The economic and social cost of type 2 diabetes by health inequalities

糖尿病是一种常见的疾病，可能会导致严重的健康问题和过早死亡。它的管理成本也很高。对健康的影响包括截肢、失明、肾衰竭和过早死亡。据估计，NHS约10%的预算用于管理糖尿病及其引发的疾病。这些估计所依据的数据都是陈旧的。了解糖尿病护理的成本、对患者健康的影响以及对病情的管理如何影响这一点是重要的。了解种族和贫困的影响可以帮助NHS改善对那些可能受益最大的人的护理。这项研究将回顾目前的文献，以强调已知的糖尿病随时间的进展，成本影响和影响疾病进展的因素。然后，这项研究将利用大量的英语健康记录来更新这一理解。这项研究将访问全科医生笔记和医院记录中的常规数据，以量化糖尿病的成本以及随着疾病从诊断到诊断的进展对患者健康的影响。它将研究良好的血糖控制对成本的影响，以及随着时间的推移对截肢和中风等关键健康影响的影响。然后，它将研究种族、贫困和生活在城市或农村地区如何直接和间接地影响糖尿病的成本和结果，通过它们对血糖控制的影响。卫生保健专员正在朝着使用卫生和社会护理的关联数据的方向发展，以更好地管理长期健康状况的患者。学生将与当地专员合作访问这些相关数据，并使用这些数据来了解糖尿病和疾病进展速度对社会护理费用的影响。这项分析将利用更详细的社会支持和精神健康数据，以了解这些因素对疾病进展速度的影响。该项目将与卫生保健专员和糖尿病患者进行访谈，以了解良好管理糖尿病和获得糖尿病患者护理的实际障碍和促进者。这项研究将更新我们对糖尿病的长期成本和结果以及维持健康血糖水平的影响的理解。它将确定环境和社会因素如何影响糖尿病的管理和疾病的进展。与患者和专员的访谈将结合这些因素，帮助理解为什么会发生疾病管理不善以及可以采取什么措施来改善这种情况。这些结果将帮助护理专员更有效地管理糖尿病，并有针对性地支持最有需要的患者，同时将成本控制在可用的预算内。

Diabetes is a common condition that can lead to significant ill health and early death. It is also expensive to manage. Health impacts include foot amputation, blindness, kidney failure and early death. It is estimated that around 10% of the NHS's budget is spent on managing diabetes and illness caused by it. The data upon which these estimates are based are old. Understanding the cost of diabetes care, the impact on patient health and how this is influenced by management of the condition is important. Understanding the impact of ethnicity and deprivation can help the NHS improve care in those who might benefit most. This study will review the current literature to highlight what is already known about the progression of diabetes over time, the cost impact and the factors which influence disease progression. This study will then update that understanding by utilizing extensive English health records. The study will access routine data from GP notes and hospital records to quantify the cost of diabetes and the impact on patient health as the disease progresses from diagnosis. It will examine the impact of good blood sugar control on costs and key health impacts such as amputation and stroke over time. It will then examine how ethnicity, poverty and living in an urban or rural area influence diabetes costs and outcomes, both directly, and indirectly though their impact on blood sugar control. Health care commissioners are moving towards the use of linked data on health and social care to better manage patients with long term health conditions. The student will work with local commissioners to access this linked data and use to understand the impact of diabetes and the rate of disease progression on social care costs. This analysis will exploit more detailed data on social support and mental health to understand the impact of these factors on the rate of disease progression. The project will undertake interviews with health care commissioners and patients with diabetes to understand the practical barriers and facilitators of good management of diabetes and access to care for people with diabetes. The study will update our understanding of the long term costs and outcomes of diabetes and the impact of maintenance of healthy blood sugar levels. It will identify how environmental and social factors influence diabetes management and the progression of the disease. Interviews with patients and commissioners will contextualize these factors and help to understand why poor management of disease occurs and what can be done to improve it. These results will help commissioners of care to manage diabetes more effectively and target support to patients most at need whilst containing costs within available budgets.