CCU097: Drivers, consequences and the COVID-19 pandemic’s effect on severe hyperglycaemia at type 2 diabetes diagnosis

Project lead:
Ewan A Walker & Rachel Denholm, University of Bristol, and Sophie Eastwood, University College London

Type 2 diabetes is one of the most common chronic diseases in the UK. With ~3.9 million people with diabetes in the UK, as of 2019, the number is increasing. Type 2 diabetes is when an individual is unable to control their blood sugar levels. A blood test measuring a patient’s average blood sugar level is used to diagnosis type 2 diabetes. A wide range of blood sugar levels are seen at diagnosis. With very high blood sugar levels potentially showing delays in diagnosis or a particular subtype of type 2 diabetes. The COVID-19 pandemic led to healthcare disruption across the UK with health service delivery being severely affected. After COVID-19 infection individuals with type 2 diabetes were seen to have worse cardiovascular disease outcomes. However, little is known about the causes, characteristics, risk factors, effect of the pandemic and cardiovascular outcomes for individuals with very high blood sugar levels at type 2 diabetes diagnosis.

The aim of the project is to characterise a group of individuals with very high blood sugar levels at type 2 diabetes diagnosis. The project will look at differences during and after the pandemic, the possible causes, risk factors and long-term outcomes of this group. By using various population level data sources, we will be able to look at patient journeys across primary and secondary care (e.g. GPs and hospitalisations, respectively), identify specific groups of at-risk patients (ethnic groups etc) and risk of worse outcomes. This will allow us to identify whether very high blood sugar levels at type 2 diabetes diagnosis is caused by differences in healthcare access and usage or is a specific subtype of type 2 diabetes.

The impact of this work is as follows:

  • It will identify an important type 2 diabetes group to target with preventative action to lower risk of these individuals in clinical practice settings.
  • For clinical practice, this work will provide evidence for identifying, contacting and helping at risk type 2 diabetes groups.
  • If there are higher rates of cardiovascular-related diabetes complications, this work will provide evidence for the cost of treatments and potentially create clear ways for tackling social inequalities in cardiovascular related long-term outcomes.
  • Provide evidence to further understand the effect of the COVID-19 pandemic on type 2 diabetes prevalence and blood sugar level at diagnosis.  

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