Diabetes rates will increase by 37 per cent in the 10-year period up to 2015, due mainly to rising obesity levels, according to a new report published by the Institute of Public Health.
The prevalence of diabetes in the Republic is expected to increase from 4.7 per cent in 2005 to 5.6 per cent in 2015, equivalent to an additional 52,800 people, bringing the total to 194,000.
Doctors specialising in obesity have warned that the cost implications of this increase will be "massive" as diabetes, which occurs when blood glucose levels are too high, can lead to a wide range of very serious medical conditions including cardiovascular disease, eye disease and kidney failure.
Dr Kevin Balanda, associate director of the Institute of Public Health, said: "These figures indicate it is becoming quite a crisis in public health. For a state of this size, 50,000 people is a very large increase." He said the majority of this increase was for Type 2 diabetes. "It is clear to us, from our research, that an increase in obesity is the key driver of changes in the prevalence of Type 2 diabetes," Dr Balanda added.
He said rapidly rising diabetes levels would prove very expensive for the public health system "if we do nothing", but the priority was to move towards prevention and early detection. It is estimated one in four people with diabetes goes undiagnosed, which means the disease progresses and complications develop, he said.
The report Making Diabetes Count: What does the future hold? is the second report of the Irish Diabetes Prevalence Working Group and gives figures for both the Republic and Northern Ireland. Diabetes rates in the North are expected to increase by 26 per cent, or 17,100, to a total of 84,000, a prevalence of 6.3 per cent.
The increase in diabetes prevalence is mainly due to a rise in Type 2 diabetes, which is linked to obesity and is the result of cells in the body becoming resistant to the hormone insulin. Type 1 diabetes, which typically affects younger people, is caused by insufficient production of the hormone by the pancreas. However, rising obesity levels in children and young adults mean that Type 2 diabetes is also a growing problem in young people. New classes of drugs being developed are aimed at reducing insulin resistance in people with Type 2 diabetes.
Commenting on the report, Dr Donal O'Shea, who runs an obesity clinic in Loughlinstown hospital in Dublin, said it was known that 80 per cent of Type 2 diabetes was caused by obesity and being overweight. There had been an "extraordinary increase" in obesity levels over the past 25 years, from 6 per cent of the population in 1983 to about 25 per cent now, he said.
"The cost implications of the increase in diabetes are massive.Diabetes is a major cause of stroke and heart attack, it is the biggest cause of kidney failure requiring dialysis and renal transplant in the developed world, and it is a leading cause of blindness," Dr O'Shea said.
The cost of treating the complications of diabetes were massive, as were the cost of preventing these complications, he added.
Dr O'Shea said obesity units in hospitals around the Republic were "already swamped" and he called for all the recommendations of a Government-appointed task force on obesity, which reported in 2005 and of which he was a member, to be implemented.
"We used to see people getting diabetes in their 40s and 50s. Now we are seeing a lot of Type 2 diabetes in people in their teens, 20s and 30s," he said.
The 2005 task force made 93 recommendations, "many of which were cost-neutral and very few of which were about treatment", he said. It had emphasised the importance of proofing policies and taking action at pre-school and school level.
Prof John Nolan, consultant endocrinologist at St James's Hospital, Dublin, said the annual cost to the health service of Type 2 diabetes is estimated at €580 million. This corresponds to 6.4 per cent of our total annual healthcare expenditure.