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House of Lords Hansard
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Health: Diabetes and Obesity
30 June 2016
Volume 773

Question

Asked by

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To ask Her Majesty’s Government what steps they are taking to ensure that those with diabetes have adequate support to tackle obesity.

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My Lords, it is for healthcare professionals to identify, in consultation with their patients, what support is needed to manage diabetes effectively. This includes people with diabetes accessing programmes to help manage their weight, eat healthily and be more active.

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Can the Minister give us a date for the obesity strategy and, when it appears, can he ensure that in the reformulation advice to the food industry not only sugar but salt and saturated fat will be taken into account? Secondly, following Brexit, can he make a statement or at least write to me about the breakdown in the research being done across the whole of the European Union with our United Kingdom colleagues to defeat obesity and diabetes, as was worried about this morning by the former research director of the European Commission on the “Today” programme?

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My Lords, it is still our intention to announce the obesity strategy soon. Clearly, there have been other events, which may create some delay, but we will announce the strategy as soon as possible. When we do, I am sure that there will be clear recommendations on diet that will include not just sugar but saturated fats and salt. Finally, as the noble Lord knows, I am arranging for him and the noble and learned Lord, Lord Morris, to meet people from the research community to discuss the outlook for research into diabetes, and I am sure that it will include any impact that Brexit might have.

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My Lords, will specialist diabetic nurses be involved in this? They are enormously valuable to patients and provide a very practical way of getting direct help to patients instead of involving consultants on all occasions.

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My noble friend is absolutely right that specialist diabetic nurses have a huge role to play in helping to identify and then manage and treat people with type 1 and type 2 diabetes. I am sure that that role will grow over time.

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My Lords, projections show that, in 20 years, 40% of the UK population may be defined as being obese and one-third as overweight. Is it not therefore important that we introduce restrictions, very shortly or even now, on the marketing of junk food to children?

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My Lords, that issue will be addressed in the obesity strategy, which comes out later this year. The levy that has been announced will, I think, lead to the reformulation of high-sugar fizzy drinks, which is a start in the right direction. It is largely a question of diet, as the noble Lord said, but also exercise and many other factors, which will be in the obesity strategy that comes out later in the year. Clearly, making it more difficult for young people to access junk food will be an important part of that strategy.

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Does the Minister agree that diabetes is a very complex condition and can be very expensive to every country in the world? Does he also agree that many diabetics love sweet things? Will the Government stimulate more health education in schools so that children grow up learning about diabetes?

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That is a very good point, and I hope that it will be covered in the obesity strategy for young people when it comes out later in the year. A key part of our diabetes prevention strategy is to identify more and more people who are at high risk of developing type 2 diabetes and give them a personalised programme to reduce the likelihood of their getting diabetes. We hope that, by 2020, 100,000 people a year will be on that programme.

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Does my noble friend agree that we do not need to wait for the obesity strategy for doctors to recommend which diet, salads and fruits those borderline diabetes patients should be taking? Could not doctors be giving that advice now?

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Of course they should be giving that advice, and indeed they are. There is also clear advice on the Public Health England website as to what is the right diet. Confusing messages have been given over the past couple of months. Therefore, I think it would do no harm to repeat in the obesity strategy what is the right diet.

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My Lords, is the Minister aware of recent emerging research that confirms the view that has been held for some time that if people with type 2 diabetes—and there are 3.5 million of them in this country—reduce their weight by 10% and take modest regular exercise, in a significant number of cases the effects and complications of their diabetes can be put into long-term remission with consequent reductions of pressure on NHS resources and capacity? Despite that, less than 10% of people with diabetes get any such help in reducing their weight and increasing their exercise, and therefore having the option and opportunity of turning off their diabetes. This issue has been raised significantly over the past five years. What urgent steps can the Minister outline, rather than simply relying on local action that is clearly not working?

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The noble Baroness is clearly right that weight reduction can reverse diabetes. My father, for example, has lost weight and his diabetes has, effectively, been put into remission. There is no question that it works. However, it is very difficult to lose weight once you are overweight. The figure is that only one in 210 people with a BMI of over 30 can reduce it to a normal level; hence the emphasis that the Government are putting on explaining this to children and young people before they get fat. That is the critical place to aim. However, I entirely agree that greater access to structured education programmes is very important.

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I fully endorse that reply from the Minister, but will he also ensure that the guidance includes recognition of emerging research that children, if they never become obese, have a different type of fat—brown fat—which maintains a higher metabolic rate and therefore decreases their long-term risk of diabetes? The importance of avoiding obesity in the first place, particularly in children and in women, in pregnancy and post pregnancy, is the only way that we will stop this ever-growing curve of diabetes associated with adult obesity.

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I entirely endorse the words of the noble Baroness, which I am sure will be reiterated in the obesity strategy when it is announced later in the summer.

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My Lords, does the Minister agree with me that far too much attention has been given to sugary drinks, the consumption of which has been in decline for the past 10 years, and not enough attention given to other unhealthy foods that are causing the problems?

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I think that the levy on sugary drinks has been universally welcomed as a start. That the proceeds of the levy will be put into the sport premium in primary schools and lengthening the school day in secondary schools is all for the good. If we are to address obesity, it has be across a very wide front.

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My Lords, with the cuts in education budgets and consequent reduction in the number of nurses in schools, who are able to keep a special eye on diabetic pupils, will the Minister give an instruction that is helpful to education authorities and schools to replace somehow the specialised nursing staff who have done such a great job over the years?

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My Lords, I cannot address the specific issue of the number of nursing staff in schools, but the Government are well aware that encouraging children to eat well and take exercise is a crucial part of any obesity strategy. As I said, our strategy will be revealed later in the year.