Influences on the variation in prevalence of type 2 diabetes between general practices: practice, patient or socioeconomic factors?
BACKGROUND
The prevalence of type 2 diabetes is known to vary between countries, districts and general practices. The influence of early detection and screening on the variation of prevalence between general practices has not previously been investigated.


OBJECTIVE
To test the hypothesis that the prevalence of type 2 diabetes is associated with awareness of and screening for diabetes within general practices and to explore other factors that may explain the variation in prevalence between practices.


METHODS
Cross-sectional study of general practices.


METHODS
Forty-two general practices in Newcastle and North Tyneside; 20% random sample of patients with type 2 diabetes (n = 1056).


METHODS
Factors thought to be associated with the variation of type 2 diabetes prevalence were collected from general practices through practice managers, medical records, and patient questionnaire. Pearson's correlation coefficient was used to quantify the association, and variables significant at the 5% level were entered into a multiple linear regression model.


RESULTS
There was a wide inter-practice variation in age/sex standardised type 2 diabetes prevalence (range = 0.69% to 2.73%; P < 0.001). There was no significant association between the prevalence of type 2 diabetes and the proportion of patients detected outside primary care or the proportion of patients detected through screening, accounting for only 2% and 3% of the variation in type 2 prevalence between practices, respectively. The mean Townsend deprivation score accounted for 42% of the variation in type 2 diabetes prevalence between practices, with more deprived practices having a higher prevalence.


CONCLUSIONS
This study suggests that socieconomic deprivation, rather than detection through screening or awareness of diabetes, accounts for much of the variation in prevalence of type 2 diabetes between practices.
Whitford
David L
DL
Department of Public Health and Primary Care, University of Cambridge. david.whitford@virgin.net
Griffin
Simon J
SJ
Prevost
A Toby
AT
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology*; D005194:Family Practice / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D016014:Linear Models; D008297:Male; D008403:Mass Screening / Q000706:statistics & numerical data; D008875:Middle Aged; D010818:Practice Patterns, Physicians'; D015995:Prevalence; D011364:Professional Practice / Q000706:statistics & numerical data; D012959:Socioeconomic Factors; D006113:United Kingdom / Q000453:epidemiology