New diabetes monitoring indicators tailored to local communities

To mark World Diabetes Day, Santé publique France is making available on Géodes the prevalence rates of pharmacologically treated diabetes from 2010 to 2019, at the departmental level. New indicators regarding the occurrence of diabetes-related complications and the frequency of recommended screening tests are also available for the years 2010, 2013, 2016, and 2019, at the regional level.

The set of indicators available on Géodes provides an overview of the diabetes situation in France in 2019, its evolution since 2010, and the regional disparities that remain significant.

A recent study^¹ published in 2019 reports a 0.9% annual increase in the prevalence of medication-treated diabetes among men and a 0.4% annual increase among women over the 2010–2017 period. Furthermore, our indicators, available on Géodes, show that this moderate increase continued between 2017 and 2019. The study also shows a decrease in incidence (number of new cases per year): -2.6% among men and -3.9% among women from 2012 to 2017. This trend was observed across all age groups among those over 45.

In addition to diabetes treated with medication, it is important to note that a significant proportion of people with diabetes are also managed through lifestyle changes (adopting a more balanced diet and increasing physical activity)—a necessary prerequisite for medication—and that some people with diabetes remain undiagnosed. In 2014–2016, the Esteban² survey found a prevalence of non-medicated diabetes of 1.2% among adults aged 18 to 74 living in mainland France and 1.7% who were unaware of their diabetes. Among all individuals identified as having diabetes in this survey, 23% were unaware of their condition.

Diabetes-related complications remain common but are stabilizing

In 2019, chronic complications related to diabetes remained very common, with marked regional disparities. The incidence of lower limb amputations and transmural myocardial infarctions has remained relatively stable since 2010. The incidence of strokes, which increased during the 2010–2016 period, has stabilized since 2016. Hospitalizations for foot ulcers continue to rise. It is important to note, however, that while foot ulcers are a serious complication of diabetes, early treatment—potentially during hospitalization—can prevent the condition from worsening, which could lead to amputation.

The rate at which recommended screenings are performed has been rising slightly since 2016

The 2004 Public Health Act recommended that by 2008, 80% of people with diabetes receive all the recommended tests for diabetes management. This management is guided by the care pathway recommendations established by the French National Authority for Health.

While the frequency of annual creatinine testing exceeded this 80% threshold, other tests still did not reach it in 2019.

• Frequency of lipid testing is on the rise (+2 percentage points since 2016) and approaching the threshold (77% in 2019)

• The frequency of the three annual HbA1c tests stood at 56% in 2019 (+2 percentage points since 2016)

• Significant increase in microalbuminuria (more than 10 percentage points between 2016 and 2019, reaching nearly 42%) with regional variability in testing rates, particularly in Réunion, where the testing rate reached 59%.

The indicators for the performance of recommended tests available on Géodes reflect the efforts made over the past several years, but also highlight the work that remains to be done to ensure that as many people with diabetes as possible receive follow-up care in accordance with recommendations.