The Mail’s diabetes front page needs context

“One in ten patients admitted to hospital are suffering from a form of diabetes linked to being overweight and inactive…

“[Data from NHS Digital] revealed there were 1,749,025 admissions for type 2 diabetes in 2018/19…”

Daily Mail, 4 November 2019

Today the Daily Mail’s front page reported that one in 10 admissions to hospitals in England are people suffering from type 2 diabetes.

That is correct, but it needs to be stressed that just because someone is admitted with type 2 diabetes, that doesn’t mean that they were admitted for type 2 diabetes.

In fact, most patients admitted to hospital suffering from type 2 diabetes are not in hospital primarily because of diabetes. The Daily Mail doesn’t clarify this in its article.

Type 2 diabetes is caused by problems with a chemical in the body (hormone) called insulin. It's often linked to being overweight or inactive, or having a family history of type 2 diabetes.

Data released to the Daily Mail by NHS Digital shows that in 2018/19 NHS England recorded 1.75 million hospital admissions of patients whose primary or secondary diagnoses was type 2 diabetes.

The primary diagnosis is the main reason the patient is receiving care in hospital while the secondary diagnoses are relevant “co-morbidities and external causes”.

NHS Digital says: “For example a patient may be treated for a broken leg, may have diabetes which would be relevant to their care, and may have broken their leg in a traffic accident.”

We can’t break down these 1.75 million admissions into patients with diabetes as a primary or secondary diagnosis, but we can look at the number of “consultant episodes” to show something similar.

When you go into hospital your care may be transferred from one consultant to another which would show up as two consultant episodes but just one hospital admission.

In 2018/19 there were 20.8 million consultant episodes in NHS England hospitals. Of these 2.5 million were for patients with type 2 diabetes. But only 47,000 had type 2 diabetes listed as their primary diagnosis.

That’s not to say that type 2 diabetes plays no role in those 2.45 million other cases where it wasn’t the primary diagnosis, and the data suggests diabetes sufferers are more likely to be in hospital, even if they are not there for diabetes specifically.

Professor in Diabetes and Endocrinology at the University of Southampton Richard Holt told us: “Admissions relating to a primary diagnosis of diabetes are relatively uncommon but admissions relating to complications are much higher.

“For example, diabetes doubles the risk of a heart attack (myocardial infarction) or stroke. In these situations, the diabetes is likely to contribute to the admission even if not a primary diagnosis.”

In 2018/19, 6.9% of patients at GP practices in England aged 17 and above had been diagnosed with type 2 diabetes.

In the same year, type 2 diabetes sufferers made up 13.5% of consultant episodes among people aged 17 and above—almost double the diagnosed rate in the population.

But this could also be related to the fact that type 2 diabetes affects older people more than younger people, and older people are more likely to go to hospital regardless of whether they have diabetes.

The average age of someone admitted to hospital in 2018/19 was 54. The average age of someone admitted to hospital who had type 2 diabetes was 71.

In other words, it’s hard to know the extent to which people with type 2 diabetes are in hospital because of their diabetes or because of other health factors related to old age.