Health impact: People with diabetes are at a greater risk of a range of chronic health conditions including cardiovascular disease, blindness, amputation, kidney disease and depression than people without diabetes. Diabetes leads to a two-fold excess risk for cardiovascular disease, and diabetic retinopathy is the leading cause of preventable sight loss among people of working age in England and Wales. Diabetes is a major cause of premature mortality with around 23,300 additional deaths in 2010-11 in England attributed to the disease.

Economic impact: It is estimated that in 2010-11 the cost of direct patient care (such as treatment, intervention and complications) for those living with type 2 diabetes in the UK was £8.8 billion and the indirect costs (such productivity loss due to increased death and illness and the need for informal care) were approximately £13 billion. Prescribing for diabetes accounted for 9.3% of the total cost of prescribing in England in 2012-13.

Type 2 diabetes

• The underlying disorder for type 2 diabetes is usually insulin insensitivity combined with a failure of pancreatic insulin secretion to compensate for increased glucose levels. The insulin insensitivity is usually evidenced by excess body weight or obesity, and exacerbated by over-eating and inactivity.

• It is commonly associated with raised blood pressure and a disturbance of blood lipid levels. The insulin deficiency is progressive over time, leading to a need for lifestyle change often combined with blood glucose lowering therapy.

• Factors which influence someone's risk of type 2 diabetes include: weight, waist circumference, age, physical activity and whether or not they have a family history of type 2 diabetes.

• Particular conditions can increase the risk of type 2 diabetes. These include: cardiovascular disease, hypertension, obesity, stroke, polycystic ovary syndrome, a history of gestational diabetes and mental health problems. In addition, people with learning disabilities and those attending accident and emergency, emergency medical admissions units, vascular and renal surgery units and ophthalmology departments may be at high risk.

• In addition to these individual risk factors, people from certain communities and population groups are particularly at risk. This includes people of South Asian, African-Caribbean, black African and Chinese descent and those from lower socioeconomic groups.

Metabolic Syndrome

• Metabolic syndrome is a combination of disorders including high blood glucose, high blood pressure and high cholesterol and triglyderide levels, that is more common in obese individuals and is associated with significant risks of coronary heart disease and Type 2 diabetes. There is also a greater risk of dyslipidemia (for example, high total cholesterol or high levels of triglycerides), which also contributes to the risk of circulatory disease by speeding up atherosclerosis (fatty changes to the linings of the arteries).