Body mass index (BMI)
Body mass index (BMI) is calculated by dividing a person's weight (in kilograms) by the square of their height (in metres). An increase in body mass index (BMI), is known to be strongly linked with the development of Type 2 diabetes. Overweight is an increasing problem in Scotland.
BMI | Classification |
<18.5 | Underweight |
18.5-24.9 | Healthy weight |
25-29.9 | Overweight |
30-39.9 | Obese |
>40 | Morbidly obese |
Overall, BMI recording is improving - rising from 39.8% in 2001 to 52.3% in 2002. Several boards have made significant progress, for example, Borders reported only one in five patients (21.6%) with a BMI record in 2001, but this had risen to nearly three quarters (73%) in 2002. However despite this encouraging progress is it is disappointing that more areas were not able to reach the target level of 60% suggested in the 2001 report. It is recommended that areas aim to include a BMI measurement in 65% of records in the 2003 Survey.
Figure 18: Diabetes register: percentage with BMI calculated
Note: D&G - data is from out-patient clinic workloads only and does not include primary care diabetes
Figure 19: Comparison - Scotland 2001 & 2002. Number on register with BMI calculated
Table 5: Diabetes register - percentage with BMI calculated
| BMI calculated | | | BMI calculated |
Scotland 2002 | 54,254 | 52.3% | Greater Glasgow | 2,991 | 71.4% |
Argyll & Clyde | 1,506 | 15.8% | Highland | 1,879 | 87.2% |
Ayrshire & Arran | 0 | 0.0% | Lanarkshire | 8,751 | 53.5% |
Borders | 2,138 | 73.0% | Lothian | 13,410 | 70.9% |
Dumfries & Galloway | 1,012 | 19.6% | Orkney | 0 | 0.0% |
Fife | 4,735 | 47.9% | Shetland | 436 | 71.7% |
Forth Valley | 3,131 | 45.7% | Tayside | 9,533 | 84.5% |
Grampian | 4,732 | 82.6% | Western Isles | 0 | 0.0% |
Diabetes and the eye
There has been an increase in the percentage of patients screened for diabetic retinopathy compared to the 2001 survey. This is mainly due to an increase of recorded screening during the last 15 months. This is a significant improvement but much work is still required. The Scottish Diabetes Framework set a target that all people with diabetes should have their eye status (retinopathy) recorded by September 2003. The introduction of a national system for diabetic retinal screening as proposed by the Health Technology Board for Scotland should see these figures improve in future surveys.
(20, 21)
Figure 20: Diabetes register: diabetic retinopathy percentage screened within last 15 months
Note: A&A - excludes 288 patients who are under 12 years old or who are registered blind/partially sighted. Grampian - data is from 38 practices only. Lanarkshire - data only available for secondary care. Orkney - no data submitted. Shetland - no data submitted. W.I. - Not recorded/Not known includes 162 patients who were not eligible for screening.
Table 6: Diabetes register - diabetic retinopathy screening
| Screened within last 15 months | Screened over 15 months ago | Not recorded / not known |
Scotland 2001 | 44,587 | 42.2% | 13,105 | 12.4% | 48,064 | 45.4% |
Scotland 2002 | 62,564 | 60.3% | 14,555 | 14.0% | 26,636 | 25.7% |
Argyll & Clyde | 4,618 | 48.5% | 1,411 | 14.8% | 3,493 | 36.7% |
Ayrshire & Arran | 6,436 | 71.5% | 0 | 0.0% | 2,562 | 28.5% |
Borders | 2,332 | 79.6% | 301 | 10.3% | 296 | 10.1% |
Dumfries & Galloway | 1,911 | 37.1% | 969 | 18.85 | 2,276 | 44.1% |
Fife | 5,601 | 56.7% | 1,108 | 11.2% | 3,172 | 32.1% |
Forth Valley | 2,659 | 38.8% | 4,052 | 59.2% | 134 | 2.0% |
Grampian | 3,150 | 55.0% | 924 | 16.1% | 1,652 | 28.95 |
Greater Glasgow | 2,953 | 70.5% | 497 | 11.9% | 741 | 17.7% |
Highland | 2,012 | 93.3% | 144 | 6.7% | 0 | 0.0% |
Lanarkshire | 10,018 | 61.2% | 532 | 3.3% | 5,808 | 35.5% |
Lothian | 11,731 | 62.0% | 2,799 | 14.8% | 4,382 | 23.2% |
Orkney | 0 | 0.0% | 0 | 0.0% | 377 | 100.0% |
Shetland | 0 | 0.0% | 0 | 0.0% | 608 | 100.0% |
Tayside | 8,562 | 75.9% | 1,818 | 16.1% | 897 | 8.0% |
Western Isles | 581 | 69.7% | 0 | 0.0% | 238 | 30.3% |
Figure 21: Comparison - Scotland 2001 & 2002. Number on register having Diabetic retinopathy screening
The 2002 Survey asked about all patients with any record of diabetic retinopathy in left or right eye. This simplified the request made in 2001 when diabetic retinopathy in both left eye and right eye was requested.
Of those screened for diabetic retinopathy, the highest prevalence of retinopathy is recorded in Tayside, an area which has used retinal photography as the screening method for a number of years. The HTBS report has recommended this methodology for Scotland. At this stage the Survey cannot define what interventions (e.g. specialist referral and/or laser therapy) are being undertaken to limit progression of disease in those with sight-threatening retinal changes.
Figure 22: Diabetes Register: Diabetic retinopathy - left or right eye
Note: A&A - excludes 288 patients who are under 12 years old or who are registered blind/partially sighted. Orkney - this information was not collected in 2001 Survey. Lanarkshire - data was submitted for Left and Right eye separately therefore the highest figure of the two was used.Shetland - no data submitted
The prevalence of permanent blindness is reported at just under 1%. However, there are some problems about how 'permanent blindness' is defined and this may impact on this figure. Blindness may not be due to specific diabetic eye disease in a significant number of cases. Work in Fife has suggested that many of the people who lose their sight as a result of diabetic retinopathy have not made use of diabetes services. This finding should be examined in other areas and if confirmed, work should be commissioned to explore why such people chose to avoid diabetes services.
Figure 23: Diabetes register: permanent blindness - percentage diabetic/non diabetic cause
Note: Shetland - no data submitted. Orkney - no data submitted
Figure 24: Comparison - Scotland 2001 & 2002. Permanent blindness
