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SCOTTISH DIABETES SURVEY 2002

ANNEX C

Scottish Diabetes Survey 2002

The following guidance was issued with the 2002 Survey.

1. Total population

Final estimated population at 30 June 2000 should be used. Source: Registrar General for Scotland

2. Area diabetes register
This allows prevalence to be calculated. The number of patients who have opted not to include their data on the register or for the Survey should be recorded.

3. Use of CHI number
The Community Health Index (CHI) is a population register used for health care purposes. The CHI number uniquely identifies a person on the index.

4. Postcode
Full postcode | Partial postcode | Not recorded/Not known.
The postcode is a basic unit for identifying geographic locations. A postcode has two component parts: part one is the outcode, and part two is the incode. Refer to Defs Manual for more details.

5. Type of diabetes
Type 1 | Type 2 | Other types of diabetes | Not recorded/Not known.
'Other' should include Gestational Diabetes Mellitus or Maturity onset diabetes of youth (MODY), but should exclude Impaired glucose tolerance.

6. Age of people on register
0-4 | 5-14 | 15-24 | 25-34 | 35-44 | 45-54 | 55-64 | 65-74 | 75-84 | >=85 | Not recorded/Not known.
Age at date of survey (i.e. September 2002).

7. Date of diagnosis
Recorded | Not recorded/Not known.

8. Sex of people on register
Male | Female | Not recorded/Not known.
Phenotype at birth.

9. Ethnic group
Ethnic group identified | Not recorded/Not known.
An ethnic group is a group of people having racial, religious, linguistic and/or other cultural traits in common. The ethnic group to which a patient belongs is judged by the patient. The standard OPCS classification of ethnicity is used here - 0 = White; 1 = Black Caribbean; 2 = Black African; 3 = Indian; 4 = Pakistani; 5 = Bangladeshi; 6 = Chinese; 30 = Other.

10. BMI
Calculated | Not calculated.
Refers to BMI based on a weight recorded within last 15 months.

11. HbA1c measurement
Measured within last 15 months | Measured >15 months ago | Not measured/Not known.
Glycated haemoglobin refers to measurement of HbA1c (not HbA1).

12. Blood pressure measurement
Measured within last 15 months | Measured >15 months ago | Not measured/Not known.

13. Cholesterol measurement
Measured within last 15 months | Measured >15 months ago | Not measured/Not known.
The Scottish Diabetes Core Dataset includes data fields for Serum total cholesterol, Serum HDL Cholesterol and Triglycerides. Measurements can be either fasted or unfasted. For the purposes of the 2002 Survey, any one of these is sufficient.

14. Serum creatinine measurement
Measured within last 15 months | Measured >15 months ago | Not measured/Not known.

15. Urinary microalbumin measurement
Measured within last 15 months | Measured >15 months ago | Not measured/Not known.
Urine specimen tested for presence of microalbuminuria by any method is sufficient for the purposes of the 2002 Survey (Albustix, albumin concentration, albumin: creatinine ratio, timed overnight albumin excretion rate or 24 hour albumin excretion rate.

16. Smoking status
Current smoker | Ex-smoker | Never smoked | Not recorded/Not known.

17. Diabetic Retinopathy Screening
Screened within last 15 months | Screened >15 months ago | Screening status not recorded.

18. Diabetic Retinopathy - Left or Right eye
Present | Absent | Not recorded.
Present means any degree of retinopathy recorded as present in left and/ or right eye; Absent means 'no retinopathy' recorded for both eyes.

19. Permanent blindness
Diabetic cause | Non-diabetic cause | Cause not recorded/not known.
Permanent blindness is defined as permanent visual acuity corrected (i.e. wearing corrective lenses) of <3/60 (I.e. CF, HM or PL) in the better eye.

20. Myocardial infarct
Recorded as ever having had an acute myocardial infarction.

21. Cardiac Revascularisation
Recorded as having undergone cardiac revascularisation.

22. Stroke
Recorded has having had a stroke.
Stroke (cerebrovascular accident) - defined as rapidly developing signs of focal (and/or global) disturbance of cerebral function lasting more than 24 hours or leading to death with no apparent cause other than vascular origin.

23. Foot ulceration
Recorded as ever having had a foot ulcer.
Foot ulcer is defined as any break in the epithelium greater than a crack below the level of the malleoli.

24. Lower limb amputation
Recorded as ever having had a lower limb amputation.
Amputation is defined as recommended in the SIGN guideline on management of diabetic foot disease as 'removal of forefoot or part of the lower limb'. This excludes loss of toes or single metatarsals.

25. End stage renal failure
Recorded as having chronic renal failure.
Either serum creatinine was chronically greater than 500 mmol/l (i.e. >500 mmol/l on two occasions three months apart), or the patient was placed on permanent dialysis or received a renal transplant.

NOTES

It is recommended that all patients with diabetes should be seen at least annually. However, in a number of the survey responses a period of 15 months has been used. This is to allow "confidence limits" around the annual review.

All aspects of the Survey remain under review. The Monitoring Group will be commenting upon any possible changes to definitions or format in the report of the 2002 Survey.

Seven new items have been added to the Survey since 2001:-

7. Date of diagnosis
9. Ethnic group
12. Blood pressure measurement
13. Cholesterol measurement
14. Serum creatinine measurement
15. Urinary microalbumin measurement

In addition, the item for diabetic retinopathy has been changed to:

18. Diabetic retinopathy - left or right eye

This replaces 'diabetic retinopathy - left eye' and 'diabetic retinopathy - right eye'. These items (which were used in the 2001 Survey) reflect the data as they are captured by SCI-DC for clinical purposes. For the purpose of the 2002 Survey, the number of patients who have any retinopathy is of interest, hence the amalgamation of the two fields.

Three other items have been amended:

2. Area diabetes register
5. Type of diabetes
20. Permanent blindness

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