title: The Association of Public Health Observatories (APHO) Diabetes Prevalence Model: estimates of total diabetes prevalence for England, 2010-2030.
abstract: OBJECTIVE
  To provide robust estimates of the total prevalence of diabetes (including undiagnosed) in England to support effective planning and delivery of services.
  
  
  METHODS
  Age- and sex-specific prevalence of diagnosed and undiagnosed diabetes in people aged 16 years and older [based on HbA(1c) of 6.5% (48 mmol/mol) or greater] were taken from the Health Survey for England 2006. Data from the Health Survey for England 2004 were used to adjust for ethnic difference in prevalence. A deprivation adjustment refined the geographical distribution of diabetes prevalence. Projected diabetes prevalence was calculated using trends in overweight and obesity prevalence from the Health Surveys for England 2003 to 2008.
  
  
  RESULTS
  In 2010 there were an estimated 3.1 million (7.4%) people aged 16 years and older with diabetes in England. Comparisons between the 2008/2009 Quality and Outcomes Framework data and estimates for 2009 suggest that that 27.1% of the total number of people with diabetes are not included on general practice diabetes registers. The total number of adults with diabetes is projected to rise to 4.6 million or 9.5% by 2030. Approximately half of this increase is attributable to the changing age and ethnic group structure of the population and half is because of the rising prevalence of obesity.
  
  
  CONCLUSIONS
  This model estimates that the prevalence of total diabetes (diagnosed and undiagnosed) in England is higher than previously suggested. An ageing population and increasing prevalence of obesity imply that the prevalence of diabetes will continue to rise and health services should be planned accordingly.
authors.affiliation: Diabetes Health Intelligence, Yorkshire and Humber Public Health Observatory, University of York, Heslington, York, UK. nh139@york.ac.uk
authors.forename: N
authors.initials: N
authors.lastname: Holman
authors.forename: N G
authors.initials: NG
authors.lastname: Forouhi
authors.forename: E
authors.initials: E
authors.lastname: Goyder
authors.forename: S H
authors.initials: SH
authors.lastname: Wild
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D003695:Delivery of Health Care; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology*; D004739:England / Q000453:epidemiology; D005260:Female; D005544:Forecasting; D006801:Humans; D008297:Male; D008875:Middle Aged; D050177:Overweight / Q000453:epidemiology*; D015995:Prevalence; D011634:Public Health; D055815:Young Adult