Quarter of diabetes cases missed over lockdown as obesity soars

One in four new cases of diabetes went undiagnosed last year - even though soaring obesity rates have put more people at risk of developing the condition, research suggests.

At least 60,000 cases of type 2 diabetes in the UK were missed after lockdown began in March 2020, as patients were less likely to see GPs and get referred for checks, researchers said.

Experts from Manchester University warned the “major reduction” in the diagnosis rate means the NHS now faces a “huge backlog” of undiagnosed patients – and many will need more complex treatment because their condition has deteriorated.

Obesity levels have doubled in the UK since the early 1990s, with two in three adults overweight or obese.

Almost 5 million people in Britain have diabetes, and nine in cases are type two, which is driven by excess weight, and can lead to serious health problems including heart disease and stroke.

In the new study, researchers compared diagnosis data from the last ten years with figures for last year and found “significant” reductions in both newly recorded diagnoses of type 2 diabetes and new prescriptions for metformin, the medication usually given to newly diagnosed patients.

The diagnosis rate initially fell by 70 per cent in April 2020 and, on average, was around a quarter below the expected level last year.

Using data covering nearly a quarter of the population of the UK, researchers found a diabetes diagnosis was missed in around 12,400 patients in England and around 1,300 in the rest of the UK between March and December last year.

Expanding the figures to the total population, they said around 60,000 people across the country had a missed or delayed diabetes diagnosis in 2020.

But they warned the true figure could be higher, as more people became at risk of developing diabetes last year due to eating more and moving less during the lockdowns.

Before the pandemic, around 254,000 people were being diagnosed with diabetes annually, with the dip last year taking the figure to less than 200,000.

Meanwhile, one in three people gained weight and decreased their physical activity levels during lockdown, while more than half admitted snacking more, separate studies have found.

Presenting the new findings at the virtual Diabetes UK Professional Conference, researcher Matthew Carr said: “Our estimate of 60,000 missed or delayed diagnoses may well be an underestimate if changes in lifestyle during the pandemic and its associated lockdowns have increased obesity rates or other risk factors for diabetes in the general population.”

He said: “It’s also likely the condition of patients with delayed diagnoses will have deteriorated further by the time [they are diagnosed], so this will inevitably increase the burden on both the patients and the health service.”

The diagnosis rate dropped when GPs reduced face-to-face appointments with patients from March last year, researchers said.

The study also found patients with diabetes were up to 88 per cent less likely to receive one of six vital health checks - such as blood pressure tests - last year, compared with pre-pandemic years.

Mr Carr said there had been “a sustained period of between five to ten months” where the rate of care being given to patients with diabetes was “significantly lower” than normal.

He added: “The obvious conclusion is that many patients did not receive the necessary level of monitoring during 2020.”

Further studies will assess whether the missed diagnoses caused hospitalisations and deaths.

Data from 450,000 people using the Covid Symptom Study app showed one in three Britons gained weight and decreased their physical activity levels during lockdown last year.

A Liverpool University study published in January found more than half of adults admitted snacking more since the pandemic began.

Nikki Joule, of the charity Diabetes UK, said the figures were “incredibly concerning”.

“These results point towards reduced engagement with healthcare during the pandemic, and highlight the urgent need to ensure that those previously identified by their GP as being at high risk of developing type 2 diabetes receive their annual checks,” she said.

“Early diagnosis of type 2 diabetes is vital in reducing the risk of serious diabetes-related complications such as problems with the heart, kidneys and eyes.”

An NHS spokesperson said: “Type 2 Diabetes is largely preventable and the NHS has continued to run our Diabetes Prevention Programme over the course of the pandemic, as well as putting extra measures in place to support people with diabetes, including digital consultations and online support for people to manage their conditions.”