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30% of people living with type 2 diabetes in England are undiagnosed, ONS analysis shows

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A new analysis has revealed that approximately 30% of people living with type 2 diabetes in England, or around one million adults, are undiagnosed. And around one in nine of all adults in England are estimated to be living with prediabetes.

This analysis was made by the Office for National Statistics (ONS) and gives us new insights into the risk factors related to living with undiagnosed type 2 diabetes and non-diabetic hyperglycaemia (NDH), also known as prediabetes. 

These figures were calculated from an analysis of data between 2013-2019 from the Health Survey for England.

What the findings showed

Younger adults, if they have type 2 diabetes, were more likely to be undiagnosed – 50% of those aged 16-44 with type 2 diabetes were undiagnosed, compared to 27% of those aged 75 and over. 

People living with undiagnosed type 2 diabetes were more likely to report better general health than those with a diagnosis. And women were more likely to be undiagnosed if they had a lower body mass index (BMI), lower waist circumference, or were not prescribed antidepressants.

Around one in nine adults were estimated to be living with prediabetes, approximately 5.1 million people in England. 

People from Black and Asian ethnic groups had more than double the prevalence of prediabetes and undiagnosed type 2 diabetes compared to White, Mixed and Other ethnic groups. 

Those most at risk of having prediabetes were those with known risk factors for type 2 diabetes. However, significant numbers were also seen in groups typically considered low risk – for example, 8% of people not living with obesity or overweight were estimated to have prediabetes. 

What do these findings mean? 

The results are concerning, because living with undiagnosed diabetes means people are unable to access the help and support they need to maintain their health and reduce the risk of complications.

The figures are also a reminder that it is not only those considered to be at high risk of developing type 2 diabetes who need to be aware of the signs. Type 2 diabetes can impact people usually considered low risk, such as younger people and those not living with overweight or obesity, with significant numbers impacted.  

We know that the numbers of people developing type 2 diabetes at a younger age, under 40, is increasing and that onset of complications can be more rapid in this group, so it is particularly important that they receive a prompt diagnosis and can quickly access the treatment and support that they need. 

How the findings were reached 

The Health Survey for England (HSE) is a survey which looks at the health of people living in England over a number of different measures. Some adult respondents to the HSE are asked to take a blood test as part of the data collection process. 

The blood test results can be used to determine whether an individual’s blood sugar levels are in the prediabetes or diabetes range. Alongside other responses on their health history, this can determine whether someone is likely to be living with type 2 or prediabetes undiagnosed.  

The HSE is conducted amongst a nationally representative sample of England, allowing for the results to be generalized to the wider population in England. 

What was the purpose of this research? 

The research aimed to better understand the scale of undiagnosed diabetes and prediabetes in the population.  

Identifying groups of people who may be at greater risk of living with prediabetes and undiagnosed type 2 diabetes is important for detecting the condition earlier and making sure people receive the support they need as soon as possible.  

Longer duration of type 2 diabetes before diagnosis can mean people only get diagnosed when complications are already developing or have already presented. Undiagnosed type 2 diabetes and prediabetes means people at greater risk of health complications are unaware of their condition, and therefore are not able to access the support and treatment they need.  

Early detection and support is vital, so better understanding of the population of people living with undiagnosed type 2 diabetes and prediabetes helps to direct resources to the areas they are most needed. 

Nikki Joule, Policy Manager at Diabetes UK, said of the findings:  

“The figures published today by ONS reveal a shockingly high number of people living with type 2 diabetes without a diagnosis, while millions more are at high risk of developing it.  

“We’re particularly concerned about the prevalence of prediabetes and undiagnosed type 2 diabetes in people from Black and Asian backgrounds, and the worrying proportion of younger people who are undiagnosed, as we know type 2 diabetes is more aggressive in younger people. 

 “The findings are a reminder of just how important it is for type 2 diabetes to be detected and diagnosed as early as possible, so people can get treatment and support to reduce the risk of devastating complications and, importantly, be offered remission programmes where appropriate.” 

Know your risk of type 2 diabetes 

Anyone concerned about whether they have diabetes should make an appointment with their GP.  

Anyone worried about type 2 diabetes can use Diabetes UK’s free online Know Your Risk tool. It takes just a few minutes to complete and gives information and support that can help you reduce your risk. 

More detailed findings and information about the study can be accessed via the Office for National Statistics.

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