Type 2 diabetes is a serious condition in which the insulin made by the pancreas cannot work properly, or the pancreas cannot make enough insulin. Consequently, the levels of glucose in the blood rise. People with diabetes have an increased risk of developing cardiovascular disease (heart attack or stroke) and dying at a younger age than people without diabetes. Once diabetes has been diagnosed, this risk can be reduced by treatment of blood glucose, blood pressure and cholesterol. Around 4.2 million people in the United Kingdom have type 2 diabetes, one million of those people have type 2 diabetes but have not yet been diagnosed. Many individuals present with complications when they are diagnosed, and there is a “latent” period of several years between when the disease starts and when a person experiences symptoms and presents to their GP. It is logical to suggest that if diabetes was detected and treated earlier, even before symptoms developed, then the risk of heart attack, stroke and premature death could be reduced. However, there are a number of uncertainties concerning the potential benefits and harms of earlier detection of type 2 diabetes by population screening.
The long term effects of treatment of individual risk factors (blood glucose, blood pressure and cholesterol) among people with established diabetes is well known. Less is known about the impact of strategies that influence multiple risk factors simultaneously, particularly among patients detected by screening who are earlier in the course of disease.
The Anglo-Danish-Dutch Study of Intensive Treatment In People with Screen Detected Diabetes in Primary Care (ADDITION study) was set-up in 2001 to address some of these uncertainties. The study consists of a screening phase followed by a pragmatic trial of intensive treatment compared to routine care in four centres (Denmark, Cambridge UK, the Netherlands and Leicester UK).
NHS Digital Information
In order to find out about the health of ADDITION participants, we will also look at national data sources held by NHS Digital. This records all hospital admission data for the NHS in England and Wales. By checking these we will be able to make sure we haven’t missed any hospital admissions for stroke or heart conditions related to the study.
By using a secure web portal, we will send your identifiable data (NHS number and Date of Birth) to NHS Digital who will link hospital admissions information to individual participants within the study. NHS Digital will then return your information to us with data about these admissions related to the study. Furthermore, in order to ensure that we have your correct contact details, NHS Digital will provide us with any changes of address and/or change of GP details.
NHS Digital make sure that the data collected is subject to strict rules of confidentiality as laid down by Acts of Parliament, including the Data Protection Act 1988 and the Health and Social Care Act 2001. NHS Digital ensures that we use and store all patient information in accordance with these strict regulations.
Further information is available on the NHS Digital website http://digital.nhs.uk/or from the ADDITION study office.