishment
of three Local Diabetes Services Advisory Groups (LDSAGs) covering
the geographical areas of Belfast, Lisburn and Down, and North Down
and Ards. These groups include representation from people with diabetes
and the parents of children with diabetes as well as professionals
involved with diabetes care.
Much has been happening under the auspices of these groups to improve diabetes services.
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For further information on this topic please contact us at publichealth@ehssb.n-i.nhs.uk Eastern Health and Social Services Board Champion
House, 12-22 Linenhall Street, Belfast BT2 8BS Telephone: (028)
9032 1313 Fax: (028) 9055 3681 Text Phone:(028) 9032 4980 Website:
www.ehssb.org
E-mail: pr@ehssb.n-i.nhs.uk |
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