Obesity in childhood is a key risk factor for later obesity and early onset of type 2 diabetes. Improving care pathways for obesity and type 2 diabetes is an important priority, but to do that we need to understand the current picture regarding the number of new and ongoing cases of obesity, pre-diabetes, type 1 and 2 diabetes and diabetes-related complications, like kidney damage and heart disease in younger people in the UK. Whilst we know some risk factors for poorer outcomes (e.g. living in poverty, being from an ethnic minority) we do not have enough data on how these risk factors map onto current obesity, pre-diabetes, type 1 and 2 diabetes in the UK specifically in children and young people up to the age 40 years. A better understanding of risk factors will help us to develop ways to identify individuals at greatest risk of poorer outcomes and to examine what happens to their health over time. For example, not all children with obesity will develop type 2 diabetes, and some young people living with prediabetes will develop type 2 diabetes quicker than others. This project will allow us to examine how sex, age, ethnicity, socioeconomic group, geographical region, and presence of a learning disability are linked to changes across time and lead to obesity, pre-diabetes, type 1 and 2 diabetes in young people. In turn, this will allow us to design better prevention programmes, interventions and care pathways that best serve the specific needs of vulnerable groups.
There is a need for a better understanding of the aetiology of type 1 and type 2 diabetes and its complications in children and young people (CYP) in the UK and a clinical need to improve effectiveness of interventions to prevent and treat diabetes. The data we request will allow us to better map and identify factors that predict the risk of obesity, pre-diabetes, type 1 and 2 in CYP as well as identifying risks for early micro- and macrovascular complications of diabetes.
We will undertake a detailed analysis of the incidence of obesity, prediabetes and type 1 and type 2 diabetes and its complications in the young population (0-40 years). We will examine current incidence and prevalence of these conditions and their association with socio-demographic variables including sex, age, ethnicity, socioeconomic group, geographical region, GP practice, presence of a learning disability from 2005 to 2020. We will also assess risk factors for type 1 and 2 diabetes and complications from diabetes.
This will facilitate effective targeting and tailoring of both prevention programmes and interventions addressing the specific needs of younger people at risk for diabetes and its complications.
Obesity (taken from BMI measurements and/or height and weight measurements). In those age <18 years the appropriate age and sex specific percentiles will be used to define obesity and in those 18 years and older, a BMI of 30 kg/m2 or more will be used to define obesity.
Diagnosis of pre-diabetes and type 2 diabetes, according to the medical diagnostic codes, or a hemoglobin A1c (HbA1c) value.
Diagnosis of type 1 diabetes.
Microvascular complications of T1D and T2D including retinopathy, nephropathy, and neuropathy.
Macrovascular complications of T1D and T2D including cardiovascular disease.
We will initially use clinical codes for diabetes and complications from diabetes taken from here: https://www.phpc.cam.ac.uk/pcu/research/research-groups/crmh/cprd_cam/c… ) and develop or adopt codelists on these for Aurum.
Francesca Crowe - Chief Investigator - University of Birmingham
Francesca Crowe - Corresponding Applicant - University of Birmingham
Jackie Blissett - Collaborator - Aston University, Birmingham
Krishna Gokhale - Collaborator - University of Birmingham
Krishnarajah Nirantharakumar - Collaborator - University of Birmingham
Peymane Adab - Collaborator - University of Birmingham
Ponnusamy Saravanan - Collaborator - University of Warwick
Renuka Dias - Collaborator - Birmingham Women's and Children's Hospital NHS Trust
Suma Uday - Collaborator - Birmingham Women's and Children's Hospital NHS Trust
Patient Level Index of Multiple Deprivation;Practice Level Index of Multiple Deprivation