The analysis of the main contributing factors for the increasing trend of Diabetes Type 2, diabetes morbidity and mortality trends in England, 2017-2022.
Main Article Content
Abstract
Background and aim: Diabetes Type 2 is a non-communicable disease which is characterized by chronic hyperglycaemia and disruption of metabolism. A poor management of diabetes leads to serious cardiovascular and neural complications. The prevalence of Diabetes Type 2 is increasing globally; in the United Kingdom, the number of people living with a diabetes increased by more than 100,000 from 2018 to 20191. In 2019, 3,9 million people had diagnosis of diabetes, and predictions are that this number will increase to 5,3 million in 2025. The aim of this research is to examine the main contributing factors and their influence on the prevalence of Diabetes Type 2 among people aged 17+ in England based on the routine epidemiological data for 2017-2022 years. Additionally, this research will analyze trends for hospital admissions with the diagnosis of Diabetes Type 2 and diabetes mortality statistics.
Methods: The Pearson’s and the Spearman’s correlation analyses are used to investigate possible associations, their strength, monotonicity and direction between the prevalence of diabetes, deprivation, low physical activity, obesity and density of fast food outlets. Stratified random sampling of 153 England counties & unitary authorities (the division of 2017) are used for the statistical analysis. A comparative analysis is used to analyze trends for hospital admissions with the diagnosis Diabetes Type 2 and diabetes mortality statistics. Descriptive statistics and quantitative analysis of secondary routine numerical data collected by the National Health Service Digital, the National Health Survey and the Office for Health Improvement & Disparities is used.
Findings: The analysis revealed positive correlations between the prevalence of diabetes and indicators of deprivation, obesity, low physical activity. In general, diabetes, obesity and physically inactive adults are more prevalent in counties with higher deprivation score. The strong positive correlation was found between density of fast food outlets and deprivation; the analysis of mean values indicated a positive linear relationships between obesity, diabetes indicators and density of fast food outlets. The comparative analysis revealed an upward trend for both, hospital admissions with the diagnosis Diabetes Type 2 and diabetes mortality.
Conclusion: In conclusion, analysis based on 80 counties & unitary authorities of England indicated that the main contributing factors for the increasing trend of Diabetes Type 2 can be the increasing prevalence of overweight and obese adults, low physical activity and deprivation. Additionally, the analysis demonstrated that the availability and abundance of fast food outlets, especially in more deprived deciles of England are closely associated with obesity and indirectly with the prevalence of Diabetes Type 2. Additionally, an increasing trend in the prevalence of Diabetes Type 2 is accompanied by a similar growth of hospital admissions with the diagnosis of Diabetes Type 2 and diabetes mortality.
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References
2. World Health Organization. Diabetes. https://who.int/healthtopics/diabetes#tab=tab_1 Published 2023. Accessed July 31, 2023.
3. Saeedi P, Petersohn I, Salpea P. et al. Global and regional diabetes prevalence estimates for 2019 and projections for 2030 and 2045: Results from the International Diabetes Federation Diabetes Atlas, 9th edition. Diabetes Res Clin Pract. 2019; 157:107843. https://pubmed.ncbi.nlm.nih.gov/31518657/ Accessed August 15, 2023.
4. National Health Service Digital. National Diabetes Audit (NDA) 2019-2020 quarterly report for England, Clinical Commissioning Groups and GP practices. https://digital.nhs.uk/search?query=national+diabetes+audit+quarterly+report Published 2020. Accessed August 6, 2023.
5. Heald A, Stedman M, Robinson A. Mortality Rate Associated with Diabetes: Outcomes From a General Practice Level Analysis in England Using the Royal College of General Practitioners (RCGP) Database Indicate Stability Over a 15 Year Period. Diabetes Ther. 2022; 13(12): 1-12. DOI: 10.1007/s13300-022-01215-1 Accessed August 17, 2023
6. Public Health England. Estimates by CCG tool for the impact of obesity on diabetes. https://www.gov.uk/government/publications/diabetes-prevalence-estimates-for-local-populations Published 2016. Accessed July 24, 2023.
7. National Health Service Digital. National Diabetes Audit Report 1- Findings and recommendations2018. https://digital.nhs.uk/data-and information/publications/statistical/national-diabetes-audit/national-diabetes-audit-report-1-findings-and-recommendations-2016-17 Published 2019. Accessed August 9, 2023.
8. Public Health England. Health Matters: obesity and the food environment. https://www.gov.uk/government/publications/health-matters-obesity-and-the-food-environment/health-matters-obesity-and-the-food-environment--2#improving-everyones-access-to-healthier-food-choices Published 2017. Accessed August 5, 2023.
9. Public Health England. Chapter 3: trends in morbidity and risk factors. https://www.gov.uk/government/publications/health-profile-for-england-2018/chapter-3-trends-in-morbidity-and-risk-factors#diabetes Published 2018. Accessed August 2, 2023
10. National Health Service. Health Survey for England 2018. Adults’ Health. London: Health and Social Care Information Centre. https://digital.nhs.uk/data-and-information/publications/statistical/health-survey-for-england/2018 Published 2019. Accessed August 3, 2023.
11. National Health Service Digital. Health Survey for England 2018: Population estimates user guide. Available from: https://digital.nhs.uk/data-and-information/publications/statistical/health-survey-for-england/2018
Published 2019. Accessed July 31, 2023.
12. Public Health England. National Cardiovascular Intelligence Network. Prevalence estimates of Diabetes. https://www.gov.uk/government/publications/diabetes-prevalence-estimates-for-local-populations Published 2016. Accessed, July 29, 2023.
13. Public Health England. Diabetes Prevalence Model. London: PHE. Available from: https://www.gov.uk/government/publications/diabetes-prevalence-estimates-for-local-populations Published 2016. Accessed, August 11, 2023.
14. National Health Service. Health Survey for England 2018. Overweight and obesity in adults and children. London: Health and Social Care Information Centre. https://digital.nhs.uk/data-and-information/publications/statistical/health-survey-for-england/2018 Published 2019. Accessed August 1, 2023.
15. Meigs, JB. (2010). Epidemiology of Type 2 Diabetes and Cardiovascular Disease: Translation From Population to Prevention. Diabetes Care. 2010;33(8): 1865-1871. https://care.diabetesjournals.org/content/33/8/1865 Accessed August 3, 2023.
16. National Heart, Lung, and Blood Institute (NHLBI ). Three generations of Research on Heart Diseases. https://www.framinghamheartstudy.org/ Published 2023. Accessed June 18, 2023.
17. Lusignan S, Sismanidis C, Carey IM, et al. Trends in the prevalence and management of diagnosed type 2 diabetes 1994–2001 in England and Wales. BMC Fam Pract. 2005; 6:13. https://bmcprimcare.biomedcentral.com/articles/10.1186/1471-2296-6-13#citeas Accessed August 12, 2023.
18. Holman N, Forouhi NG, Goyder E, et al. The Association of Public Health Observatories (APHO) Diabetes Prevalence Model: estimates of total diabetes prevalence for England, 2010-2030. Diabet Med. 2011; 28(5): 575-82. https://onlinelibrary.wiley.com/doi/10.1111/j.1464-5491.2010.03216.x Accessed August 10, 2023.
19. Imkampe AK, Gulliford MC. Increasing socio-economic inequality in type 2 diabetes prevalence--repeated cross-sectional surveys in England 1994-2006. Eur J Public Health. 2011; 21(4): 484-90. https://pubmed.ncbi.nlm.nih.gov/20685812/ Accessed June 30, 2023.
20. Chung GK, Chung RY, Chan DC, Lai FT, Wong H, Lau MK, Wong SY, Yeoh EK. The independent role of deprivation in abdominal obesity beyond income poverty. A population-based household survey in Chinese adults. J Public Health (Oxf). 2019 30; 41(3):476-486. https://pubmed.ncbi.nlm.nih.gov/30215743/ Accessed July 30, 2023.
21. Feuillet T, Vallete JF, Charriere H, et al (2020). Influence of the urban context on the relationship between neighbourhood deprivation and obesity. Soc Sci Med. 2020; 265: 113537. https://www.sciencedirect.com/science/article/abs/pii/S0277953620307565 Accessed August 4, 2023.
22. Public Health England. Diabetes prevalence estimates for local authorities. London: PHE. https://www.gov.uk/government/publications/diabetes-prevalence-estimates-for-local-populations Published 2023. Accessed July 30, 2023.
23. Public Health England. Local Authority Health Profiles. Available from: https://fingertips.phe.org.uk/profile/health-profiles Published 2023. Accessed July 27, 2023.
24. Office for National Statistics. Mortality statistics- Underlying cause, sex and age. https://www.nomisweb.co.uk/query/construct/summary.asp?reset=yes&mode=construct&dataset=161&version=0&anal=1&initsel= Published 2023. Accessed August 13, 2023.
25. National Health Service Digital. Hospital Admitted Patient Care Activity, 2021-22. https://digital.nhs.uk/data-and-information/publications/statistical/hospital-admitted-patient-care-activity/2021-22 Published 2022. Accessed July 31, 2023.
26. Woodward, Mark. Epidemiology: Study Design and Data Analysis, 3rd edition. Boca Raton: CRC Press. https://online.vitalsource.com/#/books/9781439839713/cfi/6/10!/4/10/26/14/2/2/2@0:0 c2014. Accessed September 13, 2020.
27. Bruce N, Pope D, Stanistreet D. Quantitative methods for health research. A Practical Interactive Guide to Epidemiology and Statistics. Chichester: Wiley-Blackwell. c2008. https://www.vlereader.com/Reader?ean=9780470022764 Accessed September 14, 2021.
28. National Health Service Digital. National Diabetes Audit: Young People with Diabetes. https://digital.nhs.uk/data-and-information/publications/statistical/national-diabetes-audit-yt2 Published 2023. Accessed August 14, 2023.
29. Lim CY, In J. Randomization in clinical studies. Korean J Anesthesiol. 2019; 72(3): 221-232. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6547231/ Accessed August 13, 2023.
30. Pop B, Fetica B, Blaga ML, et al. The role of medical registries, potential applications and limitations. Med Pharm Rep. 2019; 92(1): 7-14. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6448488/ Accessed August 8, 2023.
31. Bonita R, Beaglehole R, Kiellstrom T. Basic Epidemiology. Geneva: WHO Press. c2012. https://rl.talis.com/3/essex/lists/FEE24BB6-E10B-385C-1484-AAB365FA5EBC.html?lang=en-GB Accessed September 13, 2021.
32. Bhopal RS. Concepts of Epidemiology: Integrating the ideas, theories, principles, and methods of epidemiology (3rd ed.) New York: Oxford University Press. c2016. https://0oxfordmedicinecom.serlib0.essex.ac.uk/view/10.1093/med/9780198739685.001.0001/med-9780198739685 Accessed August 31, 2021.
33. Thygesen L.G, Ersboll A.K. When the entire population is the sample: strengths and limitations in register-based epidemiology. Eur J Epidemiol 2014; 29(8): 551-558. http://www.jstor.org/stable/43775005 Accessed August 16, 2023.
34. Mooney SJ, Westreich DJ, El-Sayed AM. Epidemiology in the Era of Big Data. Epidemiology. 2015; 26(3): 390-394. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4385465/ Accessed August 9, 2023.
35. Green J, Tones K, Cross R., et al. Health Promotion: Planning and Strategies. Edition: 4th. London: SAGE. c2019. https://online.vitalsource.com/#/books/9781526470980/cfi/6/30!/4/2/4/2@0:0 Accessed September 13, 2021.
36. Abramson JH, Abramson ZH. (2001) New York: Oxford University Press. Making sense of data: A Self-Instruction Manual on the Interpretation of Epidemiological data. c2001. https://0-oxford-universitypressscholarship-com.serlib0.essex.ac.uk/view/10.1093/acprof:oso/9780195145250.001.0001/acprof-9780195145250-chapter-2 Accessed September 9, 2021.
37. Cotti C, Tefft, N. Fast food prices, obesity, and the minimum wage. Econ Hum Biol. 2013; 11(2): 134-147. https://www.sciencedirect.com/science/article/abs/pii/S1570677X12000585 Accessed August 14, 2023.
38. Mortensen A. Sweeteners permitted in the European Union: safety aspects. Scand J Food Nutr. 2006; 50(3): 104–116. https://doi.org/10.3402/fnr.v50i3.1588 Accessed August, 9, 2023.
39. Johnston CA, Stevens B, Foreyt JP.The Role of Low-calorie Sweeteners in Diabetes. Eur Endocrinol. 2013; 9(2):96-98. https://pubmed.ncbi.nlm.nih.gov/29922361/ Accessed August 17, 2023.
40. Coca-Cola®. Coca Cola Store Online. https://us.coca-cola.com/products/coca-cola/original# Published 2022. Accessed April 24, 2022.