The Issue Of Diabetes In The UK
Diabetes is a condition affecting 3.9 million people in the UK with 90% of these cases being type 2 diabetes. This is including the many people who are living with the condition but are currently undiagnosed. Type 2 diabetes is caused by problems with the hormone insulin, the body may resist the effects of insulin or the pancreas may not produce enough insulin to control blood glucose levels. The number of people being diagnosed with diabetes each year is rapidly increasing in the UK with an increase of more than 100,000 from 2018 to 2019. At this rate, the number of people with diabetes, including the undiagnosed population, is expected to rise to 5.3 million by 2025. (Diabetes UK, 2020)
A variety of modifiable lifestyle factors increase the chance of developing type 2 diabetes such as a sedentary lifestyle, lack of physical activity, smoking and alcohol consumption. (Wu, Ding, Tanaka and Zhang, 2014) Type 2 diabetes can be caused by having a family history of type 2 diabetes, especially when it is diagnosed at a younger age. (NHS, 2020)
However, the main factor is obesity, it is responsible for 80 to 85% of the cases of type 2 diabetes and three in five cases could be prevented by individuals living a healthier and more active lifestyle. (Diabetes UK, 2020) The increase in the incidence of the condition is being fuelled by the rapidly increasing obesity rates in the United Kingdom. Abdominal fat in particular is known to increase the risks of type 2 diabetes, this is due to the visceral fat-releasing pro-inflammatory chemicals which disrupt the function of insulin causing insulin resistance which is the cause of type 2 diabetes. Reducing body weight can improve the body’s insulin sensitivity and therefore greatly reduce the risk of diabetes. (Diabetes and Obesity, 2020) A diet high in saturated fat and low in fibre has been shown to increase diabetes risk as opposed to a diet high in sugar. (BNF, 2020) In addition to this, people in lower socio-economic groups have an increased risk of type 2 diabetes as deprivation is strongly associated with higher levels of obesity, physical inactivity, smoking and an increased energy intake. (British Nutrition Foundation, 2019) There is also a link between increasing age and higher diabetes prevalence, 9.0% of people aged 45 to 54 are estimated to have diabetes and 23.8% aged 75 years and over. (Public Health England, 2020) However, the number of younger people being diagnosed with the condition is also increasing.
As the number of people with diabetes is increasing, there are many more social and financial consequences developing. Type 2 diabetes is one of the biggest causes of premature illness and death, this is mostly due to the increased risk of cardiovascular disease in people with diabetes. Diabetes, when not managed sufficiently through diet, exercise and medication can cause serious problems such as loss of sight, heart failure, stroke, nerve damage which can lead to amputation and kidney failure. (British Nutrition Foundation, 2019) At the time of diagnosis, half of the people with type 2 diabetes already show early signs of these health conditions and within 20 years of being diagnosed, 60% of people have some degree of retinopathy. (Diabetes Complications, 2020) This highlights the importance of preventative measures in order to tackle the condition.
In addition to these complications, type 2 diabetes can cause mental health problems such as depression and anxiety. Being diagnosed with a long-term condition such as this can be challenging to come to terms with. In addition to this, the development of complications, dealing with new medication and the stress of managing their diabetes daily can impact the emotional wellbeing of individuals. Around 40% of people with diabetes, type 1 and 2, struggle with their mental health, often because of the demands diabetes has on their life. (Peyrot et al., 2005) Also, as the condition is more prevalent in older people, they are more likely to struggle to make changes to their lifestyle and diet as their lifelong habits may be hard to break. Anxiety can be caused by the diagnosis as the greater chance of health problems may affect their ability to work and would cause them to worry about income for themselves and their family.
The large number of people living with this condition is putting an unsustainable strain on the NHS. Prescriptions for both types of diabetes cost NHS England alone more than £1 billion a year. However, it is estimated that the total cost of diabetes to the NHS may be over £10 billion a year when diabetes complications and diagnostic and monitoring devices are considered. (BBC News, 2020)
However, although the diagnosis of type 2 diabetes may be hard to come to terms with and daunting for the individual, it can be managed through diet and medication. In addition, with support, the potential complications of type 2 diabetes can be minimised. It is also possible for some people to put their type 2 diabetes into remission through losing weight with a healthy balanced diet and exercise. The diagnosis may also help people take control of their health and are an opportunity for them to be educated on how to eat a balanced diet and exercise regularly in order to live a healthy life.
Due to the fact that three out of five cases of type 2 diabetes can be prevented, the PHA has developed the Diabetes Prevention Programme which is currently running in Northern Ireland and in other parts of the United Kingdom. It is aimed at people with pre-diabetes, this is when the blood glucose levels are slightly out of the normal range but not in the diabetic range. It is a free nine-month long programme delivered by health coaches. They offer help and assistance to participants for them to change their lifestyle, diet and physical activity with the aim of delaying the onset and reducing the likelihood of complications of type 2 diabetes. (HSC Public Health Agency, 2020) However, this requires people to be proactive about their health and to find out if they are at risk as they must be referred to the programme by a nurse, doctor or pharmacist.
Diabetes UK is working to raise awareness of the condition, they have a free ‘Know Your Risk’ online tool for people to assess their risk of developing type 2 diabetes with information such as ethnicity, BMI and age being collected to inform people of their risk. The charity is also encouraging people living in England aged 40 or over to get a free NHS health check which is available to them every five years. (Diabetes UK, 2020)
Chris Askew, the Chief Executive at Diabetes UK, has also highlighted the importance of actions by the government being ‘supported by industry’ in order for real change to be made. (Diabetes UK, 2020) There has been an example of this recently when the government imposed a sugar tax that caused companies to reformulate their products in order to avoid the excess costs on their products.
In conclusion, the threat to the health of the UK population and the financial burden of the rapidly increasing number of diabetic patients is soon going to be unsustainable for the NHS. In many cases, type 2 diabetes is a preventable condition, in order to tackle this there is a need for widespread age and culturally appropriate educational literature that informs the population of the importance of a healthy active lifestyle. (Diabetes UK, 2019) There has been industry intervention with reducing sugar, salt and fats in foods in many cases. However, people are largely responsible for their own diet and lifestyle, for behavioural change individuals need to be proactive in working to improve this.