Background: Diabetes mellitus affects over 3.9 million people in the United Kingdom (UK), with over 2.6 million people in England alone. More than 1 million people living with diabetes are acutely admitted to hospital due to complications of their illness every year. Complications include Diabetic emergencies such as Diabetic Comas, Hypoglycaemia, Diabetic ketoacidosis and Diabetic Hyperosmolar Hyperglycaemic State. Diabetic retinopathy (DR) is a common microvascular complication of type 1 and type 2 diabetes and remains a major cause of vision loss and blindness in those of working age. This dataset includes acute all diabetic admissions to University Hospitals Birmingham NHS Trust from 2000 onwards with linked eye data including the national screening diabetic grade category (seven categories from R0M0 to R3M1) from the Birmingham, Solihull and Black Country DR screening program (a member of the National Health Service (NHS) Diabetic Eye Screening Programme) and the University Hospitals Birmingham NHS Trust Ophthalmology clinic at Queen Elizabeth Hospital, Birmingham .

Geography: The West Midlands has a population of 5.9 million. The region includes a diverse ethnic, and socio-economic mix, with a higher than UK average of minority ethnic groups. It has a large number of elderly residents but is the youngest population in the UK. There are particularly high rates of diabetes, physical inactivity, obesity, and smoking.

Data sources:

1. The Birmingham, Solihull and Black Country Data Set, University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom. They manage over 200,000 diabetic patients, with longitudinal follow-up up to 15 years, making this the largest urban diabetic eye screening scheme in Europe.
2. The Electronic Health Records held at University Hospitals Birmingham NHS Foundation Trust is one of the largest NHS Trusts in England, providing direct acute services and specialist care across four hospital sites, with 2.2 million patient episodes per year, 2750 beds and 100 ITU beds. UHB runs a fully electronic healthcare record both for systemic disease as well as the Ophthalmology records.

Scope: All hospitalised patients admitted to UHB with a diabetes related health concern from 2000 onwards. Longitudinal and individually linked with their diabetic eye care from primary screening data and secondary care ophthalmology data including • Demographic information (including age, sex and ethnicity) • Diabetes status • Diabetes type • Length of time since diagnosis of diabetes • Visual acuity • The national screening diabetic screening grade category (seven categories from R0M0 to R3M1) • Diabetic eye clinical features • Reason for sight and severe sight impairment • ICD-10 and SNOMED-CT codes pertaining to diabetes • Diagnosis for the acute/emergency admission • Co-morbid conditions • Medications • Outcome