Diabetes: key data sources
Scottish Diabetes Survey
The Scottish Diabetes Survey is the most complete routine data source for diabetes in Scotland. Based on data provided by Scottish health boards, it combines information from primary and secondary care. The report presents a wide range of information on patients registered as having diabetes in Scotland, at both national and health board level. This includes the number of registered patients, information on the management and health status of registered patients, and an assessment of the completeness of the data. The most recent published survey is the 2014 Scottish Diabetes Survey, which is available in the publications section of the Diabetes in Scotland website.
Primary care data
Practice Team Information (PTI)
Statistics on consultations for diabetes in primary care in Scotland are available from Practice Team Information (formerly Continuous Morbidity Recording). The figures are based on consultations with GPs and practice in around 60 practices across Scotland. The sample is not sufficiently large to provide reliable prevalence estimates below national level. Further details on Practice Team Information are available on the ISD website.
However, as of September 2013, PTI data is no longer collected. A new national GP information system known as the Scottish Primary Care Information Resource (SPIRE) is in development which will supersede and build on the data collected for PTI. SPIRE aims to include richer data from a greater number of practices and will help to inform public health surveillance, research and data linkage. Further benefits will see the creation of a mechanism to feedback data analysis to practices and an improved data extraction process.
Quality and Outcomes Framework (QOF)
The new General Medical Services contract was introduced in April 2003. The Quality and Outcomes Framework (QOF) for 2014/15 included 9 indicators for diabetes worth a total of 74 points. To achieve points for diabetes, practices need to maintain a register. Register sizes from Scottish QOF data can be used to estimate the prevalence of diabetes across Scotland. The advantage of this data source is its national level of coverage; one important disadvantage is that only aggregated data are available, so that it is not possible to adjust for age or other differences when making comparisons between populations. The QOF rules exclude people with diabetes aged less than 17 years and those with gestational (pregnancy) diabetes. Diabetes prevalence rates from QOF use the whole practice population as the denominator but include only those aged 17 and over in the numerator. This leads to an underestimate of total prevalence.
Secondary care data
Statistics on hospital admissions for diabetes are held in the Scottish Morbidity Record (SMR) databases and are presented in the section on secondary care. However, diabetes is often not recognised or recorded as the underlying reason for complications that lead to hospital admission. Anwar et al (2011) found that among people previously diagnosed with diabetes and admitted to hospital in Scotland in 2007, only 59% of had a record of a diagnosis of diabetes in their hospital discharge data.
Eye testing data
Information is available on the number of eye tests carried out for people with diabetes (in the data table entitled "sight tests by exemption type"). Information on the number of screening tests is also available from the national retinopathy screening programme.
Other relevant information developments
Scottish Care Information - Diabetes Collaboration (SCI-DC)
SCI-DC is an information system that allows sharing of patient care information between primary and secondary care. Data from hospital specialists and from GPs are transferred into a data warehouse. This allows access to up to date information for all those involved in the care of patients with diabetes.
Each health board in Scotland maintains a diabetes register that includes people with diabetes in contact with primary or secondary care. These registers are used for day to day clinical care and to audit and improve the quality of care. They are also the main source of information for the Scottish Diabetes Survey (see above).
Diabetes among minority ethnic groups in Scotland
In 2007, the National Resource Centre for Ethnic Minority Health and Diabetes UK Scotland produced a joint publication on managing long term conditions in black and ethnic minority communities, one of which was Diabetes.
The Diabetes Minority Ethnic Subgroup (DMEG) of the Scottish Diabetes Group produced a report in 2012 on best practice cross-cultural working across NHS Boards. This was intended to support NHS Boards' progress in working with minority ethnic groups with diabetes, including patient education, self-management and support for healthcare professionals.
Information on the epidemiology of Diabetes in Children in Scotland
The Scottish Study Group for the Care of Diabetes in the Young maintains a register of children with diabetes in Scotland and has published data on the incidence of type 1 diabetes in children (Rangasami et al 1997).
Model-based estimates of undiagnosed diabetes
A model produced by the Association of Public Health Observatories (APHO) has been used to estimate the true number of diabetes cases in Scotland. More information about this work is available in the section on estimates of undiagnosed diabetes in Scotland.