Diabetes

1. Key messages

2. Background

Diabetes is a condition that is characterized by recurrent high blood sugar levels. If left untreated, diabetes may cause long-term complications such as foot ulcers, damage to the eyes, chronic kidney disease, and cardiovascular disease. A diabetic diet and exercise are important parts of diabetes management, but in a large number of cases, insulin treatment will also be required.

A distinction is made between three main types of diabetes:

• Type 1 diabetes, resulting from an autoimmune destruction of the insulin-producing beta cells in the pancreas;
• Type 2 diabetes, mainly caused by a combination of excessive body weight and insufficient exercise; and
• Gestational diabetes, occurring in pregnant women without a previous history of diabetes.

Nationally representative diagnosis-based information on diabetes prevalence in Belgium is available through the InterMutualistic Agency (IMA-AIM), an organization and platform where data gathered from the seven Belgian health insurance funds are collected and analyzed. IMA-AIM data are, amongst others, made available through the IMA-AIM Atlas [1], a permanently accessible reference source with policy-relevant statistics and indicators derived from the available IMA-AIM data.

In the IMA-AIM database, diabetes prevalence is estimated based on the number of insured people with episodes of prescriptions of antidiabetics (ATC code A10) or with diabetes referring nomenclature (diabetes convention, diabetes pass, diabetes care trajectory). Women who gave birth during the year under review are excluded in order to exclude gestational diabetes.

Socio-economic characteristics are scarce in the IMA-AIM database. The status of “insured people having right to an increased compensation” is the only available proxy indicator, and it has only two values, yes or no. Persons with a low income or specific medical characteristics such as invalidity are entitled to an increased compensation status.

3. Diabetes prevalence

Belgium

In 2016, 6.4% of the Belgian population was diagnosed with diabetes. The prevalence of diabetes increases with age, and is higher among men, especially in the older age groups.

Trends and regional differences

The prevalence of diabetes is increasing in all three regions, as a result of both the ageing of the populations and a true increase in the risk of developing diabetes. The prevalence of diabetes is highest in Wallonia and lowest in Flanders, despite the relatively higher age of the Flemish population. The relatively low diabetes prevalence in Brussels is the result of the young age structure: when corrected for age, the diabetes prevalence in Brussels becomes higher than the Belgian average.

Socio-economic differences

The risk of developing diabetes is nearly twice as high among individuals with an increased compensation status than among individuals with a normal compensation status. The prevalence of diabetes has been increasing evenly in both groups.

4. Read more

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Definitions

Age-standardized prevalence

The age-standardized prevalence is a weighted average of the individual age-specific prevalences using an external standard population. It is the prevalence that would be observed if the population had the age structure of the standard population. Since age has an important influence on the risk of diabetes, this standardization is necessary when comparing several populations that differ with respect to their age structure. Here, the Belgian 2013 mid-year population is used as standard population. 

Increased compensation status

Persons with a low income are entitled to an increased compensation status. They pay less for healthcare and have other financial benefits. Currently, this is the only variable available in the IMA-AIM Atlas that allows assessing socio-economic differences.

References

1. InterMutualistic Agency Atlas. http://atlas.aim-ima.be/base-de-donnees