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Health: Diabetes

Volume 709: debated on Thursday 2 April 2009


Tabled by To ask Her Majesty’s Government what is their response to the report in a recent edition of the Journal of Epidemiology and Community Health about the incidence of type 2 diabetes

My Lords, on behalf of my noble friend Lord Harrison and at his request, I beg leave to ask the Question originally standing in his name on the Order Paper.

My Lords, we welcome the Journal of Epidemiology and Community Health report, which raises awareness of the close link between type 2 diabetes and obesity. We know that the number of people developing diabetes continues to increase and that is why we are working with the NHS to help prevent people from developing the condition. Initiatives such as Healthy Weight, Healthy Lives and the vascular checks programme will be key to achieving this.

My Lords, I thank my noble friend for that reply. In the light of these research findings, is she aware that the number of new cases of type 2 diabetes, which, as she said, is strongly linked to obesity, rose by 69 per cent in the six years between 1997 and 2003? It is vital that diabetes is identified early to prevent the onset of complications such as blindness and amputation. Does she agree that a wide range of measures needs to be taken to tackle this threatening time bomb? There are worrying reports that the diabetic specialist services are being cut back. What steps are the Government taking to ensure that these vital services are available to all people with diabetes in order to prevent the appalling complications that can ensue?

My Lords, my noble friend is right: the number of people being diagnosed with diabetes is increasing. Consequently this has led, for example, to increased spending on the drugs being prescribed. We are not aware that there has been any reduction in expenditure or workforce at local level. We are investing heavily in prevention, particularly in the programmes I have already mentioned—Healthy Weight, Healthy Lives and the vascular checks programme—in self-medication and in self-management, and we are encouraging comprehensive services for diabetes at local level. Indeed, the NICE guidelines issued in 2008 recommended a comprehensive programme for people with type 2 diabetes, encouraging lifestyle changes, healthy eating and increased physical activity.

My Lords, are there any specific plans for dealing with diabetes in children, which is a growing problem and one that the health service at the moment sometimes overlooks?

My Lords, managing diabetes in children and young people is different and is significantly more complex than it is for adults. We estimate that there are 20,000 children with type 1 diabetes in England and there may be up to 1,000 children with type 2 diabetes. The close link between diabetes and obesity means that it is vital that we reduce the number of children becoming overweight and obese and we are focusing on that. We recognise that there are particular issues about helping children and young people both to have access to the best quality care and to provide them and their families with the support and training to enable them, over a period of time, to become competent at managing their condition.

My Lords, does the noble Baroness accept that the serious cardiovascular, renal and ocular complications of diabetes, often thought to occur only in type 1 diabetes, occur with equally high incidence in type 2 diabetes? As she said, there is a positive correlation between the increasing incidence of type 2 diabetes on the one hand and the development of obesity on the other. What advice are the Government giving to the public at large about the risks of overeating?

My Lords, I thank the noble Lord. He is, of course, quite correct in his diagnosis. In January 2008 we launched a £372 million cross-government strategy, Healthy Weight, Healthy Lives, which set out our ambition to enable people to achieve and maintain a healthy weight. We launched Change4Life, a national movement that brings together community groups, health professionals, teachers, government departments, supermarkets and the media to help people make positive changes to their diet, levels of activity and lifestyle, leading to better health. Indeed, yesterday the vascular checks programme kicked in as we announced our programme of vascular checks for everyone in England aged between 40 and 74. This has real potential to prevent many cases of diabetes and identify thousands more cases earlier.

My Lords, does the noble Baroness agree that the increase in obesity among the population, which leads to diabetes and to type 2 diabetes in particular, is not so much to do with eating junk food and overeating generally, which human beings have always done given the chance, but to do with lack of exercise? What plans do the Government have to address this problem? In particular, could not this House set an example, perhaps by jogging on the spot during debates or having a morning exercise session after Prayers and before business starts?

My Lords, I shall not comment on the noble Baroness’s suggestion about the amount of exercise that Members get. I agree that it is up to all of us to take responsibility for taking exercise. The noble Baroness is also correct about the link between type 2 diabetes and obesity being clear. It is, indeed, due to lifestyle; not only eating, but exercise. It is also due to such things as an ageing population. Because diabetes is a progressive condition, as you grow older, your risk of diabetes increases, particularly if you are not taking care of yourself and not taking exercise. If people have better access to support and can identify what they need to do to manage their condition and health day to day, we will prevent diabetes and help to keep it under control.

My Lords, following the earlier question about the worrying rise in the number of children with diabetes, what particular strategies and training are being provided in schools to handle that increase and, I hope, contain it?

My Lords, we recognise that, as the noble Earl said, diabetes care for children is very variable. As long ago as October 2005, we set up a working group to discuss that. Its recommendations are being taken forward by the clinical director for children at Diabetes UK, who is working with our educational specialists to make sure that teachers and nurses in schools have the right kind of briefing and know how to deal with young people who are striving to control their condition and lead as normal a life as possible, given their condition.