Researchers studying the effects of COVID-19 on the NHS in the UK reviewed the health records of 14 million people between March and December 2020 and found that 13,700 people were missed or delayed in diagnosing type 2 diabetes. When the results were extended to the total population of the United Kingdom, the researchers estimated the number was around 60,000 people.
The study “Influence of COVID-19 on Diagnosis, Monitoring and Mortality in People with Type 2 Diabetes in the UK” was published today in The Lancet Diabetes Endocrinology. It was funded by the National Institute for Health Research of the Greater Manchester Patient Safety Translational Research Center (NIHR GM PSTRC), a partnership between the University of Manchester and Salford Royal Hospital.
In April 2020 alone, according to researchers, there was a 70% decrease in registered diagnoses of the disease compared to expected rates based on 10-year trends in 23 million people. In April, the rate of diabetes monitoring (HbA1c blood tests) in people with type 2 diabetes was reduced by 77% in England and 84% in Northern Ireland, Scotland and Wales.
Dr. Matthew Carr of the University of Manchester, who led this study at GM PSTRC, said, “Patient outcomes are vastly improved when type 2 diabetes is diagnosed early and monitored regularly. If the condition is not verified, complications can arise, the treatment of which can be more complex. Prior to the pandemic, diagnosis and monitoring were based on face-to-face contact so it is no surprise to see an initial reduction as patients simply were unable to get the level of monitoring they needed. However, such a significant decrease within 9 months is worrying and an indication of the challenges health services are facing during the pandemic. “
The research also found a significant reduction in the prescription of the two drugs commonly used to treat the condition, insulin and metformin. The rates of diagnosis and surveillance were particularly evident in the elderly, in men and in people from disadvantaged areas.
Dr. Carr continued, “What is important is that our research has identified the extent of the problem along with information about population characteristics. This will help health services clear the diagnosis, testing, and prescription backlog. Effective communication should ensure that people with diabetes continue to be engaged in diabetes services. There must also be more emphasis on providing relevant information and possibly glucose monitoring systems with simple data uploads to enable remote support. “
The study looked at the death rates of people with type 2 diabetes in April 2020 and reported a 110% increase in England. In Northern Ireland, Scotland and Wales, the increase in the death rate was less high (increase of 66%).
Professor Martin K. Rutter of the University of Manchester, Manchester University’s NHS Foundation Trust and co-author of the study said: “There have been excellent advances in the treatment of type 2 diabetes in recent years. Resources have been put into early detection and management so that the development of the disease can be delayed and, in some cases, reversed through weight loss interventions. As we recover from the pandemic, our research will help UK health services focus their efforts on identifying these missed cases and providing more support to people with diabetes so that they can continue to benefit from these recent advances. “
Nikki Joule, Policy Manager at Diabetes UK, said: “It is incredibly worrying that the rate of type 2 diabetes diagnoses in the UK was much lower in the first part of the COVID-19 pandemic than in previous years. While the numbers showed a gradual increase in diagnoses from May to December 2020, they remained well below expected values.
“These results suggest less healthcare exposure during the pandemic and underscore the urgent need to ensure that those previously identified by their GP at high risk for developing type 2 diabetes receive their annual review . This will ensure that individuals are either diagnosed or referred to the NHS England National Type 2 Diabetes Prevention Program or equivalent when appropriate.
“Early diagnosis of type 2 diabetes is critical to reducing the risk of serious diabetes-related complications such as heart, kidney and eye problems. To find out your risk for Type 2 Diabetes, visit Diabetes UK’s Know Your Risk Tool. If you are concerned that you are at an increased risk, it is important to speak to your GP. “
Type 2 diabetes makes up around 90% of all diabetes diagnoses and is often associated with being overweight, inactive, or having a family history of the disease. It causes blood sugar levels to rise, leading to excessive thirst, weight loss, and fatigue. Diabetes, especially if badly treated, can cause serious long-term problems with the eyes, heart, kidneys, and nerves.
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