Diabetes within the Western Health Board: an overview of trends in mortality, morbidity and prevalence (52Kb)

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1 Diabetes within the Western Health Board: an overview of trends in mortality, morbidity and prevalence (5Kb) Item Type Report Authors Evans, David S;Western Health Board (WHB) Rights Western Health Board Download date 0/09/01 17:0:46 Link to Item Find this and similar works at -

2 Diabetes Within the Western Health Board: An Overview of Trends in Mortality, Morbidity, and Prevalence 1. Death rate per 0 population Male Female Age group Department of Public Health March 199

3 Diabetes Within the Western Health Board: An Overview of Trends in Mortality, Morbidity, and Prevalence Final Report by The Department of Public Health Western Health Board Author: Dr David S. Evans March 199 1

4 CONTENTS Page 1. Introduction 3. Morbidity and Mortality of Diabetes Within the Western Health Board 3 3. Diabetics Within the Western Health Board 3.1 Number of Diabetics 3. Age/Gender Profile 4. Summary and Conclusions 10 References 10

5 1. Introduction Diabetes is a major and growing cause of ill health throughout western Europe, currently affecting approximately -5% of the population (Cunningham, 1991). Over million people world-wide suffer from diabetes with projections indicating that there will be over 30 million diabetics by 010 (Macarty and Zimmet, 1994, cited in Zimmet, 1997). Diabetes and complications resulting from diabetes can lead to a diminished quality of life and premature mortality. For example, the following statistics given by Zimmet (1997) are testimony to the seriousness of the disease: Diabetes is the leading cause of adult blindness in developing countries Diabetes patients are 17 times more prone to Kidney disease Diabetes is one of the five leading causes of death by disease in most countries Cerebrovascular diseases are -3 times more common in diabetics than nondiabetics Macrovascular disease is -3 times more common in diabetics than nondiabetics However, with early detection and treatment it is possible to control or prevent such complications and enhance the quality of life of diabetes sufferers. Zimmet (1997) notes for example that complications can be reduced by as much as 76% by good metabolic control resulting from intensive therapy.. Morbidity and Mortality of Diabetes Within the Western Health Board Figure.1 shows trends in mortality rates for Diabetes for the Western Health Board and Ireland. It is evident from figure.1 that mortality rates per,000 population have been increasing up until the late 190 s, since when a downward trend has emerged. However the mortality rate for remains 17% higher for the Western Health Board and 31% higher for Ireland than that experienced in In comparing the trends for the Western Health Board and Ireland it can be seen that a similar pattern was experienced up until the late 190s where the Western Health Board mortality rate declined to a greater extent. 3

6 Figure.1: Direct Standardised Mortality Rate per,000 Population for the Western Health Board and Ireland ( )* Direct standardised mortality rate per,000 population Period ending year Western Health Board Ireland * Standardised to WHO European standard population ** Data prior to 1993 are based on year of occurrence; data for inclusive are based on year of registration Source: Public health information system, Department of Health (unpublished) Figure. shows trends in mortality rates for diabetes for the Western Health Board by gender. It can be seen that mortality rates per,000 population are higher for men. However, it can be seen that gender differences gradually reduced up to 1991 (although have again increased sharply in the period ). 4

7 Figure.: Direct Standardised Mortality Rate* per,000 Population for the Western Health Board by Gender ( )** Direct standardised mortality rate per,000 population Period ending year Male Female * Standardised to WHO European standard population ** Data prior to 1993 are based on year of occurrence; data for inclusive are based on year of registration Source: Public health information system, Department of Health (unpublished) Figure.3 shows mortality rates for diabetes by age for the Western Health Board and Ireland. Mortality rates remain relatively low for diabetics under 55 years of age. However mortality rates significantly increase from the age of 55 years upwards, particularly for diabetics over the age of 75. Age variations between the Western Health Board and Ireland only appear notable for those over 5 years of age, where the mortality rate for Ireland is considerably higher than that experienced in the Western Health Board. Gender variations by age for the Western Health Board are shown in figure.4. It can be seen that males exhibit higher death rates for the majority of age groups. However, the main exception is for those aged 5 years or over, with female diabetics having a considerably higher death rate (1. compared to 0.6 per 1,000 population). 5

8 Figure.3: Death rate per 1,000 Population* for the Western Health Board and Ireland by Age (1995)** Death rate per 0 population Western Health Board Ireland Age group * Provisional data based on estimated population for 1995 ** Provisional data based on year of registration Source: Public health information system, Department of Health (unpublished) Figure.4: Death rate per 1,000 Population for the Western Health Board by Age and Gender (1995) Death rate per 0 population Male Female Age group * Provisional data based on estimated population for 1995 ** Provisional data based on year of registration Source: Public health information system, Department of Health (unpublished) Compared to other conditions, diabetics when admitted to hospital have a longer average length of stay (9.1 days compared 7.0 days for the Western Health Board in 1995). Figure.5 shows that this is particularly the case for diabetics admitted to hospital under 55 years of age, with negligible differences for those over 55 years. 6

9 Average length of stay in hospital for diabetics in the Western Health Board follows a similar pattern to Ireland as a whole (9.1 days compared to. days for Ireland in 1995). However figure.6 shows that there are some variations with age- notably those over 75 have a lower average length of stay in the Western Health Board; and those aged 5-34 have a longer average length of stay in Western Health Board hospitals. Figure.5: Average Length of Stay for Diabetes and All Causes of Hospitalisation by Age for the Western Health Board (1995) 14 1 Average length of stay All causes of hospitalisation Diabetes Age group Source: Public health information system, Department of Health (unpublished) Figure.6: Average Length of Stay for Diabetes in the Western Health Board and Ireland by Age (1995) Average length of stay Western Health Board Ireland Age group Source: Public health information system, Department of Health (unpublished) 7

10 3. Diabetics Within the Western Health Board In 1997, the Department of Public Health developed a diabetes database for the Western Health Board. The database contains all patients registered either on the GMS or the LTI scheme for diabetes and was obtained from the General Medical services (payments) Board. From the database, it has been possible to obtain the following background data on diabetes within the Western Health Board. 3.1 Number of Diabetics Within the Western Health Board there are 4946 known diabetics. As it is estimated that for every person diagnosed with diabetes there is another who remains undiagnosed, the actual figure is likely to be much higher (Zimmet, 1997). It was possible to classify 494 (99.%) of these diabetics by county of residence. This is shown in table 3.1. Table 3.1: Diabetics Within the Western Health Board by County (1997) County of residence Galway Mayo Roscommon Other Number Percentage of diabetics Percentage of population na Source: Diabetes database, Department of Public Health, Western Health Board (unpublished) Although the largest proportion of diabetics reside in county Galway (53%), County Mayo has the largest proportion of its population (1.46%) registered as a diabetic (table 3.1). The prevalence of diabetes overall is 1.41%, which is similar to the prevalence of diabetes in other health boards. 3. Age/Gender Profile A larger proportion of those registered as diabetics are males (54%). This pattern is experienced for all counties of the Western Health Board (table 3.). Table 3.: Gender Profile of Diabetics Within the Western Health Board by County (1997) Galway Mayo Roscommon Other Total Gender No % No % No % No % No % Male Female Total Source: Diabetes database, Department of Public Health, Western Health Board (unpublished)

11 Figure 3.1 shows the age/sex profile of registered diabetics throughout the western Health Board. The vast majority of registered diabetics are over 45 years old (1%), with the largest proportion (54%) of diabetics comprising the over 65 age group (mean age = 61 years). It can also be seen from figure 3.1 that the proportion of female diabetics rises with increasing age. Figure 3.1: Diabetics by Age and Gender for the Western health Board (1997) Up to Age group 75 and over Sex Female Male 70 Percent Source: Diabetes database, Department of Public Health, Western Health Board (unpublished) The age profile of diabetics follows a similar pattern for the constituent counties of the Western Health Board (table 3.3). Table 3.3: Age Profile of Diabetics Within the Western Health Board by County (1997) Galway Mayo Roscommon Other Total Age No % No % No % No % No % Up to and over Total Source: Diabetes database, Department of Public Health, Western Health Board (unpublished) 9

12 4. Summary and Conclusions This report has provided an overview of diabetes, showing trends in mortality and morbidity and prevalence rates in the Western Health Board. The key points that have been established are: Mortality rates for diabetes within the Western Health Board are lower than for Ireland as a whole and have been declining since the late 190s, although remain 17% higher than that experienced in Mortality rates are higher for men than women, although the differences have declined since Mortality from diabetes primarily affects those over 55 years of age. Compared to other conditions, diabetics admitted to hospital within the Western Health Board have a longer average length of stay, particularly for those under 55 years of age. This pattern is similar to Ireland as a whole. In 1997, there were 4946 known diabetics within the Western Health Board. This represents 1.4% of the population of the Board and is similar to the prevalence of diabetes in other health boards. As it is estimated that for every person diagnosed with diabetes there is another who remains undiagnosed, the actual figure is likely to be much higher (Zimmet, 1997). Within the Western Health Board, county Mayo has the largest proportion of its population registered as a diabetic (1.5%). The vast majority of registered diabetics are over 45 years old (0%; mean age = 61 years). Diabetes and its complications remain a growing cause of ill health. As the condition can be effectively managed and its complications prevented, it is clear that the needs of diabetics and the level of service provision within the Western Health Board warrants further attention. These issues will be addressed in subsequent reports of the Department of Public Health, and will involve close consultation with key providers of diabetes services within the Western Health Board. References Cunningham, M.F., Design a Study to Evaluate the Care of Diabetic Patients in the Community, Master of Public Health Thesis, Department of Community Medicine and Epidemiology, University College Dublin, 1991 Zimmet, P., The Epidemiology of Diabetes Mellitus, In Detels, R., Holland, W.W., McEwen, J., Omenn, G.S., Oxford Testbook of Public Health, V3, 3rd Edition, Oxford University Press, 1997, p