Diabetes
Cardiovascular Disease
Adult Healthy Weight
Diabetes
Physical Activity
Stroke
Cancer
Introduction
Diabetes is a condition that causes a person’s blood sugar level to become too high and affects about 7.3% of the adult population in England, the equivalent of 3.2 million people.1 A further 850,000 people are estimated to be living with type 2 diabetes but are yet to be diagnosed.2
There are 2 main types of diabetes:
- Type 1 diabetes - a lifelong condition where the body’s immune system attacks and destroys the cells that produce insulin
- Type 2 diabetes - where the body does not produce enough insulin, or the body’s cells do not react to insulin properly
Type 2 diabetes is far more common than type 1. In the UK, over 90% of all adults with diabetes have type 2.
High blood pressure that develops during pregnancy is known as gestational diabetes. It usually goes away after giving birth.
The amount of sugar in the blood is controlled by a hormone called insulin, which is produced by the pancreas (a gland behind the stomach).
When food is digested and enters your bloodstream, insulin moves glucose out of the blood and into cells, where it is broken down to produce energy. However, if you have diabetes, your body is unable to break down glucose into energy. This is because there is either not enough insulin to move the glucose, or the insulin produced does not work properly.
There are no lifestyle changes you can make to lower your risk of type 1 diabetes.
You can reduce the risk of type 2 diabetes through healthy eating, regular exercise and achieving a healthy body weight.
You may be more at risk of type 2 diabetes if you:
- Are living with overweight or obesity
- Do not have a healthy diet (consume a lot of sugary or low-fibre foods)
- Have a family history of type 2 diabetes
- Are of Asian, Black African or African Caribbean origin
- Take certain medicines such as steroids for a long time
- Have high blood pressure
- Have had gestational diabetes during pregnancy
- Are a child of someone who had gestational diabetes
- Have Polyendocrine Metabolic Ovarian Syndrome (PMOS) or Metabolic Syndrome
- Were premature when born
- Had a low birth weight3
It is important to know the signs and symptoms of type 2 diabetes as being diagnosed earlier can help with long-term outcomes. Symptoms can include:4
- Weeing a lot - especially at night
- Being really thirsty
- Feeling more tired than usual
- Losing weight without trying to
- Genital itching or thrush
- Cuts and wounds taking longer to heal
- Blurred eyesight
- Behaviour changes - such as feeling more irritable
Why is it important to Population Health?
Leading cause of mortality: Both type 1 and type 2 diabetes can increase the likelihood of premature death significantly, with nearly 95,000 deaths attributed to all causes of diabetes in 2015/16.5 Population health approaches to preventing people developing diabetes through timely access to lifestyle services in Derbyshire can support the reduction in risk at a population level.
Complications related to diabetes: Diabetes can lead to significant complications, the most common complications of diabetes which can lead to early death are strokes and cardiovascular disease. Every week in the UK, 680 people suffer a stroke as a complication of diabetes (one in five strokes is caused by diabetes), 530 people suffer a diabetes-related heart attack, and there are around 2,000 cases of diabetes-related heart failure.6
Other long-term complications related to diabetes include:
- Eye problems (retinopathy): High blood sugar can damage vessels behind the eye, and cause new, abnormal vessels to grow on the retina (Diabetic Retinopathy). Early diagnosis can prevent sight loss.7
- Foot and nerve (neuropathy) problems: High blood sugar can damage vessels in the feet and legs causing pain, numbness and infections.8
- Kidney problems (nephropathy): High blood sugar levels can damage small blood vessels and tiny filters in the kidneys. Early diagnosis and treatment can slow this condition down.9
- Gum disease: This can increase blood sugar levels and the risk of pre-diabetes and type 2 diabetes, and having diabetes increases the risk of gum disease. Keeping mouth, teeth and gums healthy is therefore vital in preventing and managing diabetes.10
- Sexual problems: An under-researched area, but men and women can experience sexual difficulties due to diabetes.11
- Increased cancer risk: Diabetes can increase the risk of developing some cancers, and share risk factors [obesity and overweight] for others.12
Some complications can lead to long-term conditions but are brought on more suddenly:
- Hypos - when your blood sugar is too low
- Hypers - when your blood sugar is too high
- Hyperosmolar Hyperglycemic State (HHS) - life-threatening emergency that only happens in people with type 2 diabetes. It is brought on by severe dehydration and very high blood sugars.
- Diabetic Ketoacidosis (DKA) - a life-threatening emergency where the lack of insulin and high blood sugars leads to a build-up of ketones.13
Health Inequalities: Health inequalities are avoidable differences in health between different groups of people. Deprivation is closely linked to the risk of both obesity and type 2 diabetes. Prevalence of type 2 diabetes is 40% more common among people in the most deprived quintile compared with those in the least deprived quintile. Similarly, people in the most deprived communities are more likely to have undiagnosed diabetes than those living in the least deprived communities. People from black, Asian, and other minority ethnic groups are at an equivalent risk of type 2 diabetes at lower BMI levels than white European populations14,15. Working with communities at high risk of diabetes can improve outcomes and enhance quality of life for people living in areas most affected by diabetes.
Modifiable Risk Factors: Overweight and obesity is the single biggest cause of diabetes and around 90% of adults with diabetes will be overweight or obese.16 Likewise, lack of exercise can be a contributing factor in developing diabetes.17 These modifiable risk factors can increase a person’s risk of developing diabetes. However, population health efforts to support people to make lifestyle changes can empower people to reduce their risk of developing type 2 diabetes, improve health outcomes and reduce the long-term pressures on the NHS.
NHS/Healthcare Burden: The NHS spends around £10bn each year treating diabetes.18 About 1 in 20 people have diabetes, yet people with diabetes account for one quarter to one third of hospital admissions for cardiovascular disease, and account for a higher proportion of bed days for cardiovascular conditions than would be expected based on the general population.19
Population health approaches aim to help prevent people developing type 2 diabetes, and if they do, to manage their condition effectively which can help ease the pressure on the NHS.
Economic Impact: The impact of diabetes can be felt in the wider economy. The cost of sickness absence from work, early retirement and social benefits costing nearly £15.5bn annually.20 Preventative action to tackle the causes of diabetes can help manage the economic burden diabetes has on the economy.
The Derbyshire Population Health Approach
The Derbyshire Population Health Approach focuses on prevention, population health, evidence-informed practices, causes, and collaboration. It emphasises proactive measures to prevent health issues, tailors interventions to specific populations, incorporates evidence-informed practices, addresses underlying causes, and promotes collaboration for effective action.
When considering diabetes within The Derbyshire Population Health Approach:
• Prevention
Preventative action to tackle diabetes is important to support the wellbeing of people in Derbyshire whilst protecting the future sustainability of the NHS. Supporting access to weight management services, such as Live Life Better Derbyshire and encouraging uptake of physical activity, especially in at-risk groups, can help people manage their individual risk of developing diabetes. If someone’s blood sugar is within the ‘pre-diabetic’ range (HbA1c of 42 or more), they can be referred onto the NHS Diabetic Prevention Programme (DPP), which has been shown to cut the risk of developing type 2 diabetes by more than a third for people completing the programme.21
• Population
Differences in the risk of developing diabetes and experiencing negative consequences of diabetes vary significantly across the county depending on where a person lives. Additionally, different ethnic groups are at higher risk of developing diabetes compared to people of white British origin. Targeted interventions to support communities who experience high levels of Cardiovascular disease can be developed to support the specific needs of those communities.
• Evidence
We have a good understanding of the evidence behind why people develop type 2 diabetes and the disproportionate impact it has on NHS services. The NHS 10 Year Health Plan highlights the importance of prevention of diabetes, a commitment to early detection, and early specialist interventions for complications of diabetes.22 The plan’s digital ambitions support people to self-manage their own health, including lifestyle changes to prevent diabetes, or to manage the condition. More localised and personalised care is central to the plan, enabling easier access to specialist support for the prevention and management of diabetes. Population health practitioners work closely with NHS and other partners to implement evidence-informed activity to prevent people developing diabetes.
• Causes
Understanding the underlying causes of developing diabetes, and those communities most at risk of developing diabetes allows population health to target cost effective and evidence-informed approaches to where they will have the greatest impact. Population health approaches to collaboratively delivering preventative services such as weight management activity through Live Life Better Derbyshire, or supporting people to become more physically active, can improve health outcomes whilst reducing the pressure on the NHS.
• Collaboration
Working with our colleagues across NHS, local authority and community, voluntary and independent sector is essential to embed a population health approach to diabetes prevention. Our partners are essential in supporting the development and implementation of strategies, plans and services to manage diabetes within at-risk communities, whilst ensuring the wider health needs of communities are also supported.
Latest Derbyshire Data
Trend Data
Prevalence Maps of Derbyshire
The maps below illustrate various geographies for Derbyshire. LSOAs and MSOAs are geographical divisions used for statistical purposes, allowing for more detailed analysis of local data. In these maps, you can explore various health indicators and data for Derbyshire, providing valuable insights into the area’s health and wellbeing.
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In the top right of the map, you’ll find the ‘Layer Control’ icon. This is an easy way to customise what you see on the map visualisation. Click the ‘Layer Control’ to choose which information is displayed on the map. Pick the indicator that interests you the most, and the map will transform accordingly. |
Slope Index
This chart illustrates the differences in health and lifestyle factors across areas in Derbyshire, from the most deprived (decile 1, red) to the least deprived (decile 10, green). As you move from left to right on the chart (from more deprived to less deprived areas), the line shows whether these factors are becoming more or less common. Essentially, it’s a way to see how living in wealthier or poorer areas affects the prevalence of these factors.
Further Analysis & Assessments
Derbyshire Joint Strategic Needs Assessment (JSNA) involves a thorough examination of a specific health problem, exploring its causes, consequences, and underlying factors. It combines various data sources, collaboration with stakeholders, and rigorous analysis to generate insights for evidence-informed interventions and policy changes.
More Information & Resources
Here is a list of useful resources and information with regard to bowel cancer. These materials are meant to provide individuals, healthcare professionals, and communities with the knowledge and tools they need as part of efforts to address bowel cancer as a population health topic.
Contributors
Ben Cooper, Advanced Public Health Practitioner, Healthcare Public Health
Annie Diamond, Advanced Public Health Practitioner, Healthcare Public Health