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Diabetes Prevalence in Ireland

Diabetes Blackboard

January 2022

 

 

There are two main types of diabetes, one of the most prevalent chronic illnesses worldwide: Type 1 diabetes and Type 2 diabetes. The differences and similarities between the two conditions are outlined here. In the absence of a register of people who have diabetes, no-one can be entirely sure how many people in Ireland live with diabetes.

 

 

Prevalence of diabetes worldwide

 

One in ten people around the world are living with diabetes1, a lifelong condition listed by the World Health Organization in 2019 as one of the top ten leading causes of deaths globally2.

 

The International Diabetes Federation (IDF) released new figures in December 2021 showing that more than half a billion adults are now living with diabetes worldwide — an alarming rise of 16% (74 million) since the previous IDF estimates in 20191.

 

 

Diabetes around the world in 2021:

  • 537 million adults (20-79 years) are living with diabetes1.
  • 541 million adults have pre-diabetes, which places them at high risk of type 2 diabetes1.
  • The prevalence of diabetes worldwide is predicted to rise to 643 million by 2030 and 784 million by 20451.

 

 

Prevalence of Diabetes in Ireland

July 2023

 

There is no National Diabetes Registry of people living with diabetes in Ireland, therefore the national estimates below are vague and are likely an overestimate. The data in the table below use the Scottish prevalence rates and are based on the Scottish Diabetes Survey 2021. The survey uses a National Diabetes Registry dataset (SCI-Diabetes) data and track the prevalence of diabetes year on year in Scotland. The most recent survey (2021) outlined that there were 327,927 people with a diagnosis of diabetes in the database that collates information from all primary and secondary clinics in Scotland. This represents approximately 6% of the population (according the National Record of Scotland, there were 5,466,000 people in Scotland in 2020).

 

According to the most recent Census findings conducted in 2022 and published in May 20233, there were 5,149,139 people in Ireland. If, similar as in Scotland, the 6% of population had a diagnosis of diabetes, it would mean that there were 308,948 people with diabetes in Ireland in 2022.

 

This prevalence estimate method using data from Scotland has been used by the HSE to answer Parliamentary Questions in 2021, and the below table outlines the estimated prevalence of type 2 diabetes (87.7% of the total diabetes population) and type 1 diabetes (10.7% of the total diabetes population) based on the Scottish prevalence data from 20213 and Irish Census 2022.

 

 

 

 

 

 

 

 

 

 

The lack of a national Diabetes Registry hinders the HSEs ability to plan for Diabetes. See our most recent Pre-budget submission 2023 highlighting this gap:

https://www.diabetes.ie/pre-budget-submission-2023/

 

 

Paediatric Diabetes

Ireland has a high incidence rate of type 1 diabetes in children and adolescents with on average 285 new cases of type 1 diabetes in those under 15 years diagnosed annually.  Our country is in the top 25% for diabetes incidence worldwide but this number appears to be stabilising1.  According to the Paediatric Diabetes National Audit, there were 2,632 children in 20134. The more recent, yet unpublished evidence suggests approximately 3,000 paediatric patients in Irish paediatric diabetes clinics, but some clinics share care of patients, meaning that some cases may be counted twice. The IDF atlas 2021 estimates a prevalence of 3,364 people between the ages of 0-19 living with Type 1 diabetes in Ireland1.

 

 

Type 1 diabetes in adults

According to the study on epidemiology of type 1 diabetes in Ireland utilizing prescription database, there were 20,081 prevalent cases of type 1 diabetes in 2016 in Ireland5, with 17,053 adults over 18.

 

 

Type 2 diabetes and Pre-diabetes

The Irish Longitudinal Study on Ageing (TILDA) 2015 showed that 10% of adults aged 50 and over in Ireland, have Type 2 diabetes rising to 16% in those aged 80 and over. This study further revealed that one in ten people with diabetes in this population are undiagnosed. A further 5.5% of the older population have pre-diabetes which puts them at an increased risk of developing Type 2 diabetes in the future6.

 

The study also found that Type 2 diabetes was more common in men (12%) than women (7%) and a self-reported history of hypertension, high cholesterol, being centrally obese and having low levels of physical activity also had strong relationships with both diabetes and pre-diabetes6.

 

 

Burden of diabetes

The burden of diabetes is continuously increasing. According to a systematic review of Irish evidence on epidemiology of diabetes and its complications, which included 15 studies published before 2016, in adults aged 18 years and over, the national prevalence of doctor diagnosed diabetes significantly increased from 2.2 % in 1998 to 5.2 % in 2015. The prevalence of diabetes complications varied ranging from 6.5 to 25.2 % for retinopathy; 3.2–32.0 % for neuropathy; and 2.5-5.2 % for nephropathy9.

 

 

Economic costs of Diabetes

According to the International Diabetes Federation Atlas 2021 Ireland is ranked 7th in the world for diabetes related health expenditure per person1.

The economic burden of diabetes on the Irish health care system is becoming a major challenge for the government and the HSE. According to national estimates comparing health-service use between people over 50 with and without diabetes (data from years 2009-2011), diabetes was associated with an 87% increase in outpatient visits, a 52% increase in hospital admissions and a 33% increase in emergency department attendances9. Although we have no diabetes register or way to monitor the costs associated with diabetes, the CODEIRE study (2006) suggests that costs associated with diabetes consume between 4% and 6% of the annual healthcare expenditure in Ireland (€377.2 million to €580.2 million in 2006)10. If the same percentage (4-6%) applied to the healthcare expenses in 2019, the costs would have been as high as €1.2 billion to €1.4 billion, with most of the costs (approx. 50% according to the CODEIRE study) associated with hospitalisations and treatment of complications. There is a need to further evaluate the economic costs of diabetes-related healthcare expenses in Ireland.

 

 

See previous data estimates from 2019.

 

 

 

 

References:

 

  1. International Diabetes Federation Diabetes Atlas (2021) available at  https://diabetesatlas.org/ (assessed 10 November 2021)
  2. World Health Organisation: Top 10 causes of death December 2020 available at https://www.who.int/news-room/fact-sheets/detail/the-top-10-causes-of-death (assessed 10 November 2021)
  3. The Scottish Diabetes Survey 2021. Scottish Diabetes Group: https://www.diabetesinscotland.org.uk/wp-content/uploads/2023/02/Diabetes-Scottish-Diabetes-Survey-2021-final-version.pdf
  4. McKenna A et al Incidence of childhood type 1 diabetes mellitus in Ireland remains high but no longer rising (2021) Acta Paediatr. 2021 Jul;110(7):2142-2148. doi: 10.1111/apa.15836. Epub 2021 Mar 18. https://pubmed.ncbi.nlm.nih.gov/33690888/
  5. Gajewska KA et al (2020) Prevalence and incidence of Type 1 diabetes in Ireland: a retrospective cross-sectional study using a national pharmacy claims data from 2016 BMJ Open 2020 available at https://pubmed.ncbi.nlm.nih.gov/32312725/ (accessed 10 November 2021)
  6. Leahy S et al (2015) Prevalence and correlates of diagnosed and undiagnosed type 2 diabetes mellitus and pre-diabetes in older adults: Findings from the Irish Longitudinal Study on Ageing (TILDA) Diabetes research and Clinical practice Volume 10 issue 3 Dec 2015 pg 241-249
  7. Knowler WC et al. (2009) 10-Year follow-up of diabetes incidence and weight loss in the Diabetes Prevention Program Outcomes Study. Lancet 374:1677–1686 available at https://pubmed.ncbi.nlm.nih.gov/19878986/
  8. Lindström J et al Finnish Diabetes Prevention Study Group (2006) Sustained reduction in the incidence of type 2 diabetes by lifestyle intervention: follow-up of the Finnish Diabetes Prevention Study. Lancet 368: 673–9 available at https://pubmed.ncbi.nlm.nih.gov/14633807/
  9. O’Neill K et al (2018) Health service utilization and related costs attributable to Diabetes available at https://doi.org/10.1111/dme.13806
  10. The Cost of Treating Type 2 Diabetes (CODEIRE). John Nolan, Domhnall O”Halloran,TJ McKenna,R Firth,Sandra Redmond. http://archive.imj.ie//ViewArticleDetails.aspx?ArticleID=1508

 

 

Additional resources:

 

O Donnell M et al (2018) A National Survey of Diabetes Care Delivery in Acute Hospitals available at https://www.hse.ie/eng/about/who/cspd/ncps/diabetes/resources/national-survey-of-diabetes-care-delivery-in-acute-hospitals-2018.pdf (assessed 10 November 2021)

 

Pandey R, et al (2020) Irish National Diabetic RetinaScreen Programme: report on five rounds of retinopathy screening and screen-positive referrals. BMJ B J Opthalmology available at https://bjo.bmj.com/content/bjophthalmol/early/2020/12/16/bjophthalmol-2020-317508.full.pdf (accessed 11 November 2021).

Sinnott et al (2015) DM VHI Healthcare Screening Project: Fasting Plasma Glucose as Initial Screening for Diabetes and Prediabetes in Irish Adults: The Diabetes Mellitus and Vascular Health Initiative (DMVhi); PLOS ONE Journal, published: April 15, 2015 available at
http://dx.plos.org/10.1371/journal.pone.0122704  (accessed on 11 November 2021)

Tracey M. L. et al (2016) Epidemiology of diabetes and complications among adults in the Republic of Ireland 1998-2015: a systematic review and meta-analysis available at: https://cora.ucc.ie/handle/10468/3145