Abstract
BackgroundThe prevalence of type 2 diabetes within the Republic of Ireland is poorly defined, although a recent report suggested 135,000 cases in adults aged 45+, with approximately one-third of these undiagnosed. This study aims to assess the prevalence of undiagnosed and diagnosed diabetes in middle-aged adults, and compare features related to either condition, in order to investigate why certain individuals remain undetected.MethodsThis was a cross-sectional study involving a sample of 2,047 men and women, aged between 50–69 years, randomly selected from a large primary care centre. Univariate logistic regression was used to explore socio-economic, metabolic and other health related variable associations with undiagnosed or diagnosed diabetes. A final multivariate analysis was used to determine odds ratios and 95% confidence intervals for having undiagnosed compared to diagnosed diabetes, adjusted for gender, age and significant covariates determined from univariate models.Principle FindingsThe total prevalence of diabetes was 8.5% (95% CI: 7.4%–8.8%); 72 subjects (3.5%) had undiagnosed diabetes (95% CI: 2.8%–4.4%) and 102 subjects (5.0%) had diagnosed diabetes (95% CI: 4.1%–6.0%). Obesity, dyslipidaemia, and family history of diabetes were positively associated with both undiagnosed and diagnosed type 2 diabetes. Compared with diagnosed subjects, study participants with undiagnosed diabetes were significantly more likely to have low levels of physical activity and were less likely to be on treatment for diabetes-related conditions or to have private medical insurance.ConclusionsThe prevalence of diabetes within the Cork and Kerry Diabetes and Heart Disease Study is comparable to recent estimates from the Slán National Health and Lifestyle Survey, a study which was nationally representative of the general population. A considerable proportion of diabetes cases were undiagnosed (41%), emphasising the need for more effective detection strategies and equitable access to primary healthcare.
Highlights
Type 2 Diabetes mellitus (T2DM), a chronic disease which causes significant morbidity and mortality, was the ninth leading cause of death worldwide in 2008 [1]
The prevalence of diabetes within the Cork and Kerry Diabetes and Heart Disease Study is comparable to recent estimates from the Slan National Health and Lifestyle Survey, a study which was nationally representative of the general population
The total prevalence of T2DM was 8.5%; 102 (5.0%) subjects had diagnosed diabetes and 72 (3.5%) had undiagnosed diabetes, representing 41.4% of all diabetes cases
Summary
Type 2 Diabetes mellitus (T2DM), a chronic disease which causes significant morbidity and mortality, was the ninth leading cause of death worldwide in 2008 [1]. The persistent hyperglycaemia that is associated with diabetes may cause serious health complications such as cardiovascular disease (CVD) and impairment and malfunction of the renal, ophthalmic, vascular and nervous systems These complications pose significant financial burdens on healthcare services; research conducted in 2006, which examined economic consequences related to T2DM, estimated that almost 10% of total health expenditure was spent on diabetes care in the Republic of Ireland (ROI) alone [3]. A recent report from the Irish Institute of Public Health (IPH) [8] based on findings from the 2007 Slan National Health and Lifestyle Survey [9], suggested a prevalence of 8.9% in adults aged 45+ This estimate consisted of 94,000 subjects who had clinically diagnosed T2DM and 41,000 with undiagnosed diabetes. This study aims to assess the prevalence of undiagnosed and diagnosed diabetes in middle-aged adults, and compare features related to either condition, in order to investigate why certain individuals remain undetected
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