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Diabetic Retinopathy Screening Services in Scotland: Recommendations for Implementation

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DIABETIC RETINOPATHY SCREENING SERVICES IN SCOTLAND: RECOMMENDATIONS FOR IMPLEMENTATION

Diabetic Retinopathy Screening: Annex C

Number of People with Diabetes and Number Receiving Diabetic Retinopathy Screening

Based upon the figures in Tayside, which is recognised as having the most accurate diabetes register, it is estimated that about 3% of the Scottish population has diabetes (see Table 1). However, numbers are increasing rapidly and the figure of 153,438 is almost certainly a conservative estimate. It has been calculated that about 13,000 newly diagnosed cases of diabetes are identified every year.

All NHS Boards have diabetes registers, but these currently show significant variation in coverage and completeness. The 2002 Scottish Diabetes Survey reported 103,835 registered diabetic patients. Of these registered patients, 60% are reported to have been screened within the last 15 months and a further 14% to have been screened more than 15 months ago; (see Table 2).

Table 1: Expected number of people with diabetes in Scotland

Population (a)

% of Scottish pop

Expected Diabetic pop Age std rate/100 (b)

Expected Diabetic pop Age std (Number)

Scotland

5,114,600

100.0%

3.00

153,438

1 Argyll & Clyde

423,500

8.3%

3.06

12,940

2 Ayrshire & Arran

373,400

7.3%

3.16

11,802

3 Borders

106,900

2.1%

3.44

3,678

4 Dumfries & Galloway

145,800

2.9%

3.47

5,057

5 Fife

350,400

6.9%

3.06

10,724

6 Forth Valley

278,000

5.5%

2.99

8,318

7 Grampian

523,400

10.2%

2.92

15,309

8 Greater Glasgow

904,400

17.7%

2.87

25,984

9 Highland

208,600

4.1%

3.16

6,590

10 Lanarkshire

562,000

11.0%

2.85

16,027

11 Lothian

783,600

15.3%

2.84

22,268

12 Orkney

19,480

0.4%

3.24

631

13 Shetland

22,440

0.4%

2.83

634

14 Tayside

385,500

7.5%

3.25

12,546

15 Western Isles

27,180

0.5%

3.42

930

(a) Estimated population figures at 30 June 2000
(b) expected figure has been calculated by applying national age-specific rates to NHS Board population. Differences in expected rate between NHS Boards reflects differences in age structure only. The rate does not take account of sex, ethnicity or deprivation which will also have an influence on the prevalence.

Table 2: Number of people with diabetes who have been screened for retinopathy

Registered patients with diabetes(2002 SDS)

Screened in last15 mths (Number)

Screened in last15 mths (%)

Screened>15 mths (number)

Screened>15 mths (%)

Scotland

103,755

62,564

60%

14,555

14%

1 Argyll & Clyde

9,522

4,618

48%

1,411

15%

2 Ayrshire & Arran

8,998

6,436

72%

0

0%

3 Borders

2,929

2,332

80%

301

10%

4 Dumfries & Galloway

5,156

1,911

37%

969

19%

5 Fife

9,881

5,601

57%

1,108

11%

6 Forth Valley

6,845

2,659

39%

4,052

59%

7 Grampian

5,726

3,150

55%

924

16%

8 Greater Glasgow

4,191

2,953

70%

497

12%

9 Highland

2,156

2,012

93%

144

7%

10 Lanarkshire

16,358

10,018

61%

532

3%

11 Lothian

18,912

11,731

62%

2,799

15%

12 Orkney

377

0

0%

0

0%

13 Shetland

608

0

0%

0

0%

14 Tayside

11,277

8,562

76%

1,818

16%

15 Western Isles

819

581

71%

0

0%

Source: Scottish Diabetes Survey 2002

Variations between NHS Boards primarily reflect different stages of development of local registers rather than real differences in prevalence rates. For example, the Greater Glasgow register at present includes date from only three LHCCs, and the Highland data includes only patients seen in secondary care.