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Health: Diabetes

Volume 718: debated on Tuesday 6 April 2010

Questions

Asked by

To ask Her Majesty's Government what assessment they have made of how many (a) adults, and (b) children, in the United Kingdom have type 1 diabetes. [HL2884]

To ask Her Majesty's Government what assessment they have made of the number of people in England who are diagnosed with type 1 diabetes each year compared with (a) Scotland, and (b) Wales. [HL2885]

We have not undertaken a formal assessment of the number of adults and children diagnosed with type 1 diabetes. Data from the quality and outcomes framework (QOF) show that that number of people with diabetes has increased annually. However, it is not possible from the QOF data to differentiate between people with type 1 or type 2 diabetes.

QOF—Number of patients with a recorded diagnosis of diabetes

2004-05

2005-06

2006-07

2007-08

2008-09

1,766,391

1,890,663

1,961,976

2,088,335

2,213,138

The diabetes register only includes patients aged 17 years and over, as the care of children with diabetes is generally under the control of specialists. Data from Growing Up with Diabetes: Children and Young People with Diabetes in England reported that in February 2009 there were 22,947 children and young people with diabetes. Of this number, 20,488 were classified as having type 1 diabetes.

Without exact data on the number of people with type 1 diabetes, we are not able to make direct comparisons with other countries.

Asked by

To ask Her Majesty's Government what assessment they have made of the cost to the National Health Service of treating type 1 diabetes and its effects. [HL2886]

To ask Her Majesty's Government what is their estimate of the lifetime cost of medical treatment for a patient with type 1 diabetes. [HL2887]

We have not undertaken either a formal assessment of the costs of treating people with type 1 diabetes, or estimated the lifetime costs of treating a person with type 1 diabetes.

Diabetes is a complex lifelong condition that can affect every part of the body, and there are a number of associated complications with the condition; this makes it difficult to calculate the exact cost to the National Health Service.

Asked by

To ask Her Majesty's Government how many people with type 1 diabetes who use insulin pump therapy are offered access to a dose adjustment for normal eating (DAFNE) course or an equivalent course. [HL2931]

There are no data held centrally about how many people with type 1 diabetes who use an insulin pump have attended a dose adjustment for normal eating (DAFNE) course or such equivalent.

Patient education is an essential part of diabetes care and many diabetes services commission or run courses to educate patients about type 1 diabetes.

The DAFNE course is designed to educate patients (usually over the age of 17) with type 1 diabetes to help them manage their multi-injection therapy, the most common treatment for type 1 diabetes. The DAFNE course is not designed specifically for people with insulin pumps. However, centres that provide DAFNE would advise that all potential pump users attend a DAFNE course before commencing pump therapy.

Asked by

To ask Her Majesty's Government how many working days have been lost due to diabetes and its effects in each of the past five years. [HL3020]

There are no data collected centrally about how many working days have been lost due to diabetes and its effects in each of the past five years.

Asked by

To ask Her Majesty's Government what estimate they have made of the cost of diabetes and its effects. [HL3021]

Diabetes is a complex lifelong condition that can affect every part of the body. There are a number of associated complications with the condition which makes it difficult to calculate the exact total cost to the National Health Service.

The department's programme budget figures indicate £1.26 billion of departmental gross expenditure in England in 2008-09 was spent on diabetes. This figure does not include spending on prevention or on general medical services or primary medical services.

£000s

Diabetes expenditure

DH gross expenditure

Diabetes as a proportion of gross expenditure

2004-05

687,402

71,922,179

1.0%

2005-06

866,000

80,185,241

1.1%

2006-07

1,043,021

84,193,209

1.2%

2007-08

1,151,183

93,183,426

1.2%

2008-09

1,262,066

96,814,987

1.3%

In England in 2008, according to the NHS Business Services Authority, about £595 million for diabetes-related items was spent on prescriptions dispensed in the community; ie by community pharmacists and appliance contractors, dispensing doctors, and prescriptions submitted by prescribing doctors for items personally administered. Also included are prescriptions written in Wales, Scotland, Northern Ireland and the Isle of Man but dispensed in England.

Drug group

NIC(£000s)

Insulins

285,764.0

Antidiabetic drugs

165,323.6

Treatment of hypoglycaemia

3,092.1

Diagnostic and monitoring agents

139,147.6

Total

593,327.3

(Net Ingredient Cost (NIC)

NIC is the basic cost of a drug. It does not take account of discounts, dispensing costs, fees or prescription charges income).

Further expenditure will have taken place throughout the NHS system that is not possible to identify. Diabetes UK estimates spending in the United Kingdom is approximately £9 billion across the NHS.

Asked by

To ask Her Majesty's Government whether they have undertaken a cost-benefit analysis of the effects of the qualifying age range of 40 to 74 for the NHS Vascular Risk Assessment programme on the level of risk of diabetes of (a) persons over 25, and (b) black, Asian and minority ethnic persons over 25. [HL3022]

The National Health Service Health Check programme (formerly vascular checks) is a universal and systematic programme for everyone between the ages of 40 and 74 that will assess an individual's risk of heart disease, stroke, kidney disease and diabetes and will support people to reduce or manage that risk through individually tailored advice. The programme was developed on the basis of advice from the National Screening Committee. It advised that, on current evidence, there was not a case for whole population screening for diabetes. However, there was a good case for targeted screening for diabetes in the wider context of cardiovascular risk assessment.

The department undertook modelling on a vascular risk assessment and management programme, which included diabetes, to establish whether such an approach would be cost and clinically effective as well as identifying the optimal starting age. Both the technical consultation on the modelling and the impact assessment are available in the House of Lords Library. Three different starting ages for the programme (40, 45 and 50) were modelled. The age range of 40 to 74 for everyone was found to be both clinically and cost effective.

In taking the decision about the age range with which to launch the programme, the department took further advice from the National Screening Committee and leading United Kingdom diabetologists. Their view was that, given the current state of knowledge, age 40 represented a good starting point for combined diabetes, cardio-vascular and kidney disease risk assessment. The content and age parameters of the programme will be kept under review.

We understand that some primary care trusts may be inviting people into the programme who are under 40 years of age, for example, in areas that have significant South Asian communities who are generally at higher risk of vascular disease including diabetes. However, this scenario was not tested through the modelling, and so we have no evidence of its clinical or cost effectiveness.

Asked by

To ask Her Majesty's Government whether insulin-dependent diabetes has been successfully treated in any species by nuclear transfer; and, if so, how. [HL3060]

The Government are not aware of insulin-dependent (or type 1) diabetes having been successfully treated in any species by nuclear transfer. This Government will continue to support all types of stem cell research to maximise the possibility of developing new treatments for unmet medical needs, such as type 1 diabetes.

Asked by

To ask Her Majesty's Government what assessment they have made of the treatment of diabetes with the drug Avandia. [HL3079]

The Government have made no such assessment. The independent National Institute for Health and Clinical Excellence (NICE) has made a number of recommendations about the use of thiazolidinediones, which include rosiglitazone (Avandia), in its clinical guideline on newer agents for type 2 diabetes published in May 2009. Further information can be found on NICE’s website at http://guidance. nice.org.uk/CG87