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Diabetes is a prevalent chronic condition with two primary forms:

The vast majority, approximately 85-90%, would be diagnosed with type 2 diabetes, approximately 10% type 1 diabetes. 1-2% have other types of diabetes.

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Unfortunately, Ireland lacks a national diabetes registry (NDR), leading to reliance on vague estimates. A national diabetes registry is under development in Ireland.

In the meantime, we use estimates from the Scottish Diabetes Survey 2021: it reported a 6% prevalence of diagnosed diabetes, and applying this to Ireland’s 2022 population of 5,149,139, it is estimated that approximately 308,000 people in Ireland have diabetes.

Breakdown:

  • Type 2 diabetes (and similar types, e.g. MODY): Approximately 272,904 individuals (approx. 88% of the total diabetes population, 5.3% of the total population)
  • Type 1 diabetes: Approximately 30,895 individuals (approx. 11% of the total diabetes population, 0.6% of total population)
  • Other forms (e.g., MODY): Approximately 5,149 individuals (1% of the total diabetes population, 0.1% of the total population).
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These figures are only vague estimates and may overstate the actual numbers due to the absence of a comprehensive national registry.

 

Category Estimated Number Percentage of Total
Type 2 Diabetes 272,904 88%
Type 1 Diabetes 30,895 11%
Other Forms (e.g., MODY) 5,149 1%
Total Estimated 308,000 100%

Other type specific data (based on Irish studies):

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 2013. The more recent, yet unpublished evidence suggests approximately 3,000 paediatric patients in Irish paediatric diabetes clinics, but some clinics share care of patients, meaning that some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 Ireland.

Type 1 diabetes in adults

According to the study on epidemiology of type 1 diabetes in Ireland utilising prescription database, there were 20,081 prevalent cases of type 1 diabetes in 2016 in Ireland, with 17,053 adults over 18. This might be under-estimated compared to the Scottish prevalence data. More recent data used in Health Technology Assessment for Continuous Glucose Monitoring for adults with type 1 diabetes in 2023 suggest 30,000-35,000 people with type 1 diabetes in Ireland.

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 future.

 

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-diabetes.

Economic Burden of Diabetes in Ireland

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 nephropathy.

 

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 person.

 

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 attendances.

 

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).

 

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.

Conclusion

The absence of a national diabetes registry in Ireland complicates the accurate assessment of diabetes prevalence and its economic impact. However, existing estimates underscore the substantial burden of diabetes on individuals and the healthcare system. Implementing comprehensive prevention and management strategies is crucial to mitigate this burden.

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. https://archive.imj.ie/ViewArticleDetails.aspx?ArticleID=1508

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