Daily Archives: 25 April, 2012

The cost of diabetes in the UK

Diabetes will consume £16.9bn of the NHS’s budget and threaten to “bankrupt” the service within a generation because so many people are being diagnosed with the disease, according to research.

The cost of treating it will soar from £9.8bn as the number of diabetics rises from 3.8 million to 6.25 million by 2035, the study estimates.

The research, published on Wednesday, was conducted by five health economists from the York Health Economics Consortium, a research and consultancy firm that is part of York University, and published in the journal Diabetic Medicine. Their findings reveal that the condition is “an unfolding public health disaster” that could overwhelm the health service, said the head of the UK’s biggest diabetes charity.

“This report shows that without urgent action, the already huge sums of money being spent on treating diabetes will rise to unsustainable levels that threaten to bankrupt the NHS,” said Barbara Young, the chief executive of Diabetes UK. The NHS needs to heed expert advice and improve its care of diabetics, especially to reduce the number who develop complications such as kidney failure, strokes and amputations, she added.

“But the most shocking part of this report is the finding that almost four-fifths of NHS diabetes spending goes on treating complications that in many cases could have been prevented. The failure to do more to prevent these complications is both a tragedy for the people involved and a damning indictment of the failure to implement the clear and recommended solutions. Unless the government and the NHS start to show real leadership on this issue, this unfolding public health disaster will only get worse”, Young said.

diabetes

Diabetes

The Impact Diabetes report by Nick Hex and his colleagues calculates that 79% of the money the NHS spends on diabetes goes on treating complications, which also include nerve damage and sight problems, including blindness. As the number of sufferers grows so the total cost of such care will soar from £7.7bn to £13.5bn by 2035, they estimate.

The research, funded by the drugs company Sanofi, also examined the costs of diabetes to the UK as a whole. Once loss of working days, early death and informal care costs are factored in this will rise from £23.7bn to £39.8bn by 2035-36, the co-authors found after studying evidence on trends in diabetes collated by bodies such as the Office of National Statistics, hospitals and the NHS’s public health observatory service.


Deaths from diabetes in 2010-11 alone led to the loss of over 325,000 working years, for example, according to the report.

The number of people in the UK over 17 diagnosed with diabetes rose from 2.2 million in 2006 to 2.9 million last year. A further 850,000 are thought to have it but have not been diagnosed, and another 30,000 under-17s also have diabetes, mainly Type 1.

About 90% of sufferers have Type 2 diabetes, which is closely associated with the huge rise in obesity. The other 10% have Type 1 diabetes, which is an autoimmune condition.

Of the £9.8bn current direct costs, some £1bn is for Type 1 and the rest for Type 2 diabetes, but £13bn of the £13.9bn indirect costs are related to Type 2. Similarly, some £20.5bn of the projected £22.9bn total costs of diabetes by 2035/36 are expected to be due to treating the much more common form of the disease, the researchers estimate.

“We agree that diabetes is a very serious illness and one that has a big impact on the NHS,” said a Department of Health spokeswoman. It is trying to tackle the disease by stopping people getting Type 2 diabetes in the first place, helping patients manage their condition better and improving the quality of hospital care, she added.

Fertility drugs linked to childhood leukaemia

Fertility drugs can more than double the chances of children born to mothers who struggle to get pregnant developing leukaemia, a study has shown.

Children were 2.6 times more likely to become ill with acute lymphoblastic leukaemia (ALL), the most common type of childhood leukaemia, if their mothers had been treated with ovary-stimulating drugs.

They had a 2.3-fold increased risk of suffering the rarer form of the disease, acute myeloid leukaemia (AML).

Children conceived naturally after their mothers waited more than a year to get pregnant had a 50 per cent greater-than-normal likelihood of developing ALL.

But no heightened risk of childhood leukaemia was associated either with in-vitro fertilisation (IVF) or artificial insemination.

The French scientists cannot yet fully explain their findings, the first to show a specific link between use of fertility drugs and childhood leukaemia.

Study leader Dr Jeremie Rudant, from the Centre for Research in Epidemiology and Population Health at the French research institute INSERM in Villejuif, Paris, said: ‘It has always been hypothesised that assisted reproductive technologies may be involved in the onset of childhood cancer as they involve repeated treatment at the time of conception and or manipulation of the sperm and egg. And it is now established that a majority of acute leukaemia have a pre-natal (pre-birth) origin.

Leukaemia cells

Leukaemia cells

‘The findings indicate that more research is now needed to investigate more closely the link between specific types of fertility drugs and what role the underlying causes of infertility may play in the potential development of childhood leukaemia.’

Dr Rudant presented the results at the Childhood Cancer 2012 conference in London, hosted by the charity Children with Cancer UK.

A total of 2,445 French children and their mothers took part in the study, comprising 764 children who had been diagnosed with leukaemia and 1,681 who were free of the disease.


Mothers were asked if they had taken more than a year to conceive a child, and questioned about the treatments they had received.

Around 44,000 cycles of fertility treatment are carried out each year in the UK.

Use of fertility technology is increasing worldwide. In the UK, 1.8 per cent of all live births in 2007 followed fertility treatment, compared with just 0.5 per cent in 1992.

Despite a significant increase in risk, the actual number of children developing leukaemia after their mothers undergo fertility treatment remains very small.

Just 400 cases of childhood leukaemia are diagnosed each year in the UK, three-quarters of which are ALL.

ALL can affect children of any age but is most common between the ages of one and four. It is also more likely to affect boys than girls.

Dr Rudant said: ‘Previous studies have suggested a link between infertility treatments and acute childhood leukaemia but there haven’t been many studies, most of them have been small and they focused either on IVF or hormonal treatment. Our study was much larger and it’s the first time that a specific increased risk linked to fertility drugs has been found.’