Prioritising Action On Diabetes In Greater Manchester
Research type
Research Study
Full title
Prioritising Action On Diabetes In Greater Manchester: A Mixed Method Study
IRAS ID
281050
Contact name
Peter Bower
Contact email
Sponsor organisation
University of Manchester
Clinicaltrials.gov Identifier
n/a, n/a
Duration of Study in the UK
1 years, 0 months, days
Research summary
Research Summary
An estimated 160,000 people are currently living with diabetes in Greater Manchester (GM).
The complications caused by diabetes lead to around 1,000 premature deaths each year among the population of GM.
These numbers are predicted to rise.
Increasing diabetes prevalence in cities is fuelled by a complexity of risk factors that leave people vulnerable to the disease.
Whilst a great deal is known about the impact of biomedical and lifestyle factors related to diabetes and its outcomes, cultural and social components - such as living environments and social connectedness - have yet to be comprehensively examined.
This study will explore social and cultural factors that enable/prevent people from living well with diabetes in GM.
It will do this by asking a wide range of people across the GM region who are living with type 2 diabetes to complete a combination of quantitative (demographic questionnaire and statement sorting exercise) and qualitative (interviews and focus groups) research exercises.
It will draw on methods that have been used in other cities in the UK and across the world through the Cities Changing Diabetes (CCD) Global Partnership Programme.
Findings will help local stakeholders tailor their actions to meet the needs of the population.
The research involves close working with the CCD global programme (led by UCL), with Health Innovation Manchester (HINM) and with local diabetes stakeholders.
The research is funded by HInM and Novo Nordisk, will span 18 months and will involve recruitment across community and NHS sites in the GM region.
Summary of Results
What we did
We have worked with Health Innovation Manchester, University College London, and Novo Nordisk to address some of the urban diabetes challenges in Greater Manchester.
Why was it important?
415 million adults have diabetes worldwide, an estimated 160,000 people in Greater Manchester, these numbers are predicted to rise. The complications caused by diabetes lead to around 1,000 premature deaths each year among the population of Greater Manchester, with almost 66% of people living with type II diabetes lbeing in urban areas. There is a need for greater understanding of how urban living impacts on type II diabetes risk, prevalence and health inequalities.
Greater Manchester joined other cities across the world participating in the Global Cities Changing Diabetes Programme. Together we have worked to further understand the burden of diabetes and its social and cultural determinants to reduce the impact of type 2 diabetes on a regional and global scale.
How we did it
We conducted a mixed methods study which:
Applied the ‘rule of halves’ framework to routine data to identify gaps in the diagnosis and treatment of individuals with type II diabetes in Greater Manchester.
Explored the social and cultural factors that make certain groups of people living in Greater Manchester vulnerable or resilient to type II diabetes and its complications.
What we found
1. Estimating the ‘rule of halves’ for Greater Manchester:
We estimate that in Greater Manchester, adults under 40 years of age, men, those from white ethnic backgrounds and those from most deprived neighbourhoods are under-represented in care records – that is, there are likely to be more people in these groups who have diabetes than have been formally diagnosed.
GP practices serving a higher proportion of younger adults with diabetes (under the age of 40), and female patients, performed worse for achieving diabetes treatment targets.GP practices in Greater Manchester improved the quality of their care to diabetes patients over the period of 2015-16 to 2018-19.
2. Social and cultural factors:
Based on the findings of the ‘rule of halves’ analysis, we explored whether we could identify sub-groups of adults under the age of 40 years of age who share specific perspectives towards health, wellbeing and living with diabetes. We explored whether these perspectives create specific barriers to and opportunities for successful diabetes prevention; diagnosis, care and management; and overall health and wellbeing. We identified five different perspectives on living as a younger adult with type II diabetes, these being:
Stressed and calamity coping
Financially disadvantaged and poorly supported Well-intentioned but not succeeding Withdrawn and worried Young and stigmatised3. We identified a number of implications that decision-makers may wish to consider, in relation to:
Response to diagnosis
Service support
Lifestyle/self-management issuesThis study may inform the design of future community-based initiatives that are sensitive to the different perspectives on diabetes care.
Who we worked with
Novo Nordisk
Health Innovation Manchester
University College LondonREC name
North West - Greater Manchester Central Research Ethics Committee
REC reference
21/NW/0030
Date of REC Opinion
3 Mar 2021
REC opinion
Further Information Favourable Opinion