Examining Trends in Type 2 Diabetes Incidence, Prevalence and Mortality in the UK between 2004 and 2014

Aims Contemporary data describing type 2 diabetes prevalence, incidence and mortality are limited. We aimed to (i) estimate annual incidence and prevalence rates of type 2 diabetes in the UK between 2004 and 2014; (ii) examine relationships between observed rates with age, gender, socio-economic status and geographic region; and (iii) assess how temporal changes in incidence and all-cause mortality rates influence changes in prevalence.
Methods Type 2 diabetes cases aged ≥16 years between January 2004 and December 2014 were identified using the Clinical Practice Research Datalink (CPRD). Up to five individuals without diabetes were matched to diabetes cases based on age, gender and general practice. Annual incidence, prevalence and mortality rates were calculated per 10,000 person-years at risk (95% CI). Survival models compared the mortality rates in patients with and patients without type 2 diabetes.
Results Prevalence rates of type 2 diabetes increased from 3.21% (3.19; 3.22) in 2004 to 5.26% (5.24; 5.29) in 2014. Incidence rates remained overall stable throughout the study period. Higher incidence and prevalence rates were related to male gender and deprivation. People with type 2 diabetes were associated with higher risk for mortality (Hazard ratio 1.26 [1.20; 1.32]. Mortality rates declined in patients with and without diabetes throughout the study period. The incidence and prevalence of type 2 diabetes in patients aged 16-34years increased over time.
Conclusions The rising UK prevalence of type 2 diabetes over the last decade is likely to be explained by patients living longer rather than increasing type 2 diabetes incidence.