Diabetes prevalence, monitoring, and targets in Irish primary care: a cross-sectional study

Background

Diabetes mellitus (DM) represents a major global health challenge. Electronic health records (EHRs) are a valuable resource for population health surveillance, particularly in Ireland where the national DM registry development is ongoing. This study aims to estimate DM prevalence and assess measurement completeness and clinical target achievement in an Irish primary care population.

Methods

EHR data from 66 primary care practices were accessed for patients seen January-December 2024. Any DM was defined by the presence of an ever-recorded diagnostic code (ICD-10 E10 type 1 diabetes(T1DM), E11 type 2 diabetes(T2DM); ICPC T89(T1DM), T90(T2DM)) or ever-elevated HbA1c (≥48 mmol/mol). Crude and age-standardised prevalence (ASP) were estimated with 95% confidence intervals (CI). Measurement completeness and clinical target achievement was assessed for the 24 months prior to the latest 2024 consultation.

Results

Data on 268,902 patients were available. Crude prevalence of any DM was 7.7% (ASP 7.5%; 95% CI: 7.4-7.6). Crude prevalence of T1DM 0.5% (n = 1,399, ASP 0.5%; 95% CI: 0.5-0.6), and T2DM 6.0% (n = 16,124, ASP 5.9%; 95% CI: 5.8-6.0). Prevalence was higher in males and increased with age. Measurement completeness was highest for HbA1c (84.5%) and cholesterol profile (83.0%), while kidney function completeness was notably low (21.0%). Completeness was higher in individuals with T2DM than T1DM. Among those with a measurement recorded, the majority met clinical targets for HbA1c (73.8%), total cholesterol (78.0%), and smoking (85.9%), while BMI (15.7%) target attainment was low.

Conclusions

This study demonstrates that primary care EHRs can be used to estimate DM prevalence and evaluate process of care in Ireland. These findings provide a foundation for surveillance, highlight opportunities to improve DM monitoring, and provide evidence for the value of EHR research approaches in the absence of a fully operational national DM registry.

Key messages

• Primary care data can estimate diabetes prevalence and evaluate quality of care in Ireland, where the national diabetes registry is not yet operational.

• Electronic health records provide a basis for diabetes surveillance and identify actionable monitoring gaps in primary care.