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48,000 additional people with diabetes in Wales by 2035 – new analysis

Published: 14 November 2023

Around one in 11 adults in Wales could be living with diabetes by 2035 if current trends continue, according to a new analysis by Public Health Wales on World Diabetes Day.

This would be an additional 48,000 people with the disease, and a 22 per cent increase compared with 2021/22.

An increase like this would put significant additional pressure on health services.  Diabetes related hospital spells cost the Welsh NHS an average of £4,518 per spell in 2021/22, not including spells requiring amputations.  £105 million was spent on drugs to manage diabetes in Wales in 2022/23.

More than 200,000 people in Wales are already living with diabetes, around eight per cent of adults.  Around 90 per cent of these cases have type 2 diabetes, over half of which could be prevented or delayed with behaviour changes.

Public Health Wales leads the All Wales Diabetes Prevention Programme, which is funded by the Welsh Government and delivered locally by dedicated trained healthcare support workers and dietetic leads working in primary care.

The programme supports people at higher risk of type 2 diabetes to make changes to their diet and to be more physically active.

People are identified as being at risk through a blood test, called an HbA1c test, which measures a person’s average blood sugar (glucose) levels over the last two to three months.

Eligible people in areas where the programme is being rolled-out are referred to a healthcare support worker who will talk to them about what they can do to reduce their risk of developing type 2 diabetes.  They can also be referred to additional sources of support.

Since the All Wales Diabetes Prevention Programme launched in June 2022 it has offered support to more than 3,000 people across Wales.  It is now being delivered in 32 of the 60 primary care clusters in Wales. 

Dr Amrita Jesurasa, Consultant in Public Health for Public Health Wales, said:

“There has been a 40 per cent increase in the number of people living with diabetes in Wales in just over the last 10 years - an increase of 60,000 people. 

“Type 2 diabetes is a leading cause of sight loss and a contributor to kidney failure, heart attack and stroke.  In 2021/22 alone, more than 560 people in Wales underwent amputations linked with diabetes.

“The increasing prevalence of type 2 diabetes is therefore very concerning for the health and wellbeing of the people of Wales, as well as recognising the extra pressure this puts on health services.

“But the good news is that by supporting people to make behaviour changes, over half of type 2 diabetes cases could be prevented.  The main risk factors which people can take action on include having a healthier weight, eating a healthy diet, and being physically active.

“The independent process evaluation of the programme showed that nearly half of those who attended an appointment with us and completed a survey were unaware they were at risk of developing type 2 diabetes before receiving information about the programme.  That is why it’s so important for people to find out their level of risk for developing type 2 diabetes.

“Finding out only takes a few minutes, and people can do this by using Diabetes UK’s Know Your Risk tool. This is an important first step because by understanding their risk, people can take action. 

“For those at high risk, this could include being referred to the All Wales Diabetes Prevention Programme if they are eligible for the programme and it is available locally.”

On World Diabetes Day, Public Health Wales is publishing a range of reports and data about the disease in Wales.

These include:

These are available on the Public Health Wales website.

Case Study

The below case study was provided by Swansea Bay University Health Board.

After a routine eye test highlighted a change to one of his eyes, Darren Rix (50) was sent for a blood test which later revealed he was prediabetic.

“It was totally out of the blue,” Darren, from Pontardawe, said.  “I had an eye test and the optometrist noticed something on the back of my eye so I was referred for a blood test.  I was called into my GP practice and told that my blood sugar levels were high.

“It was a bit of a shock. If I had looked in the mirror, I wouldn’t have thought I was prediabetic.

“The GP asked me if I would be willing to have a discussion with the Diabetes Prevention Programme team, to which I agreed.”

Darren went to a consultation with a healthcare support worker at his GP practice, who encouraged him to increase his exercise.

He added: “I went along and had a chat and found it interesting.  They got me into doing more exercise as I didn’t do much before apart from walking the dog.

“I also started swimming as a result, which I still do now as I really enjoy it. I make sure I fit it in around my shift work.

“I also made substitutes here and there to my meals and cut back on my sugary treats.”

“In my latest appointment they told me what I’d done had been great and I’d brought my weight down,” he said.  “I was told I’m no longer prediabetic and that I should carry on doing what I’ve been doing.

“I’m grateful to the optometrist for sending me for the blood test and also to my GP for referring me to the programme.

“I don’t think people realise how serious diabetes can be.

“There are probably people out there who don’t realise they could be prediabetic.

“I don’t know how many years I had been prediabetic and I probably still would be now without the intervention.

“Sometimes you need that bit of a shock to get you to do something about it.”

Rachel Long, Swansea Bay University Health Board’s lead dietitian, said: “Until now a lot of patients hadn’t been made aware that they were at high risk of developing type 2 diabetes.

“So, when they do come into the consultation, it's been a little bit of a relief for them to be able to speak to somebody and have that advice.

“Prevention is better than finding a cure and the follow-up data so far is showing promise and heading in the right direction.”