Turning the tide of Type 2 diabetes

Diabetes is the most devastating and fastest growing health crisis of our time, with around 90 per cent of diabetes cases classified as Type 2 diabetes. In this article, Chanelle Corena, Type 2 Diabetes Prevention Lead at Diabetes UK, will set out why tackling the prevention of Type 2 diabetes is so crucial and set out the steps that the charity is taking to transform the health of the nation

The number of people diagnosed with diabetes in this country has more than doubled in the last 20 years to 3.7 million, with further increases predicted. Approximately 12.3 million people, around one in five of the population, are at an increased risk of developing Type 2 diabetes. There are several risk factors for Type 2 diabetes, but the rise in cases is mainly connected to the behaviours that lead to being overweight or obese. And the increased risk is starting earlier and earlier, with one in three children overweight or obese by the time they leave primary school.

Living with Type 2 diabetes impacts both people’s quality and length of life, as well as putting an enormous amount of pressure on our healthcare system. We also know that without proper intervention the health of millions could be affected by the increased risk of developing the complications associated with diabetes. This in turn has placed an incredible financial burden on an already-strained NHS – spending £10 billion a year to treat diabetes.

Despite the number of people affected by diabetes in the UK, our recent survey showed that many people are dramatically underestimating the severity of diabetes, with 75 per cent of the 1,000 asked unaware that sight-loss and amputations were complications of diabetes. In reality, there are more than 160 amputations each week. Alarmingly, even fewer were able to name kidney disease or heart problems as complications. Complications also represent around 80 per cent of the financial burden of diabetes for the NHS.

While there is currently no cure for diabetes, the good news is that three in five cases of Type 2 diabetes can be prevented or delayed with through lifestyle changes such as healthy eating, weight management and becoming more active.

Where someone has already been diagnosed with diabetes, we know that employing these same techniques will make it much easier for that person to manage their diabetes and to keep their blood fats, blood sugar and blood pressure within a healthy range, reducing their risk of diabetes complications.

Type 2 diabetes is a condition that could affect every family in one way or another in the UK, and making sustainable lifestyle choices at a population level could have a lasting and profound impact on the health of the nation.

Diabetes UK’s approach to preventing Type 2 diabetes
The time to respond is now: a rapid increase in diagnoses of Type 2 diabetes (including in children) has resulted in prevention being a key feature in government policy, and a significant focus for the media. We need to find a way to authentically engage with people to raise awareness of the seriousness of diabetes, and to influence organisations to take action. Often it’s assumed that there’s little or nothing to be done, but this isn’t the case, and we need to ensure that Type 2 diabetes prevention remains firmly in the spotlight.

Encouraging people to take action to reduce their risk of developing Type 2 diabetes and creating a society that makes the healthy choice the easy choice are both key parts of how we contribute to tackling the diabetes crisis.

We have already begun this journey. We have already developed resources, commissioned research, built strong partnerships and influenced the government in this area. And, most importantly, we have listened to the people who need support.

Our ambition, in partnership with others, is to reduce the rate of people developing Type 2 diabetes by: supporting people, by raising the awareness of the risk factors to developing Type 2 diabetes, and linking people to services, and helping to create a society where the healthy choice is the easy choice, by advocating for policy change, and working in partnership to deliver quality services.

If we are to achieve what we need to transform the UK’s health, we need learn as much as possible about the key barriers and motivations for those at increased risk of developing Type 2 diabetes. We need to work closely with local community groups, every level of the NHS, and industry to create the right interventions. To change behaviour, we need to acknowledge that it is both about building an individual’s capability, and also about changing their environment.

Raising awareness
Many people are not aware of the risk factors of Type 2 diabetes or their own individual risk of developing it. This is why it’s so important for people across the UK to find out, and understand their risk.

Our Know Your Risk tool, available on the Diabetes UK website, developed with the University of Leicester, helps people to find whether their level of risk is low, increased, moderate or high, and what to do to lower it. The tool, which has been used over 1,000,000 times, considers age, gender, ethnicity and waist measurement so that people can fully understand the environmental and genetic factors that impact their risk. Knowing where they stand, they can then take steps towards reducing their risk by making changes to their lifestyle.

Linking individuals and families to the right services and support
We're working to make sure there is more support for people at high risk of Type 2 diabetes. In England, the NHS Diabetes Prevention Programme – a partnership between NHS England, Public Health England and Diabetes UK – supports thousands to reduce their risk of Type 2 diabetes, leading to a delayed diagnosis or preventing it altogether. The programme provides a combination of healthy eating advice, tips on how to increase physical activity and weight management.

Since 2016 the NHS Diabetes Prevention Programme has been reaching ambitious targets for people in England going on the programme and for the weight loss they achieve.

Helping society make the healthy choice the easy choice
We want to create a society where the healthy choice is the easier choice. We're working across the UK, at the local and national level, for a comprehensive approach to tackling obesity and the rise of Type 2 diabetes.

This includes supporting Public Health England’s programmes to reduce calories and sugar in everyday foods; calling for stricter rules on the marketing of junk food to children: and the introduction of the levy on the sugary drinks industry, commonly known as the sugar tax.

As a steering group member of the Obesity Health Alliance, one of our major recent successes has been the publication of Chapter Two of the governments Childhood Obesity Plan in June. It set a national ambition to halve childhood obesity by 2030 and proposed a range of ambitious measures to help us get there, including consultations on a 9pm watershed for the advertising of unhealthy foods and on banning promotions of unhealthy foods by price (such as BOGOF offers) and location. It also committed to a consultation on mandatory calorie labelling in the out of home sector, as major focus of our Food Upfront Campaign.

Our Food Upfront Campaign was one Diabetes UK’s first campaigns to launch as a result of our Future of Diabetes insight work, where we spoke to over 9,000 people with diabetes. Through this, we heard that people with diabetes wanted more information about the food they eat at home and out and about. Being able to make an informed decision about food choices, while out and about, would clearly not just benefit those living with diabetes, but would help anyone looking to cut their risk of Type 2 diabetes and the health of the whole population.

We were delighted to see the proposed commitment to clear, consistent calorie labelling in restaurants, cafes and takeaways because it sets out a promising route for people looking to have a healthier diet. Research has shown us that having this information available helps consumers make healthier choices, so this could, when implemented full across the country, be an incredibly positive step in the right direction.

We know we should be doing everything we can to stem the tide of Type 2 diabetes and the reality is that we need to effect change from the micro to the macro levels of our society. Small changes can have a huge impact over time. We're supporting people across the UK to find out their risk and take action to reduce it. But this problem is too big to tackle alone, which is why we're working alongside healthcare providers to make it easier for people to make healthy choices every day.